Treatment of adenoids in children – remove ornot?

Update: December 2018

Tonsils are natural defenders in the body that
are part of the immune system and are made up of lymphoid tissue, they
recognize infections and viruses and actively fight pathogens
microorganisms when they enter the nasopharynx. All such
tonsils in person 8 and one of them will be discussed in this article –
This nasopharyngeal tonsil or adenoids, more precisely, we consider
methods of treatment of adenoids in children.

At the age of 7 years, adenoids in children can physiologically
increase significantly, this is due to their increased
activity, since during this period the formation of
immune system. And after 7 years, this protective function goes to
nasopharyngeal mucosa receptors. And parents when they appear
The following symptoms of adenoids in a child are experiencing serious
stress, constant experiences, long time engaged
treatment of the baby, since the child has a considerably broken nasal
breathing and serious health problems arise:

  • The child can not breathe through the nose at night, and at 2-3 degrees
    an increase in adenoids and in the daytime.
  • In the dream, the child sniffles, snores and in severe cases it is possible
    appearance of obstructive apnea – when stops appear,
    breath hold.
  • The child’s speech becomes not legible, the voice is nasal.
  • At the child hearing can decrease, otitis often recur,
    sinusitis.
  • Children with adenoids often and more seriously ill
    colds, viral diseases, they are more likely to have bronchitis,
    pneumonia, tonsillitis, sinusitis.

Diagnosis of adenoids in a child

To see the adenoids in a child, just when you open the mouth is impossible,
for this there are special diagnostic methods – inspection with
using a mirror, x-ray, finger examining and endoscopy
nasopharynx.

  • The study by the finger method today is not
    applied as it is painful and uninformative
    inspection.
  • X-rays are more accurate in determining the size of adenoids, but also
    not informative enough in terms of the presence of the inflammatory process
    in the nasopharyngeal tonsil, besides even a lump sum
    X-ray examination carries a radiation load on the fragile
    child’s body.
  • The safest, most painless and most informative
    modern method for the diagnosis of adenoid proliferation is
    endoscopy – while the doctor and parents can see the whole picture on
    monitor screen. The only condition for such
    examination, is the lack of recurrence of inflammation of the adenoids,
    it should be performed only if the child has not been ill for a long time, otherwise
    the clinical picture will be false. This may entail
    vain experiences and possible referral to surgery when
    this can be avoided.

Myths about adenoids

  • Миф 1  — После удаления аденоидов у ребенка снижается
    immunity – yes, it decreases, but only after the operation and during
    2-3 months after adenotomy, it recovers, since after
    removal of nasopharyngeal tonsil protective functions impose upon themselves
    tonsils rings Valdeyer Pirogov.
  • Myth 2 – If the tonsils are enlarged, then the child is often sick
    viral and infectious diseases due to their increase.
    Just the opposite, from the fact that a child has internal and
    external reasons, there is frequent ARVI, each time the baby
    lymphoid tissue increases all the more.
  • Myth 3 – Removal of adenoids at an early age leads to their
    secondary sprawl. Re-adenoid enlargement rather
    depends not on the age of the children, but on the quality of the operation, 20 years ago,
    when operations were performed almost blindly, particles
    lymphoid tissue in 50% of cases remained not removed, which
    increased the likelihood of their further growth. Modern
    endoscopic surgery helps the doctor to see the entire clinical
    the pattern and secondary growth of the adenoids is now occurring significantly
    less often, in about 7-10% of cases.
  • Myth 4 – Adults do not suffer from enlarged adenoids. There are
    cases that adenoids do not decrease with age in adults
    similar operations are also carried out.

Как лечить аденоиды у ребенка — удалять или not?

