The reason that parents practically do not face the problem of acute adenoiditis until the child is three years old is not due to the selectivity of the pathology's age preferences. A certain milestone is at the junction of two periods - the home, when the child is protected from infections by practical isolation from pathogens, and social. The second of these stages of a child’s life involves being in the midst of peers. As a result, the potential dangers of infection become greater, and the load on the baby’s body increases many times.
Tonsils and adenoids
The transition to social life in a child begins, as a rule, abruptly, against the background of a weakened immune system. Faced with a huge number of unfamiliar irritants of a bacterial nature, a child’s natural defense not accustomed to such an onslaught begins to suffer.
The amygdala is located in the nasopharyngeal system of a small person, which performs a barrier function between the external microbial environment and the fragile child's body. The capabilities of the protective organ are not unlimited, and when the load on the tonsil increases under the influence of provoking factors, it begins to grow rapidly, forming into adenoids.
By the beginning of puberty, adenoids atrophy by themselves, and it is extremely rare to find them in an adult. But while their functionality is at the peak of activity, any strong provocation can lead to inflammation and the formation of acute adenoiditis.
At this stage, detecting and stopping the process is the first task of parents and medical workers. Lost time with an acquiescent attitude to the child’s health leads to irreversible pathologies in the formation of the facial part of the skull, chronic rhinitis, tonsillitis, inhibition of general development and other disorders.
Forms and degrees of adenoiditis
Classification of adenoiditis involves the separation of the disease according to the form of the course, type of lesion and severity of the condition:
- Acute adenoiditis The temperature during a long course rises to 38 degrees, while all segments of the lymphatic ring fall into the area of ​​inflammation. The acute form is observed after a child is diagnosed with SARS and other infectious or bacteriological infections. In the presence of congenital tonsil pathologies, adenoiditis in subacute form can be fixed in infants.
- Chronic adenoiditis is noted for an increased duration of six months. Symptoms can be significantly erased by multiple signs of concomitant ENT diseases, since this type of adenoid inflammation covers all parts of the respiratory tract and adjacent organs.
Further, on the scale of the complexity of the disease and the volume of lesions of the tonsils of the nasopharynx, the level of the pathological condition is assessed:
- I degree - an inflamed tonsil obstructs the third part of the nasal septum and respiratory tract.
- II degree - the second part of the septum bone is blocked by an adenoid.
- III degree - one third of the septum remains free from an inflamed organ.
- IV degree - means the complete impossibility of breathing through the nose due to the extensive inflammation of the nasal septum.
Symptoms
Acute adenoiditis in children is expressed by such obvious signs that it is impossible not to notice the process at the very initial stage. Even before the enlarged lymph nodes under the lower jaw begin to replace and begin to respond with pain to touch, the child’s breathing in a dream will be interrupted by snoring, and nose discharge will change the texture and color to a thick, unpleasantly smelling mucus.
Other symptoms will be:
- temperature jumps, or a steady increase to 38 degrees;
- the child begins to utter sounds with a "gundos" voice, "googling";
- deterioration in the hearing of the child is noted - he interrogates several times and perceives worse what he heard;
- in the morning, the baby coughs without sputum;
- a child who can clearly explain his condition may complain that a lump is constantly felt in his throat, sometimes this sensation is accompanied by pain.
The so-called "adenoid face" appears in the child due to the extreme neglect of all previous signs by the parents. Such children are always noticeable with a special, as if senseless or surprised expression on their face, in which the mouth is always parted and a swollen tubercle is formed between the upper raised lip and nose. With increased salivation, the chin of such children is always wet from the salivary fluid.
Over time, if measures are not taken in this case, the configuration of the cranium also changes. The lungs and bone structure of the chest are affected by improper breathing.
Causes of the disease
The disease does not occur from scratch, this is always preceded by inflammation of the nasopharyngeal tonsil. The causative agents of the process are pathogenic fungi or agents of viral infections, such as bacteria Staphylococcus aureus and streptococcus. The degree of predisposition of the child to a response to damage by microorganisms is also important. Therefore, it is very important not to miss the beginning of the process and always take into account circumstances that can lead to the formation of pathology:
- there is a risk of infection with another person;
- the child froze;
- frequent diseases caused immunodeficiency;
- history of severe infectious diseases: scarlet fever or measles;
- chronic rhinitis, respiratory diseases;
- malnutrition is observed;
- living conditions do not meet general hygiene standards;
- in the presence of a child smoke;
- there is a pronounced allergic susceptibility.
Based on the authoritative opinion of Dr. Komarovsky (treatment of acute adenoiditis in children became the topic of his separate video conversation), it can be argued that the vast majority of recorded cases of the transition of the disease into a chronic form is due to inferior therapy for acute respiratory viral infections.
Purulent adenoiditis
Under the influence of infectious pathogens of chlamydia, or on the basis of general immunodeficiency, due to which the body is not able to reject foreign cells, adenoids begin to exude pus. After the accumulation of a large amount of liquid substance, the discharge goes down the throat, spreads in the sinuses, and getting into the vessels along with the blood, they even begin to travel through the body, settling on the filtering organs - the liver and kidneys.
It is worth remembering that this stage of the disease is a natural continuation of the vivid symptoms of an acute course, which means that the stage of decay of the inflamed tonsil could be prevented.
