Almost 25% of children and their parents hear in the otolaryngologist’s office that the baby has enlarged adenoids. These formations are combined with the nasopharyngeal mucosa. In a healthy child, they actively function. It is the adenoids that are the first to encounter various toxins, bacteria, allergens, microbes and trigger a protective mechanism.
Classification of problems
Experts call adenoid inflammation adenoiditis. But even in the absence of an active pathological process, they can be increased. The doctor may say that
adenoids are 2-3 degrees in children. In this case, this nasopharyngeal tonsil can be harmful.
Otolaryngologists during examination can say that the child has adenoids:
- 1 degree, provided that they cover no more than 1/3 of the nasopharynx, only the upper section of the opener (the plate that forms the back of the nasal septum) is covered;
- 2 degrees, as a rule, the resulting swelling closes half of the nasopharynx, 2/3 of the openers overlap;
- 3 degrees, almost the entire nasopharynx is blocked.
With their increase, associated problems also develop. So, grade 3 adenoids in children cause difficulty breathing, hearing is noticeably impaired. With stage 2 hypertrophy, snoring appears in a dream, frequent coughing. Nasal breathing is noticeably impaired. With grade 3 adenoids, air enters the lungs only through the mouth.
Signs of the disease
Suspect that the child has enlarged
palatine tonsils, and parents can. Most often, this problem occurs in children aged 3-7 years. But it can also bother teenagers. They testify that 2-3-degree adenoids have developed in children, the following symptoms:
- difficulty in nasal breathing, the child breathes mainly through the mouth;
- prolonged recurring runny nose;
- worse sleep, snoring is heard;
- the appearance of nasal;
- illegible speech;
- hearing loss;
- apathy, fatigue, lethargy;
- complaints of a headache.
Having noticed one or more symptoms, it is advisable to show the child to ENT. This doctor can establish an accurate diagnosis and, if necessary, prescribe treatment.
Diagnosis of the disease
A routine visual inspection is not enough to understand that grade 3 adenoids in children. But most otolaryngologists do not have the equipment to establish an accurate diagnosis. They can use only the finger method. But it is considered uninformative. In ordinary clinics, as a rule, it is recommended to do radiography. Using this method, you can visualize an increase in these tonsils, but determine if the inflammatory process does not work out.
One of the diagnostic methods is pharyngoscopy. This is an examination of the oropharynx with a spatula and a special laryngeal mirror. Such a study allows us to assess the state of the nasopharynx and identify 2-3 degree adenoids in children. Treatment can be prescribed after such an examination.
Anterior rhinoscopy may also be performed. A special nasal dilator is needed for it. During the procedure, you can assess the condition of the nasal passages, septum. If vasoconstrictor drugs are instilled before the study, then you can see the back of the nasopharynx and adenoids.
Rear rhinoscopy, which is carried out using a fiberscope and a nasal mirror, is practically not done to children. Although this method is considered harmless and informative.
Modern survey methods
An accurate diagnosis and determination of the degree of enlargement of the nasopharyngeal tonsil can be made using computed tomography. This is a fairly expensive survey method, but it is informative. True, they use it extremely rarely.
The most progressive method is considered to be an endoscopic examination. It is this diagnostic method that confirms that grade 3 adenoids in children. Photos of problem areas in this study are not at all difficult to do.
To carry it out, a small tube is inserted into the nasal cavity, at the end of which a video camera is located. With its help, you can not only determine the size of the adenoids, but also clarify their location. Also, the doctor can see if there is inflammation and check whether this process extends to the auditory tubes.
The purpose of the adenoids
Many parents mistakenly believe that nasopharyngeal tonsils are an absolutely useless formation that is better to remove. But they are not quite right. Of course, if the diagnosis is "grade 3 adenoids" in children, the doctor will recommend removing them. But in some cases, you can try to get rid of the problem by conservative methods.
Often adenoids begin to grow amid persistent infectious diseases. They are part of local immunity. The nasopharyngeal tonsil is a kind of barrier that can cope with viruses even before they enter the body. In this gland, local cellular immunity develops. It is a natural barrier to pathogens.
Adenoids themselves are an important part of the immune system. If there is an opportunity to restore their work and relieve the inflammatory process, then it should be used.
Failures in local immunity
Of course, excessively increased grade 3 adenoids in children can no longer fulfill their purpose. The outflow of lymph is disturbed, the glandular tissues grow, and the inflammatory process practically does not subside.
In this case, adenoids can no longer be a barrier to bacteria. Mucus in the nasal cavity begins to linger due to disturbances in the mucociliary apparatus. But it is with her that a significant part of the trapped microorganisms, dust particles, and potential allergens is excreted.
