How to treat adenoids of the 2nd degree in a child

Approaches to the treatment of adenoids in childhood continue to be constantly reviewed by specialists. Previously, adenoids of grade 2 in children were recommended to be removed immediately, but later the tactics changed. Consider the clinical picture and principles of treatment of this pathology in toddlers. We learn what aspects doctors are guided by when they decide to remove or not adenoids in a child.

• Causes
• Possible complications and consequences of the disease
• Clinical picture and symptoms
• Diagnostics
• Principles of treatment
• Surgical methods
• Treatment without surgery
• Alternative methods

Causes

The growth of the pharyngeal tonsil is typical for children aged between 1 and 14 years. Adenoids can persist in adults, but more often they gradually decrease in size and atrophy.

The pharyngeal tonsil is an accumulation of lymphoid tissue. This is the body of the immune system, the main task of which is to fight infection with the nasopharynx.

The enlargement of the amygdala is called adenoids or adenoid vegetations.

Important! Adenoids themselves are not a disease, but pathological hypertrophy of the tonsils. But with a significant increase and addition of secondary infection complications develop - violation of breathing and hearing, frequent colds, adenoiditis.

One of the reasons for the growth of the amygdala is the immaturity of the children's immune system. In response to the action of pathogenic bacteria and viruses, the immunity of a child reacts with an increase in lymphoid tissue.

The appearance of adenoids is provoked by the following factors:

1. Decreased overall immunity. Adenoid vegetations are more common in children, who often and are long-term sick.
2. Other foci of infection (carious teeth, pharyngitis, tonsillitis, otitis). Frequent exacerbations of chronic inflammation provoke the growth of the nasopharyngeal tonsil.
3. Genetic predisposition. If the parents had similar problems, the risk of adenoid hypertrophy in the child increases.
4. Allergy. Unfavorable environmental conditions, the spread of chemical, food and other allergens leads to swelling of the tissues, secondary infection of the enlarged tonsil.

Interesting! In the roto-and nasopharyngeal region, other clusters of lymphoid tissue are concentrated! These are palatine, tubal, lingual tonsils. They can also grow. It is not the increase itself that matters, but its degree and developing complications.

Possible complications and consequences of the disease

A full-fledged nasal breathing is important for a person of any age. But serious consequences are more common in young children than in adolescents and adults.

Complications can be divided into several groups:

1. The absence of normal nasal breathing in childhood leads to disturbances in the formation of the bite, teeth and bones of the facial skull. Breathing with the mouth provokes frequent and prolonged colds, snoring.
2. Problems with the middle ear. The auditory tube located next to the adenoids plays an important role in the normal functioning of the middle ear. If overgrown adenoids overlap the mouth of the auditory tubes, frequent otitis occur. The result can be a persistent hearing loss.
3. Somatic diseases. Lack of oxygen leads to hypoxia of the brain. The child becomes more tired, lags behind in development, his sleep and appetite are disturbed.

In severe cases, the baby can deform the chest due to improper breathing, speech is broken, the work of the gastrointestinal tract and endocrine glands. Currently, such complications are practically not found.

Clinical picture and symptoms

Symptoms of the disease depend on the degree of hypertrophy of the tonsils. The diagnosis of "adenoid of the second degree" means that the overgrown vegetation half closes the vomer (the bone located in the posterior sections of the nasopharynx).

Parents should pay attention to the following symptoms:

• snoring or sniffing during sleep;
• change voice timbre in children 2-5 years, the appearance of nasal;
• regular diseases of the middle ear (congestion, otitis);
• absence of nasal breathing;
• problems with smell;
• frequent colds and SARS;
• change in the general condition of the child - capriciousness, drowsiness, fatigue, a violation of appetite.

The totality of 2 or more signs should alert parents about adenoids, become an excuse for visiting a doctor-otorhinolaryngologist.

Diagnostics

Adenoids are located in the nasopharynx, so parents can not see them. Externally, the amygdala resembles a cauliflower inflorescence or a cock's comb.

Adenoid vegetations can be diagnosed in several ways:

1. Inspection of the nasopharyngeal mirror. It is performed in older children with low gag reflex. For examination, the doctor enters a small mirror in the child's mouth and examines the nasopharynx.
2. Endoscopic examination. Older children are treated without anesthesia, in children - under short-term sedation. This method of diagnosis allows us not only to assess the degree of adenoids, but also to consider other structures - the mouth of the auditory tubes, the presence of hypertrophy of the posterior ends of the inferior nasal concha, curvature, polyps,
3. X-ray images with contrast.

Important! Widely used earlier finger method of research does not give the doctor a complete picture of changes in the nasopharynx. In addition, manipulation is unpleasant and painful for children.

Principles of treatment

Treatment of adenoids of the 2nd degree depends on the concomitant complications from the ears and nose. Known to most parents, the pediatrician Komarovsky believes that each case should be treated individually. On the question of parents, whether adenoides remove 2 degrees, there is no unequivocal answer. With frequent exudative otitis, adenoiditis, strong snoring, nasal must be removed. In the absence of complications recommend dynamic observation and conservative therapy.

Surgical methods

Indications for the removal of adenoid outgrowths of the second degree are:

1. Disturbance of nasal breathing.
2. Pathology from the organ of hearing.
3. Changes in bite, deformation of the bones of the facial skull.
4. Regular colds of the respiratory system associated with hyperplasia of lymphoid tissue.

In such situations, surgery is the optimal method of treating the disease. Surgical intervention is performed under general or local anesthesia. Classically, adenoids are removed with a special tool (adenotoma). Modern clinics offer removal by laser or shaver. Otolaryngologists prefer endoscopic surgeries.

Treatment without surgery

In the absence of complications, the doctor recommends effective conservative therapy. Treatment without surgery is performed by the following drugs:

• Nasal drops on the basis of sea water (Akvalor, Salin);
• antihistamines (Zodak, Erius) to eliminate allergic edema;
• hormonal sprays (Nazonex from 2.5 years old, Avamis from 6 years old);
• immunomodulators (Derinat);
• homeopathic remedies (Sinupret, Tonzipret).

In parallel, the child is taught self-washing of the nose with saline solutions or performs the procedure under the supervision of a doctor (cuckoo or the method of moving liquids along the Proetz).

The scheme of treatment of adenoids includes the appointment of physiotherapy procedures - inhalations with the use of moisturizing and antiseptic solutions (saline, septomyrin), electrophoresis, magnetic or laser therapy.

Important! To cure adenoids conservatively means to reduce their size and eliminate complications associated with vegetation! Complete removal of the amygdala is possible only during surgery.

Alternative methods

The effectiveness of folk remedies is challenged by doctors. With adenoids of the second degree without complications, one can try treatment with the methods of alternative medicine. It is important to understand that their clinical effectiveness is not proven. In children prone to allergies, such therapy can have the opposite effect.

In adenoids of the second degree, both surgical and conservative methods of treatment are used. The choice of tactics depends on the condition of the child and the presence of concomitant complications. The task of parents in a timely manner to observe changes in the child's body and treat according to the scheme proposed by the doctor.