To detect acute purulent adenoiditis will help such characteristic features:
- constant nasal congestion of the child with the continuous discharge of dark, earthy mucus;
- deterioration in sleep quality, the child often wakes up, and during sleep does not completely cover his mouth;
- the temperature is kept within 37.5 degrees;
- persistent headaches are present;
- hearing loss is observed;
- in young children, belching passes into the copious compartment of vomit, older children complain of frequent nausea, toilet visits become irregular due to frequent constipation or diarrhea.
For the treatment of acute adenoiditis in a purulent form, multiple rinses of the nasopharyngeal apparatus are used and a full course of antibiotics is prescribed.
Subacute adenoiditis
Subacute adenoiditis, as well as chronic, is a state of unstable symptoms, with stages of remissions and relapses. But in the case of quickly taken therapeutic measures, noticeable improvements with the dynamics of the inflammatory decline occur within two weeks. This complication of acute adenoiditis at the beginning of the process goes along with the development of lacunar angina.
The temperature in a child with subacute adenoiditis can remain for some time after the disappearance of the remaining symptoms, and even during the recovery period. Physical examination will reveal enlarged cervical and submandibular lymph nodes with pain during palpation.
Diagnostics
If children have symptoms of adenoiditis, treatment and supportive measures do not always keep up with the true diagnosis. In cases where the increase in submandibular lymph nodes is a pronounced sign, parents rush to show the child to the dentist. Complete debridement of the oral cavity sometimes takes up a lot of precious time, while the correct treatment of acute adenoiditis should begin immediately.
The specialist to whom complaints should be addressed if at least two symptoms are found from the top lists is an otolaryngologist. The ENT doctor’s arsenal has all the required tools for endoscopic examination, but parents need to be prepared for the fact that radiological and laboratory tests will be required to clarify the diagnosis.
A big problem for many children is a simple physical examination, in which the doctor probes the adenoids with the contact, finger method. But this method is rarely practiced, since viewing pathological growths using posterior rhinoscopy (with a mirror, through the oral cavity) or with a fibroscope (flexible endoscope) gives a fairly complete picture of the level and complexity of the disease.
A characteristic clinic that allows you to diagnose pathology and determine whether the child needs to remove adenoids is shown in the degree of swelling of the pharyngeal tonsil, the formation of suppuration and the structure (friability, density) of the diseased organ.
If adenoiditis occurs repeatedly, and there is a suspicion that the microflora of the tonsils does not perceive treatment, a smear from the mucous membrane is taken to inoculate the bacterial medium in order to select adequate antibacterial therapy.
Adenoiditis Treatment
The main task facing doctors in diagnosing the symptoms of adenoiditis in children is the treatment of the leading disease, which is most often an ARVI. This is included in general-purpose measures, and actions aimed at stopping painful manifestations are considered local measures.
The removal of alarming signs and pain of adenoiditis is facilitated by:
- Rinsing the nasopharynx with saline or by means made on its basis. In order not to irritate the mucous membrane, salt rinses are recommended to be alternated with infusions and decoctions of medicinal plants that have established themselves as antimicrobial. These are: sage, chamomile, calendula, St. John's wort.
- To stop the secretion of mucus from the nose using (course no more than a week) means for local narrowing of blood vessels. These are: Rinostop, Fornos, Nazol, Naphthyzinum (for children). The release forms can be any, but aerosol irrigation has the advantage of the uniform distribution of the liquid.
- Of the local antibiotics, children's doctors continue to prescribe the tried and tested "Albucid", but the burning sensation that occurs in children when using the drug makes the therapy painful for both the child and parents. Therefore, sprays “Isofra”, “Bioparox” (it has two nozzles in a set - for irrigation of the nose and throat), “Polydex” have long been and successfully an alternative to the old drug.
The appointment of nasal steroids for the treatment of adenoiditis is considered the same mandatory measure as the use of antibiotics, especially recently, when the choice of drugs allows you to maximize the individual characteristics of the child's body. Among these drugs, "Nazofan", "Avamis", "Flixonase" are isolated. The drug Nazonex deserves special attention. In acute adenoiditis in children, the use of this drug is justified by clinical recommendations. Also good compatibility with most drugs with a narrow and wide spectrum of action.
How a child can be treated with acute adenoiditis of the second and third degree of difficulty, the attending physician decides, but only after all conservative methods have been tried and the result is lower than expected, the question may arise about the removal of inflamed tonsils with surgical intervention.
Complications and consequences
Acute adenoiditis in children, which has passed into the chronic phase, also acts depressingly on the child's psychoemotional state. Surrounding it becomes noticeably quick “rolling” it in school performance, loss of interest in games, especially among peers.
In infants, the occurrence of adenoiditis is a rare phenomenon, but it is just as pronounced and cannot hide from attentive eyes. The baby becomes restless, while crying, suffocates, refuses to eat food. Already consumed food often comes in the form of profuse belching or even vomiting.
With advanced forms of the disease, it is possible to diagnose the most dangerous complication of acute purulent adenoiditis in a child - sepsis.
Prevention
Prevention of adenoiditis should begin with the birth of the baby, and continue all the time until the child reaches adolescence. In addition to constantly monitoring the behavior of the child during sleep (with a closed or open mouth, he sleeps, snores, or suffocates), it is necessary to arrange sanitation of the nasopharynx with weak saline solutions from time to time. The measure is especially relevant for influenza epidemics or when a child visits a kindergarten, where rhinitis is ubiquitous.
Of great importance in preventing the load on the tonsils is the timely treatment of any respiratory diseases caused by viruses.