The adenoids ( tonsils increase ) - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Respiratory Diseases

adenoids (adenoid vegetations, adenoid razrascheniya) are abnormal growths nasopharyngeal tonsils, which is located deep in the nasopharynx, they are composed of lymphoid tissue.Normally, this amygdala is well developed in childhood, and after twelve years, it begins to decrease, so in adults adenoids are rare.Normally

tonsils are small cluster of lymphoid tissues in the mucosal thickness around the holes that lead into the nasal cavity, mouth or throat.There are paired amygdala, two pipe, two palatine;and unpaired - three lingual and pharyngeal (nasopharyngeal) amygdala.Almonds make up the so-called ring limfoepitelialnogo Pirogov-Valdeera, which is part of the body's immune system - it protects it from external pathogenic influences.So, the main function of the tonsils - protective.They are a barrier against foreign bacteria and viruses inhaled with the air, "catch" them and destroy.

adenoids - these are not the amygdala, which you see on the sides of the throat, looking at the child's mouth.Adenoi

ds without the proper tools, you generally can not see because they are located above the pharynx, approximately opposite the nose almost in the center of the skull.

Location

adenoids Adenoids - frequent disease among children.It is common in the age from 1 to 15 years, but is more common in children 3-7 years.

often confused and adenoids adenoids.Adenoids - inflammatory disease pathologically razraschennoy nasopharyngeal tonsil (adenoids).It occurs both in isolated form or combined with inflammation razraschёnnyh tonsils.Adenoids accompanied by fever and a sharp violation of nasal breathing.

Some of the reasons for the formation of adenoids:

1. A variety of childhood diseases (measles, scarlet fever), which affects the mucous membrane of the nasal cavity and tonsils;
2. Frequent inflammation of the upper respiratory tract;
3. Viral diseases;
4. Immunodeficiency;
5. allergization child.

symptoms by which a child may be suspected adenoids:

• Difficulty breathing and nasal discharge from the nose;
• Frequent runny nose;
• Snoring during sleep;
• Poor sleep;
• the child's mouth often open;
• The appearance of nasal speech and promiscuity.
• Fatigue, lethargy, apathy;
• Headache;
• Hearing loss.The child often asks.

If you do find some, or even one of the symptoms of a child, you should immediately visit the ENT doctor for diagnosis and of adequate treatment.

Complications that may result from the adenoids:

1. Violation of the normal functioning of the middle ear.
When nasopharyngeal tonsil is increased, it closes the mouth of the Eustachian tube.This anatomical education (the Eustachian tube) is used to control the pressure difference between the inside (in the nasal cavity and nasopharynx) and external (atmospheric).Normally at the hearing tube from the air enters the nasal cavity to the middle ear.When the mouth is blocked, hindered ingress of air into the middle ear.As a result, the eardrum become less mobile, and this is reflected at the hearing.In advanced cases, the hearing loss (deafness) can not be cured completely.

2. Inflammatory diseases of the middle ear.If the passage of air into the middle ear is difficult, it creates excellent conditions for the penetration and development there is infection (otitis media).

3. deformities of the facial skeleton and chest, malocclusion.These complications resulting permanent mouth breathing.

4. Violation of lung ventilation, and decreased performance.This leads to a reduction of blood oxygen saturation, resulting in the brain does not dopoluchaet it and this affects the normal operation.Therefore, children who have adenoids often poorly learn, less functional and attentive.

5. The constant presence of a chronic source of infection in the body.Because nasopharyngeal tonsil constantly inflamed, it contains a lot of viruses and bacteria, which has a bad effect on the child's body as a whole.

6. Inflammatory airway disease.Mucus, which is constantly produced in chronically inflamed tonsil drops below and causes pharyngitis (inflammation of the mucous membrane of the pharynx), laryngitis (inflammation of the larynx), tracheitis (inflammation of the trachea) and bronchitis (inflammation of the bronchi).

7. Violation of the gastrointestinal tract.

8. Violation of the blood.

9. enuresis (bedwetting).

10. spasm of the larynx.