Today adenotomy in pediatric ENT practice is
the most common surgery. Indication of compulsory
the removal of adenoids are the following symptoms and concomitant
diseases:Аденоиды

  • If a child has a serious violation of breathing through the nose,
    apnea syndrome appears in a dream, i.e. breath holding
    is 10 seconds or more, it is dangerous the occurrence of a constant
    hypoxia of the brain and leads to a lack of supply
    oxygenated all organs and tissues of the growing organism.
  • If a child develops exudative otitis, when
    mucus accumulates in the cavity of the middle ear and hearing is decreased in
    baby
  • In malignant transformations of the nasopharyngeal tonsil.
  • If overgrown adenoids lead to maxillofacial
    anomalies.
  • If conservative treatment for at least a year does not
    tangible effect and adenoiditis is repeated more than 4 times a year.

Adenotomy is contraindicated in the following
cases:

  • Availability an infectious disease or flu epidemic, only
    2 months after recovery possible
    operations.
  • Blood diseases.
  • Serious cardiovascular diseases.
  • Removal of adenoids is contraindicated in children with asthma.
    and with serious allergies, because the operation
    exacerbates the disease and worsens the condition of the child, the treatment of adenoids with
    such pathologies are carried out only by conservative methods.

If after examination it turns out that adenoids in a child
enlarged and he suffers a lot from this, sleeps badly, breathes in
mostly mouth, which prevents normally eat, sleep, of course it is
requires treatment. In each clinical case, the method of therapy –
conservative or surgical, is solved individually:

  • The choice of treatment method

When choosing – surgery or drug treatment can not
rely only on the degree of adenoid enlargement. At 1-2 degrees
adenoids many consider that their removal is not advisable, and at 3
degree just need adenotomy. This is not entirely true, all
depends on the quality of diagnosis, there are often cases
false diagnostics when the examination is performed on the background of the disease or
after a recent illness, the child is diagnosed with grade 3 and
recommend adenoids remove. A month later, adenoids significantly
decrease as they were increased due to the inflammatory process,
at the same time, the baby breathes normally and does not get sick too often. And there are
cases, on the contrary, with grade 1-2 adenoids, the child suffers from
persistent acute respiratory viral infections, recurrent otitis media, in a dream occurs syndrome
апноэ —  даже 1-2 степень может быть показанием к удалению
adenoids.

  • The child is often sick

If the child lives in the city, goes to the kindergarten and often
sick 6-8 times a year – this is normal, and if he is diagnosed
1-2 degree adenoids, but at the same time it breathes normally during the day and at night
иногда дышит ртом, это не является 100% показанием к operations.
It should be regularly diagnosed, preventive procedures
and complex conservative treatment.

  • Do not rush the operation

If your doctor insists on prompt removal
adenoids – take your time, this is not an emergency operation when there is no
time for reflection and additional monitoring and diagnostics.
Wait, follow the baby, listen to the opinions of others
otolaryngologists, make a diagnosis after a few months and
try all medical methods. Here if conservative
the treatment does not give a tangible effect, and the child in the nasopharynx
permanent chronic inflammatory process then for
Consultations should be directed to operating physicians, those who
makes an adenotomy.

  • The dangers of not removing the adenoids

It should be remembered that adenoids are not removed because a baby often
sick, but because overgrown adenoids do not allow to breathe
nose, lead to complications – otitis, sinusitis, antritis.

  • Treat or delete?

If there is a recurrence of adenoids after surgery, this is
an obvious sign that the removal was not advisable,
since one should not operate, but eliminate a pronounced
иммунодефицит у baby Many doctors contradict themselves
arguing that recurrent adenoids should be treated conservatively,
then why remove non-recurring adenoids that are even easier
treat than recurrent. Therefore, deciding whether to
whether a child should remove adenoids, you should think carefully, any
surgery in the child’s body has negative
consequences and not always justified.

