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With adenoids, the child experiences heavy breathing, and he breathes through his mouth. It is generally accepted that the only effective treatment for such a disease is surgical removal. However, despite medical recommendations, many parents are trying to find an alternative treatment method. To figure out whether to remove adenoids or not, you should find out the cause of their occurrence, find out whether a surgical operation can harm a particular child, and in what cases it can be avoided.

Reasons for the development of pathology

Adenoids are the pharyngeal tonsil, which consists of lymphoid tissues. This tonsil is located in the nasopharynx, and its purpose is to protect the body from infections and produce lymphocytes. As they grow older, adenoids usually atrophy, so in adolescents over 15-18 years of age they are small.

Lymphocytes produced by lymphoid tissue help neutralize microbes that penetrate the nasopharynx. When a virus enters a child’s body, an inflammatory process develops. To suppress inflammation and destroy harmful bacteria, lymphoid tissues begin to enlarge and intensively produce lymphocytes.

In the case of frequent inflammatory processes, the adenoids in children are constantly in an enlarged state, begin to grow, and as a result, they themselves can become a source of chronic inflammation.

Adenoiditis can also develop as a result of chronic or allergic rhinitis. As a rule, it is caused by household allergens - dust, mold spores, pet hair.

Statistics show that in 20% of cases of adenoiditis, the cause of its development is an allergy.

Other causes of pathology include:

• Pregnancy and childbirth occurring with pathologies. Thus, adenoids can occur as a result of birth trauma, birth asphyxia or fetal hypoxia. The cause of adenoids in a baby is sometimes a viral disease suffered by the pregnant mother, the use of toxic pharmacological drugs or antibiotics.
• Child's habit of overeating.
• Abuse of chemical and sweet products.
• The body's reaction to vaccinations.
• Frequent colds.
• Insufficiently strong immune system.
• Dust and air pollution in the place of residence.

Symptoms and degrees of the disease

Symptoms of the pathology are:

• Impaired breathing through the nose.
• Chronic otitis media, accompanied by serous nasal discharge.
• Periodic breathing through the mouth.
• Open mouth while sleeping.
• Restless sleep, accompanied by wheezing and snoring.
• Otitis media, hearing problems.
• Nasal voice (occurs in case of significant enlargement of the tonsil).

If the doctor confirms the presence of the disease, then he must determine its degree. To determine the exact degree, the child is examined using x-rays.

There are 3 degrees of the pathology in question:

1. Enlarged adenoids occupy 1/3 of the lumen of the nasopharynx, and are barely visible from behind the edge of the choana. When examined with a mirror, it is clear that the adenoids have not yet formed, but only line the roof of the nasopharynx. The child's hearing, breathing and sleep in the first degree, as a rule, are not disturbed. The only symptom that allows you to suspect the disease is a runny nose against the background of enlarged tonsils or swelling of the mucous membrane.
2. An X-ray shows an increase in the lumen of the nasopharynx by 50%. Endoscopy reveals that they also occupy 50% of the lumen of the choanae. Inspection with a mirror allows you to see the same picture - the gap is half blocked. In grade 2, children breathe normally through their nose while awake, but sleep at night is accompanied by snoring. If the lymphoid tissue blocks the mouths of the Eustachian tubes, discomfort in the ears occurs and hearing deteriorates.
3. The third degree is characterized by the proliferation of adenoids, accompanied by blocking of the entire lumen of the nasopharynx. It is impossible to perform endoscopy at this stage, since the adenoids in the nose do not allow the endoscope to be inserted into its cavity. Examination with a mirror allows you to see only lymphoid tissue, but the choanae and the mouths of the eustachian tubes are no longer visible. Parents may visually notice enlarged adenoids in the nose. The child cannot breathe through his nose either at night or during the day. A year after the development of the 3rd degree, the formation of the so-called “adenoid face” occurs - the child’s mouth is constantly half-open, and the eyes are half-closed, the oval of the face is elongated. Hearing also deteriorates significantly and speech intelligibility decreases.