11. The attacks of coughing.

Degrees enlarged adenoids:

first degree - adenoids cover the upper part of the opener.In first-degree child may experience discomfort and shortness of breath only when sleeping.

second degree - adenoids close the upper two-thirds of the opener.When second-degree child regularly snores at night and daytime mouth breathing often, because of the difficulty of nasal breathing.

third degree - adenoids close all or almost all of the opener.When third-degree airflow through the nose is blocked completely adenoids, and the child can only breathe through the mouth.

Degrees enlarged adenoids

Adenoides 1 degree photos through the endoscope

Adenoides 3 degrees, a photo through the endoscope

clinical picture (the severity of pathological changes) does not always correspond to the degree ofenlarged adenoids.It so happens that the adenoids first and second degree can cause severe difficulty in nasal breathing, sudden hearing loss, adenoids and third degree does not cause visible irregularities.Therefore, only the size definitely can not say that you need to do - be treated conservatively or radically (remove the adenoids).

Diagnostics adenoids.

Diagnose diseases with the help of key (for scanning, inspection) and other research methods.The latter include:
- pharyngoscope - method of visual examination of the oropharynx.Her
conducted under artificial light, using a spatula, and nasopharyngeal, laryngeal mirror.When pharyngoscope assess the condition of the oropharynx (the color of the mucous membrane, the posterior pharyngeal wall surface) reveal abnormal formation of the Department of the pharynx.You can see the adenoids, to assess their degree of enlargement.

- anterior rhinoscopy - a method of research of the nasal cavity.It is carried out by means of nasal dilator.At the same time inspect and examine the front nasal passages (the presence of swelling, discharge from the nose), its partition.If the drip decongestants, you can see the back wall of the nasal part of the pharynx, adenoids.

nasal dilator

- rear rhinoscopy - method of investigating the rear of the nose.
It can be carried out by means of a nasal mirror, fiberscope.At the back you can see rinoskopii coulter, the rear surface of the soft palate, pharynx arch, choanae, rear sections turbinates.It is informative and harmless, but in children is difficult to conduct.

- X-ray examination.It allows you to diagnose a child's adenoids and establish their degree of sprawl.

- Endoscopy of the nasopharynx.It is a detailed examination of the nasal cavity and nasopharynx, assess their functionality by means of special endoscopes.This informative and harmless method.It allows you to record the results of a study on the photos and videos.

Treatment of adenoids.

There are two ways of treatment - conservative and surgical.

1. Conservative treatment (without surgery) adenoids in children

carried out with the help of drugs and physiotherapy treatments.Conservative methods are usually used at low magnification nasopharyngeal tonsil or with contraindications to their removal.

Conservative treatment should be local and general.In the topical treatment using anti-inflammatory and anti-microbial agents.For topical treatment (instillation into the nose) used vasoconstrictive drops.Drops are used for five to seven days.The nose buried naftizina 0.05% solution or 1-2% ephedrine solution galazolin, Sanorin and others. Then use a nasal lavage.

nasal lavage appointed against adenoids, all types of rhinitis, as well as for the prevention of upper respiratory tract diseases and their complications.However, most solutions for the treatment of rhinitis in the form of finished nose sprays imply irrigation procedure, rather than directly lavage.Unlike Irrigation washing may reduce a thick consistency nasal secretions, but does not solve the problem with their removal along with harmful bacteria.After irrigation mucous dries quickly, which further aggravates the cold, provokes edema.
Washing helps to reduce the inflammation of the nasal mucosa improve performance and reduce the risk of sinusitis and sinusitis.Modern technique involves rinsing the nasal passages with special antiseptic.For example, the components of the preparation "Dolphin" get to the sinuses, diluting mucus clots and naturally taking them out.

Along with the local impact of use and overall treatment.Common effects include bracing means (vitamins with trace elements, immunostimulants (Echinacea tincture)), antihistamines (Phencarolum, suprastin).

To improve the effectiveness of conservative treatment is additionally used physiotherapy methods:

1. UFO.It can be used endonasal (inside the nose) to 10 procedures.
2. Helium - neon laser.Also endonasal up to 10 times.
3. Electrophoresis with a solution of potassium iodide, diphenhydramine - endonasal.
4. UHF on the nose to 10 procedures.