Grade 3 adenoids in a child contribute to the fact that pathological microorganisms are retained in the nasopharynx. At the same time, local immunity is already suppressed by a constant inflammatory process. This is the main reason that the likelihood of developing the disease increases. As a result, a vicious circle is formed: due to the enlarged nasopharyngeal tonsil, diseases become more frequent, and due to diseases, adenoids grow even more.
Ways to solve problems
As a rule, the majority of otolaryngologists recommend removing grade 3 adenoids in children. But choosing this path, we must remember that they tend to grow. Of course, this is not happening at all. But there are patients who have a problem after six months or a year returns again.
Sometimes the nasopharyngeal tonsil is enlarged due to poor heredity. The tendency to overgrowth of this gland is transmitted at the gene level. Some babies are born with a weak Valdeyer ring. It includes lingual, tube tonsils, as well as tonsils and adenoids.
Some doctors find that surgery is optional. They offer their options for how to cure grade 3 adenoids in a child. As a rule, complex therapy is needed, aimed at suppressing inflammation and reducing edema.
The proliferation of nasopharyngeal tonsils is an exclusively childhood problem. In most adults, this organ atrophies. After all, starting from the age of 12, adenoids begin to decrease.
Conservative therapy
Before recommending the removal of grade 3 adenoids in children, qualified doctors will offer parents a set of measures aimed at relieving edema and reducing inflammation. In some cases, they help to cope with the problem without surgery.
The doctor prescribes vasoconstrictive drops, which must be used for 5-7 days. “Naphthyzin”, “Ephedrine”, “Sanorin”, “Galazolin” and other children's options are suitable. After instillation, rinse the nasal cavity. This can be done with the help of special antiseptic solutions, for example, means "Furacilin" or "Dolphin". Do not confuse flushing with irrigation.
Simultaneously with instillation and washing prescribe a general treatment. It should be aimed at strengthening immunity. Prescribing general strengthening agents, vitamins, immunostimulants and antihistamines. Antiallergic medicines should be taken if grade 3 adenoids are diagnosed in children. This treatment is necessary due to the fact that allergy is one of the main reasons for the onset of pathological changes in these tonsils.
Good results are also given by physiotherapy. Quartzization of the nasopharynx cavity, helium-neon laser therapy, UHF and electrophoresis with a solution of diphenhydramine, potassium iodide are considered effective.
Surgery
Many doctors, having seen grade 3 adenoids in a child of 3 years old, send him immediately for surgery. But it is indicated in case of unsuccessful attempts at conservative treatment. These tonsils are also removed in cases where:
- breathing through the nose is difficult or almost impossible;
- the child has constant colds or infectious diseases, including tonsillitis, tonsillitis, pneumonia, otitis media;
- complications develop in the paranasal sinuses (known as sinusitis);
- There is the appearance of snoring and breath holding during sleep.
Before surgery, it is necessary to calm the inflammatory process, otherwise it will not be possible to remove the entire focus of the spread of infection.
Removal process
Surgical treatment can be performed on an outpatient basis (in a regular clinic) or in a hospital hospital. The operation is done under local or general anesthesia. It lasts no more than 20 minutes, and the process of cutting off overgrown tissue takes up to 3 minutes. An operation is performed using Beckman adenotome. This is a special knife, made in the form of a ring, which captures the overgrown tissue of the nasopharyngeal tonsil. It is cut off in one motion.
During the operation, the child should sit with his head back. It is held by a nurse, pressing lightly from above so that the patient does not have the opportunity to rise. At the same time, the nostrils are closed with cotton.
Beckman Adenot is inserted into the throat. It is advanced up to the stop and the fabric is cut off with a sharp movement back and down. After this, the cotton wool covering the nasal passages is removed. After removal, the patient should blow his nose and breathe through his nose with his mouth closed.
But this is not the only option for how to cure grade 3 adenoids in a child. A more modern method is endoscopic removal. Such an operation is performed under visual control, the doctor may well consider the location of the adenoids and completely remove them.
Folk methods
In addition to conservative and surgical treatment, there are alternative methods of therapy. Many parents drip into the nasal passages a mixture of 2 parts of beetroot juice and 1 part of honey. For 2-3 weeks, it is necessary to instill 5 drops several times a day.
You can also use aloe juice. But such treatment should last several months. It is enough to instill 2-3 drops three times a day. Many recommend gargling with an infusion of eucalyptus leaves. This must be done 3 times a day for six months.
There are other folk methods designed to reduce the swollen glandular tissue of the tonsils. You can drip sea buckthorn, eucalyptus oil or infusion made from birch leaves.