Treatment depending on stage

The first degree does not require treatment, much less surgery. The second degree definitely needs to be treated, but the choice of treatment method depends on the cause of the enlarged adenoids.

In some cases, the disease, which has reached the third stage, can be cured without surgery. However, to achieve recovery, it is important to begin treatment immediately. If the patient’s facial skeleton has already been deformed according to the “adenoid face” type, then the adenoids will have to be cut out.

Conservative therapy

Drug treatment is carried out using:

• Vasodilator drops (Farmazolin, Naphthyzin, Glazolin, Rinozalon, etc.).
• Anti-inflammatory hormonal nasal sprays (Nasonex, Flix).
• Antihistamines (Erius, Diazolin, Zyrtec, Suprastin).
• Saline solutions (Nasomarin, Quix, Aquamaris).
• Antiseptic drugs (Albucid, Protargol).
• General strengthening agents - immunostimulants, vitamins.

If the enlargement of the tonsil is not due to its growth, but to swelling caused by an allergy, then treatment is carried out with the help of antihistamines.

To enhance the effectiveness of medications, patients are prescribed physiotherapy, traditional medicine or homeopathic medicines.

Surgery

The operation can be performed using one of the following methods:

• Instrumental (classic method using a Beckman knife).
• Radio wave (the operation is carried out with a special Surgitron device, which melts the affected tissue).
• Using laser therapy.
• Removal with a shaver (a special sharp device with a rapidly rotating head).

Is it possible to remove adenoids?

It is not always possible to remove adenoids in children. For example, surgery is contraindicated for bronchial asthma and severe allergic diseases.

Even if the child does not have asthma or allergies and the pathology has not developed to the last degree, it is advisable to treat the disease with conservative methods. It is not always possible to get rid of adenoids surgically the first time. In addition, the removal procedure is carried out under general anesthesia, which is associated with high health risks for young patients.

• Removal of adenoids in children under 6 years of age leads to a weakening of the body’s natural protective functions. The amygdala helps protect it from viruses and microbes, and also has a positive effect on the formation of the immune system. Surgery at an early age can also cause the development of allergic rhinitis, hay fever, tracheobronchitis and even bronchial asthma.
• The operation does not replace conservative treatment in the future. On the contrary, after removal the patient requires particularly careful treatment, which includes rinsing, nasal drops and breathing exercises. In addition, even taking such measures does not always avoid a relapse - after all, lymphoid tissue can begin to grow again.
• The cause of difficulty breathing may not be the adenoids, but a deviated nasal septum, inflammation of the sinuses, or an allergic rhinitis, which provokes the development of swelling of the nasopharynx.
• Parents whose child has first-degree diseases with mildly expressed symptoms should carry out conservative treatment as carefully as possible and remember that after approximately 11-13 years, the tonsil begins to atrophy and independently decrease in size.

Therefore, before exposing a small patient to such stress, you should first weigh the pros and cons. It may be worth consulting with another doctor who has a good reputation.

The doctor, in turn, before making a decision on surgery, when examining the child, pays attention to the following points:

• The presence of mucus and pus on the adenoids. If they are present, then first of all it is necessary to clear the tonsil of them and observe whether breathing improves.
• What surface do adenoids have? If it is smooth, then there is swelling or an inflammatory process, in which surgery cannot be performed. The surface of healthy adenoids should be slightly wrinkled.
• What color is the tonsil? If it is pink, then surgical intervention cannot be avoided. If it is bluish or bright red, then you should first try conservative treatment.

When is it better to remove adenoids from a child?

If the decision to carry out the operation has already been made, and you are in doubt when to carry it out - in summer or winter, then it is better to plan for summer or spring. During the cold season, there is a high risk of inflammation or viral infection. The operation should be postponed if there is a flu epidemic in the area where the child lives. If a small patient has recently undergone routine vaccination, then he can have his adenoids removed no earlier than a month after vaccination.