Climatotherapy often gives positive results on the state of the child.Especially the good resorts of Crimea and the Black Sea coast.

final decision on the choice of treatment method takes a physician based on the state of child

2. Surgical treatment of adenoids (adenotomy).

This operation should be carried out as soon as possible from the moment of detection and diagnosis of adenoids setting, but only when indicated.This is the most effective treatment.Because adenoids - is an anatomical education, and it is not going anywhere, and no medicines capable of it sucked.

Surgery is indicated in:

- the failure of conservative treatment of adenoids;
- persistent difficulty breathing through the nose, which leads to constant colds and infectious diseases of the child (tonsillitis, pneumonia, chronic tonsillitis);
- frequent otitis;
- the appearance of complications in the sinuses (sinusitis);
- snoring and breath holding during sleep.

Some contraindications for surgery:

1. Blood Diseases
2. The acute period of infectious and skin diseases or recent myocardial diseases.

adentomiyu most common operation is carried out before the age of three years, from five to six years, from 9 to 10 years and after 14 years.The choice of this age for surgery is associated with periods of a child's body growth.

Before the operation, you need to sanitize the mouth and heal inflamed adenoids.If this is not done, the surgeon may not be able to remove the entire focus of infection and postoperative complications may be different.

Surgical removal of the adenoids (adenotomy) can be performed on an outpatient basis (in the clinic) or in a hospital under local anesthesia or under general anesthesia.There are the usual methods of removing and using modern medical equipment (endoscopes).Under local anesthesia, surgery is performed quickly and painlessly.Under general anesthesia, surgery do with increased excitability of the child or when the adenoids are located near the mouths of the auditory tubes in the nasopharynx.

Operation short time, lasts 15-20 minutes, "cutting" overgrown tissue takes only 2-3 minutes.Adenotomy Beckmann (knife in the shape of a ring) is captured by adenoid tissue and cut in one motion (normal procedure).

adenotomy Beckman

During the operation the child is sitting, his head thrown back slightly.The nostrils of the nose shut up wool.The head holds Assistant (nurse), gently pressing the top, it was impossible to climb.

Stages of the operation:

1. anesthesia.First, anesthetize the nasal cavity, focusing on the rear end of the opener, and then - back wall of the nasopharynx and nasopharyngeal surface of the soft palate.Sometimes it is possible to do without anesthesia.
2. Language crush spatula for a better view.
3. adenotome held his right hand, like a stick, and is introduced into the throat of the soft palate.
4. An annular knife is pulled forward until it touches the opener and moves up to the failure.
5. adenotomy sudden movement backward, and is cut down while turning the adenoid tissue, and then the knife is expelled.

Stages of adenotomy

After removal of the adenoids of the nose take out the fleece.Operated need to blow your nose and then breathe in through the nose, mouth closed while.Usually, bleeding is observed that quickly stops.Spend a few repetitive inspections for a couple of hours.If there are no complications, the bleeding has stopped, it is usually allowed to go home (this is the case, if the operation is performed under local anesthesia).

On the first day after the operation the child at home shows a strict bed rest.It is necessary to exclude the exercise (at least for two weeks), hot and rough food.It is necessary to limit exposure to the sun, should not be washed in hot water and steam.It is useful to conduct breathing exercises, which must consult an ENT doctor.Further gradual transition to normal life.

Endoscopic adenoidectomy

addition to the usual method of removing the adenoids there is a more modern operation - endoscopic adenoidectomy.This operation is carried out with the help of special equipment (endoscope).With it, there is penetration into the nasopharynx, which can not only consider the size and condition of the adenoid tissue of the child, to make a photo of this tissue and remove it.

Endoscopic adenoidectomy

effect of the surgery is usually good in most cases, nasal breathing is restored immediately after the operation, the child becomes mobile, it begins to develop better.Unfortunately, relapses, adenoids can grow back again.In such cases a second operation is needed.

to relapse may lead:

1. Incomplete removal of the adenoids (even if by a millimeter of tissue, it can grow again).When using an endoscope this usually does not happen ;
2. Early age of operation (up to three years).But if there are absolute indications for surgery, it is carried out at any age;
3. The tendency of the child to an allergy;
4. Specific features of rapid proliferation of adenoid tissue in the child.

re-operation is necessary not to be afraid, because its implementation will take about five minutes, and bring relief to the child.If a second operation is needed, and it does not hold, then the child will be complications, which have been described above.