Remove adenoids or not child

Update: January 2019

When a child sniffles, breathes badly, snores and often gets sick
runny nose, you can hear that blame the adenoids. What is it
is it? How to live with it and whether to actively fight?

Adenoids in children: where is it?

A person has 6 accumulations of lymphoid tissue that serve
the barrier between environmental and respiratory infections.
They are called tonsils. Among them there is a unpaired education
nasopharyngeal vault – nasopharyngeal tonsil, pathological
changes which are called adenoids. By this concept
two states are hidden:

  • adenoid vegetation – nasopharyngeal growths
    tonsils.
  • adenoiditis – its bacterial or viral inflammation
    of nature.

In babies whose immunity only trains, nasopharyngeal
the amygdala is well developed. Adenoids at age 10 usually begin
decrease, and in adults this education is generally capable
atrophy.

Increase and growth of the amygdala contribute to frequent colds and
childhood infections: measles, rubella. By themselves magnified
tonsils are not causes of colds, but make them more
protracted and may contribute to the development of complications from
respiratory organs.

How to distinguish inflammation from growths

Symptoms of adenoiditis occur during ARVI. Usually this –
violation of nasal breathing, mucous discharge from the nose.
Chronic forms of adenoiditis can be with purulent secretions,
caused by persistent bacterial agents (more than half
cases – Staphylococcus aureus) and on the blade are similar to
hypertrophy. Rarely, with frequent use of antibiotics,
there are also fungal lesions. The course of inflammation worsens
allergy, especially to dust mites.

Symptoms of hypertrophy of the nasopharyngeal tonsil do not depend on
inflammation in the nasopharynx. In this child:

  • stubbornly does not breathe nose
  • snores during the day, snores at night,
  • often wakes up due to lack of air,
  • says “nose”
  • he often has inflammation of the paranasal sinuses (in babies this
    usually ethmoiditis),
  • more often than other children, is ill with otitis and has violations
    hearing

How to share the growth

Since the size of the nasopharyngeal tonsil is
relative, hypertrophy is divided by degrees depending on
Relationships with the posterior nasal opening (Choana) and disturbances
breathing.

  • The first degree can be considered the upper limit of the norm. With her
    the amygdala is no more than a third of the choanas, and nose breathing is normal.
  • Adenoids 2 degrees – in half choanas.
  • Third – in 2/3
  • The fourth – the entire diameter of the lumen of the nasal passage.

Grade 3 adenoids, like 4, make the child breathe all the time
mouth

What to do

A child with such signs should immediately show the ENT.
Than to suffer, whether there are adenoids, to delete or not, it is more reasonable to entrust
The solution to this issue is a professional.

Today, experienced pediatric otolaryngologists recommend practicing
tonsils without operations to treat their inflammation, and in the case of
hypertrophy wait for puberty and self reverse development
lymphoid tissue.

Treatment is usually carried out by washing the nose and nasopharynx with saline,
Dolphin, Aquamaris, Humer, Nosol. Washed nose 2-3 times
daily. After washing the nose is thoroughly blown out.

Use drops on the basis of silver: Protorgol, Siolor. Than
the smaller the child, the less shown to him is washing in order to avoid
inflammation of the middle ear.

With purulent adenoiditis, drops are used with Isofra antibiotics,
Polydex. If necessary, prescribe antibiotics in pills,
giving preference to penicillins (amoxicillin).

Add drops with hormones: Nasonex (mometasone furoate) (in
children not younger than 2-3 years). fluticasone furoate.

With persistent violations of nasal breathing, laser and
cryotherapy.

Deletion

Surgical removal of the amygdala is indicated at 3–4 degrees
hypertrophy when nasal breathing is almost gone. It is fraught with
frequent inflammations of the ears, deformations of the facial skull,
the formation of the wrong bite, speech problems.

Absolute indications for tonsil removal:

  • episodes of nocturnal breathing (apnea),
  • chronic suppurative otitis media

in combination with grade 3-4 hypertrophy.

The question may be left to the discretion of the attending physician if
1-2 courses of drug treatment of purulent left without effect
adenoiditis or have neurological symptoms: hearing loss,
urinary incontinence, convulsive seizures.

The most careful selection for the operation are children with allergies,
since for them the removal of the tonsils may increase the risk of developing
инфекционнозависимой  бронхиальной астмы.

Many are interested in “are adenoids removed under general anesthesia or not?” 
Since the doctor needs to carefully determine the amount of tissue to be removed and
see the operative field, then general anesthesia is required. it
allows you not to inflict psychological trauma on the child, but to the surgeon
preserve some of the fabric needed for immune protection
nasopharynx.  The operation can be carried out as an adenotome, and
laser, radio wave or deep freeze
tissues.

Prevention

  1. Full nutrition.
  2. Daily walks, hardening.
  3. Adequate toilet nasal and oral cavity (rinsing the nose,
    teeth cleaning).
  4. Limiting contact with patients with SARS.

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