As for age, most doctors recommend removing adenoids at the age of 3-4 years.

Indications for surgery

Both domestic and Western doctors recommend removing adenoids only in three cases. Absolute indications for removal are:

• The development of obstructive apnea syndrome - a condition in which a snoring person holds his breath during sleep. In some cases it leads to death. In children who have a significantly enlarged tonsil, apnea occurs quite often.
• Surgical intervention is also required in cases of severe disruption of the structure of the facial skeleton.
• Suspicion of the development of a malignant tumor in lymphoid tissues. In this case, the doctor must prescribe a comprehensive examination for the small patient, which will confirm or refute the presumptive diagnosis.

As for all other indications - recurrent sinusitis, recurrent otitis or inflammatory processes in the nasopharynx, all indications are relative. In these situations, removal of the tonsil is considered mandatory only in the absence of a positive effect from conservative therapy.

The pathology of the adenoids is familiar to many parents of children under 13-14 years of age, but in some cases adults also have to deal with this otolaryngological problem. This tonsil, consisting of lymphoid tissue, is located in the nasopharynx and acts as an immune defense. However, under certain factors (for example, frequent or infectious diseases), it experiences increased stress and begins to undergo hypertrophic changes. As it increases in size, one has to face the following dilemma: is it necessary to remove the adenoids or can the disease be amenable to therapeutic treatment?

To answer this burning question of many otolaryngologist patients, we will briefly introduce you to the problem of enlarged adenoids. This will help you understand the essence of the pathology and the principle of drawing up a treatment plan for such a disease.

Why do adenoids enlarge?

There are two main reasons for the enlargement of the nasopharyngeal tonsil:

1. Hypertrophic changes of a non-inflammatory nature. Such damage is not provoked by allergic or inflammatory processes.
2. Development of adenoiditis (that is, inflammation of the adenoid tissue). This process is caused by infection of the nasopharyngeal tonsil with bacteria or viruses. It can occur acutely, subacutely or chronically. In this case, the patient will have symptoms such as mucous or purulent discharge from the nasal passages, fever and dry cough.

Now the most effective method of diagnosing and finding out the cause of changes in the adenoids is a video endoscopic examination of the nasopharynx, in which the doctor can not only assess the condition of the area under study (size, color, structure), but also collect tissue for laboratory tests. After such a diagnosis, the otolaryngologist can determine the degree of enlargement of the nasopharyngeal tonsil and determine further treatment tactics:

• I – covers the posterior edge of the nasal septum by 1/3 (this fact is the limit of the physiological norm), the pathology does not require treatment unless chronic adenoiditis develops;
• II – the adenoid covers the posterior edge of the nasal septum by 2/3, the need for therapy is determined after rhinomanometry individually for each patient (the degree of nasal breathing impairment is taken into account);
• III – the adenoid completely blocks the posterior edge of the nasal septum and nasal breathing becomes impossible, and the elimination of the pathology can only be carried out surgically (that is, by adenotomy).

Who is indicated for adenotomy?

Indications for adenoid removal are always strictly individual. Why? The answer is simple - the fact is that even an increase in the nasopharyngeal tonsil to degree III can be expressed differently in different children. In one patient, adenoid hypertrophy will cause difficulty breathing, while in another it will not. Or degree I hypertrophy causes hearing impairment in one group of patients, but not in another.

• Adenotomy is never performed urgently. And this moment can be used by parents to get advice from various specialists. This approach will help them form a more complete opinion about the competence of a particular otolaryngologist and make an informed decision.
• In addition, as before any operation, the child will have to undergo a number of preparatory measures before adenotomy. For this purpose, the small patient is prescribed a full course of examination and, if necessary, sanitation of existing chronic foci of infection. Such interventions should not be carried out at a time when there is an epidemic or other infectious disease. If the child has recently been ill and his immunity is still weakened, then adenotomy is postponed until the little patient has fully recovered.

The intervention can be performed at any age – there are no special recommendations or preferences in this regard.