Conservative treatment

In addition to the otolaryngologist, a child with adenoids should be examined.
and an immunologist, and an allergist, and a TB doctor, and an infectious diseases specialist.
Consultation and diagnosis with these doctors will help determine
the true cause of the growth of adenoids and their inflammation, which may
direct to the correct path of therapy. Conservative
drug treatment includes a variety of different procedures and
use of various drugs:

  • Balneotherapy – very effective in treating children with adenoids in
    Sanatoriums of the Caucasus and Crimea
  • Physiotherapy – laser therapy, UV, electrophoresis, UHF
  • Homeopathy is the safest and in most cases quite
    эффективный на сегодняшний день метод лечения adenoids.
  • Washing the nose and nasopharynx with various solutions
  • Use of local antibiotics
  • The use of topical glucocorticosteroids topically as
    sprays

Therapy of this disease is long, painstaking, requires
parents of patience, perseverance and skill. Moreover, the mother should
carefully observe what helps the child, what is not, what
causes allergies or worsens the condition. Selection of methods and
medicines for treatment should be individualized
helps one child, may not help another. The only thing that
helps everyone is an operation, but you should try all possible
methods of conservative treatment and, if possible, to avoid any
surgical intervention.

Washing the nasopharynx in a child can be done with
Dolphin devices. Sometimes even a few nasal washings.
able to significantly improve condition of the child. As
solutions for washing can be used pharmacy sea salt
no additives, 2 teaspoons of salt should be dissolved in a glass
warm water, strain and use the Dolphin device. Also
you can make a similar composition of sea water from salt – 1 h.
a spoonful of salt, 1 tsp of soda and 2 drops of iodine, also per cup
water.

You can use ready-made pharmaceutical solutions of sea salt in the form of
Spreev – Aquamaris, Quicks, Aqualor, Gudvada, Dolphin, Atrivin-More,
Marimer, Dr. Tayse Allergol, Physiomer.

For washing it is very good to use decoctions of medicinal herbs,
if the child is not allergic to them – it is sage, chamomile, St. John’s wort,
eucalyptus leaf, calendula. In addition to mechanical cleansing such
solutions have anti-inflammatory effects.

You can use propolis for washing the nasopharynx – 20
drops of propolis alcohol solution dissolved in 1/4 tsp of soda
в стакане теплой water.

Pharmaceutical drug Protorgol also used in adenoids, but
its use helps only after thorough washing.
mucus, otherwise the effect will be insignificant.

Otolaryngologists sometimes recommend using both Protorgol and
thuja oil with adenoids, and Argolife. Bury one week
Protorgol and Tui oil, the second week of Argolife and Tui oil and so
alternate for 6 weeks. Before digging
washing the spout, then instilling 2 drops in each nostril 2-3
times a day.

Often, complex therapy includes immunomodulatory
drugs, local – such as Imudon, IRS-19 or general action –
Ribomunil, Dimephosphone. These funds should be assigned and be under
control by the attending physician.

For local treatment, sprays are also used – Propolis spray,
Ingalipt spray, as well as Chlorophyllipt.

Homeopathic treatment

In addition to washing and using oil of thuja, Protrohol and
Argolife is very effective homeopathic treatment with
German remedy Lymphomyozot – this complex drug
обладает выраженным лимфодренажным, противоаллергическим,
detoxifying action. Take it inside 3 times a day
5-10 drops in 2 weeks, such courses can be periodically
to repeat. As with any homeopathic treatment, it may first
be a slight aggravation, in this case, as well as if
any side effects should stop taking and contact
to the doctor.

In addition to these drops, you can use homeopathic granules.
Job-baby. It is also a complex drug, with
the use of which many children dissolve even the most
advanced stages of adenoids, reduced inflammation
adenoiditis, decreases nervous irritability in children with adenoids.
Contraindications to their use are acute inflammatory
processes in the nasopharynx – sinusitis, sinusitis.

Treatment should be long-term, homeopathic therapy.
characterized by the fact that only in the case of long continuous
medication is achieved effect. For full recovery
sometimes it takes a whole year if aggravation occurs
symptoms at the beginning of the application of Job-baby, it is recommended to interrupt it
reception for 2 weeks, then start over again if adverse
reactions will repeat again, the scheme should be changed – to accept
less often, for example, 2 days to take, 5 days break. During the period
no vaccinations can be given. If a child occurs
such a primary deterioration, doctors homeopaths consider it a good
sign, then the body is rebuilt for recovery.

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