The main condition when prescribing an adenotomy is the correct determination of the indications for its implementation and careful preparation of the child for the upcoming operation.

After performing the intervention, which can now be performed under the control of endoscopic equipment, the patient’s rehabilitation, most often, does not take a long time and does not involve significant restrictions in the usual way of life. The main conditions for successful recovery after adenotomy are not to eat solid or hot foods in the first few days after removal of the adenoids and to avoid contact with sources of infectious agents.

How the operation is performed

When prescribing an adenotomy, parents should not panic! Why? This operation, when performed endoscopically, is one of the shortest among all surgical treatment methods. In addition, modern technology allows the surgeon to visualize the surgical field in detail and perform all manipulations with extreme precision. This fact reduces the risk of medical errors and reduces the likelihood of complications to a minimum.

Now surgery to remove adenoids is performed under general anesthesia.

• During adenotomy, a special instrument is inserted into the nasopharynx - an adenotomy, which is a ring-shaped knife.
• It is pressed against the roof of the nasopharynx so that the lymphoid tissue enters its ring.
• After this, the doctor cuts off the adenoid in one motion.

However, despite all the advantages of endoscopic technology, a certain risk of complications during surgery is still present. Fortunately, it is minimal, but:

• In some cases, adenotomy can lead to bleeding and damage to the palate.
• In rare cases, the operation is complicated due to anesthesia.
• And when carrying out the classical technique (that is, without the use of endoscopic equipment), there is a need to psychologically prepare the small patient for the intervention in order to minimize the risks of complications.

How effective is adenoid removal?

Almost all parents of young patients suffering from adenoiditis want to know the answer to this question.

• In fact, to completely remove the nasopharyngeal tonsil during a classic operation, which is still performed in Russia, Ukraine and other post-Soviet countries due to insufficient equipment in operating rooms with endoscopic equipment, is beyond the power of even the most eminent and qualified otolaryngologist.
• That is why leading experts recommend endoscopic adenotomy - after all, after it, the risk of recurrence of adenoiditis is much lower, since the adenoid is removed as completely as possible.
• In addition, classic adenotomy always requires postoperative treatment and long-term rehabilitation. And this fact cannot but upset both child patients and their parents.
• Another important point that should be taken into account when prescribing adenotomy is the fact that excision of lymphoid tissue is always damaging to the immune system as a whole. This means that in the future the child may begin to suffer from infectious diseases of the respiratory system more often.

That is why, when prescribing such an otolaryngological operation, the doctor must weigh the pros and cons. As a rule, such interventions are a last resort and are carried out only in cases of severe hearing and breathing disorders or the ineffectiveness of conservative therapy.

Which doctor should I contact?

If you experience difficulty in nasal breathing, snoring, or purulent or mucous discharge from the nose, you should consult an otolaryngologist. Making a decision about the need to remove adenoids should always be balanced and based only on certain indications, implying the impossibility of eliminating the existing problem with therapeutic measures. In such cases, the patient must undergo a comprehensive examination using endoscopic equipment. Next, the doctor will be able to determine the degree of growth of the adenoids, the reason for their enlargement and draw up a plan for further treatment.

Most parents have their own views on any pediatric problem. And often this view does not coincide with the opinion of doctors. In this sense, the question of adenoid removal is no exception. Almost all mothers think: “I won’t put my own child under the knife.” The attitude of some doctors can be expressed by one catchphrase from the famous film: “Cut to hell, without waiting...” Stop! But what is so terrible that you can expect from adenoids?

First, let's try to figure out what kind of disease this is, why it occurs, and by what signs it can be detected in a child.

What are adenoids

Adenoids is a pathological enlargement (hypertrophy) of the nasopharyngeal tonsil. Normally, the amygdala performs the most noble function - it protects the body from infections, in fact serves as a border guard, who, in the event of an attack by an enemy - bacteria or viruses - is the first to enter the battle for health.

But its increase leads to the appearance of not very pleasant symptoms: profuse nasal discharge, nasal congestion and, as a result, difficulty breathing. Overgrown lymphoid tissue blocks access to air entering the lungs through the nasopharynx.

It all ends with the child beginning to breathe exclusively through the mouth. He closes it only after the urgent request of his parents. But after a few minutes everything returns to normal: the baby walks, plays, eats and sleeps with his mouth open. Some adults may ask: So what? What harm does this do? What difference does it make how a child breathes? But it turns out there is a difference. When breathing through the mouth, too little oxygen enters the body.

All tissues and organs feel a lack of nutrition, and above all, this concerns the brain. For this reason, a baby with adenoids develops worse than his peers. He has trouble concentrating, gets tired quickly, and is lethargic and apathetic. At school, such children often have poor performance. Although, in fact, their intellectual development remains normal.

Constant breathing through the mouth also leads to deformation of the facial skull. Otolaryngologists even came up with a special term - adenoid face. A specialist can easily determine the presence of a disease in a child by his drooping lower jaw, inflamed upper lip and smoothed nasolabial folds. Over time, young patients develop an abnormal bite, speech therapy problems arise, and this is against the background of the existing nasal tone. If the disease occurs in an early period - up to a year, then the baby has difficulty mastering speech.

Children with severe adenoids often suffer from restless sleep. It happens that they wake up several times a night because they have difficulty breathing, as well as because of their own snoring or because of a dry cough that occurs reflexively in response to swallowing secretions from the nasal mucosa. In some cases, bedwetting may occur due to changes in the rhythm of blood circulation in the brain.

Another unpleasant consequence of an enlarged tonsil is hearing impairment. Adenoids close the openings of the Eustachian tubes and disrupt the normal ventilation of the middle ear, which leads to the development of frequent otitis media and even hearing loss.

Every mother can check whether her child’s hearing is okay on her own, without turning to a specialist for help. For this, there is a simple diagnostic method - whispered speech. How to apply it? Just call your child in a whisper from a distance. If he doesn't hear the first time, move closer and repeat his name again.

Continue talking to your baby until he responds. If it turns out that the child perceives whispered speech from a distance of less than six meters, then this is a reason to contact an otolaryngologist. If hearing loss is associated with adenoids, then you should not be afraid of it. Hearing impairment will go away as soon as the problem that caused it is resolved. True, the cause may be another disease, for example, acoustic neuritis. In any case, you should not hesitate to consult an otolaryngologist.

We have listed quite a lot of complications caused by adenoids. Probably even too much for one single tonsil, isn’t it? But that's not all. Add to all of the above frequent headaches, problems with the gastrointestinal tract, anemia, asthmatic attacks... In general, it turns out that one pathology in the body automatically entails another. And the neglect of the process leads to the fact that the child’s health is under serious threat.

What are the causes of such a dangerous disease? It has been noted that most often adenoids appear in children aged 3-7 years, when children begin to go to kindergarten, school and exchange not only their toys, but also microflora with their peers. As a result, frequent diseases arise: scarlet fever, measles, diphtheria, ARVI, etc. They, in turn, provoke enlargement and inflammation of the tonsil. Hereditary factors also play a large role in the development of the disease. If a child’s father or mother was diagnosed with adenoid growths in childhood, then the likelihood of them appearing in the baby is very high.

It is important that the disease is diagnosed as early as possible. Then the likelihood of successful treatment of adenoids increases significantly.

Treatment of adenoids

A logical question arises: “How to deal with adenoids in the nose?” It all depends on the degree of growth of the tonsil. If it does not significantly block the lumen of the airways, then you can get by with drug treatment, physiotherapy, breathing exercises and spa therapy. But in fairness, it must be said that all these measures are not always effective. If no improvement is observed from their use within six months, and the child continues to suffer from the disease, then it is time to think about a surgical solution to the problem.

Surgery

Surgery to remove adenoids (adenotomy - partial removal or adenectomy - complete removal of the nasopharyngeal tonsil) is today performed under local anesthesia or general anesthesia. The first is considered safer from a physiological point of view. But most doctors believe that watching an operation progress on an unprepared child can cause serious psychological trauma. The memory of the execution and the fear of people in white coats will remain for many years. That is why hospitals are increasingly resorting to general anesthesia as a more humane method of pain relief for the child.

The operation is performed quickly: in just a few minutes with local anesthesia and 20-30 minutes with endoscopic intervention. For the first three postoperative days, the child should not be given hot food: it can cause vasodilation and bleeding.

The intake of spicy and cold foods is also excluded. Heated soups and cereals are fed starting from the fourth day, not earlier. This regime is set for the baby for 9-10 days. Then he will be able to return to his normal lifestyle.

Side effects and complications from adenotomy or adenectomy are rare. At first, after the tonsil removal, the child will breathe through his mouth. This does not mean that the operation was useless. It’s just difficult for a baby to immediately switch to nasal breathing. In addition, postoperative swelling appears at the site of the removed adenoids. It blocks the nasopharynx and prevents you from taking a full breath in the first days after surgery. But by the tenth day everything goes away, and the child breathes freely.

There is one more problem: a removed tonsil can grow back. And she is also not immune from hypertrophy and inflammation. But this does not always happen, and newly appeared adenoids are rarely removed again. In such cases, doctors try to limit themselves to conservative treatment.

Sometimes it happens that the child’s parents refuse to undergo surgery after learning that with age the nasopharyngeal tonsil decreases in size, and in most adults it even atrophies. Indeed, why remove a problem that may disappear over time? To begin with, we need to remember that excessive categoricalness has never brought anyone any good. Common sense, rather than speculation and prejudice, should prevail in the final decision.

We need to weigh everything, think it over carefully and, together with the pediatrician, come to a definite, and most importantly, reasonable conclusion. Doctors know that up to 5 years of age, the nasopharyngeal tonsil plays a big role in the formation of children's immunity and adhere to the golden rule: if a child can do without surgery, then it is better not to prescribe it. Surgery is a last resort. If the doctor insists on it, then it is really necessary.

Conservative therapy

For small and medium-sized adenoids (disease of 1st and 2nd degrees), conservative treatment is prescribed: instillation of a 2% solution of protargol into the nose, rinsing the nasal cavity, using children's vasoconstrictor drops to save the nose from congestion.

Nasal rinsing in the presence of adenoids in a child should be approached with extreme caution. An incorrectly performed procedure can lead to the solution entering the middle ear cavity and the development of acute otitis media. In 100% of cases, this situation occurs with grade 3 and 4 adenoids. Therefore, it is important to remember that in severe forms of the disease, rinsing the nose is prohibited. Just as you can’t do this with frequent nosebleeds and chronic otitis media in young patients.

How to properly rinse a child's nose

Most children are hostile to this treatment method and are even afraid of it. Therefore, it is important to approach the issue delicately, to explain to the child that this is necessary for his health - so that his nose can breathe better. It would be good if the process was carried out in a playful way or if one of the parents showed by example that rinsing the nose is absolutely painless. A clear demonstration of the procedure by dad or mom should convince the child that doing it is not scary at all.

Many parents are interested in the question: at what age can a child’s nose be washed? The answer is simple. From the moment you can explain to him the procedure and you will be confident that the baby will be able to understand you correctly. Doctors advise doing this no earlier than 4 years. Until this moment, to cleanse the nasal cavity, they use special children's drops, which soften thick mucous secretions, cotton wicks and aspirators.

For rinsing, you can use ordinary boiled water, decoctions of medicinal herbs (chamomile, eucalyptus, calendula, sage, St. John's wort), sea water, isotonic solution or special ready-made formulations that are sold in pharmacies. It is allowed to alternate different means: use one or the other. Solutions are selected together with an otolaryngologist, based on the child’s history of allergic reactions. The finished preparation should be slightly warm (temperature 34-36°). A volume of 100-200 ml will be quite enough for one procedure.

It not only removes accumulated mucus very well, but also relieves swelling and sea water has a bactericidal effect. You can prepare it from dry sea salt (1/2 teaspoon diluted in a glass of water) or, in the absence of it, from ordinary food salt (1/3 teaspoon dissolved in a glass of water and add 2 drops of iodine).

Before you begin the procedure, make sure that your child’s nose is not stuffy. Otolaryngologists advise to first clear the cavity of secretions either using an aspirator or by carefully blowing your nose. If after this the passage of the nasal passages remains difficult, it is allowed to instill vasoconstrictor drops into the baby (one drop in each nostril). After this, you can begin washing.

The procedure is carried out while standing over a sink. The solution is drawn into a small syringe with a thin spout or using a special pharmaceutical device (also called a “nasal douche”). The child needs to lean forward 90°. The head should be kept strictly vertical; you cannot tilt it left or right during the procedure. Ask your child to take a deep breath and squeeze a small amount of solution into one of the nostrils. The liquid will completely fill the nasal passage and flow out of the other.

If water gets into the mouth, you can advise the child to pronounce a drawn-out sound “and-and” while injecting. The soft palate rises and delimits the nasopharynx. After this, you need to blow your nose and repeat the procedure with the second nostril. And so - several times. Complete the rinsing by blowing out the nasal passages, which will remove the remaining solution from the mucous membrane.

If this flow-through method of rinsing (from one nostril to the other) causes difficulties, you can try a simpler method: inject a small amount of liquid into the child’s nose and ask him to blow his nose immediately. Make sure that your head is again in an upright position and under no circumstances tilts back. The solution should not get into your mouth, much less into your ears. Even a small amount of fluid trapped in the middle ear cavity will provoke serious otitis media, which will then be very difficult to cure.

After 15 minutes after washing, it is the turn of the aniseptic or antibacterial agents prescribed by the doctor. Antiseptics include colloidal silver preparations, in particular protargol.

Unlike vasoconstrictor drops, which need to be instilled into the baby’s side so that they do not get into the mouth and act only on the nasal mucosa, protargol is instilled on the back. This is done so that the substance flows from the nasal cavity into the nasopharynx and reaches the surface of the tonsil. Silver ions contained in protargol kill all pathogens and also slightly dry out the inflamed lymphoid tissue, reducing it in size. 2-6 drops of the drug are instilled into each nostril (depending on the age of the patient and the severity of the disease).

It is recommended that the child lie on his back for some time after this, without raising his head. Ideally, 15 minutes. But if the baby is naughty, you can limit yourself to 5 minutes. Instillation is carried out on the recommendation of a doctor, usually 2 times a day for 2 weeks. A second course of treatment may be prescribed after a month. Do not forget that the shelf life of a 2% solution of protargol is very short. Only 30 days from date of manufacture. Therefore, the old bottle of the drug can no longer be used for the new course.

You should not neglect breathing exercises, which are recommended by experts for the treatment of adenoids. It is better for the mother to conduct it at the same time as the baby, turning the process into a fun game. Gymnastics strengthens the respiratory muscles, stimulates blood circulation in the sinuses, and helps prevent sinusitis. In addition, during exercise, the sick body is saturated with the oxygen it lacks.

Hypertrophy of the palatine tonsils

Unfortunately, in children, adenoids are often accompanied by another disease - hypertrophy of the palatine tonsils (popularly called tonsils). In this case, breathing becomes difficult not only through the nose, but also through the mouth. The palatine tonsils, like the nasopharyngeal tonsils, protect the baby from pathogenic microorganisms, but they do this much more actively. Therefore, their removal is a more significant loss for the body. Without them, the child is at greater risk of bronchopulmonary diseases.

Inflamed tonsils pose a much greater danger than possible colds. They are a source of chronic streptococcal infection, which, periodically exacerbating, provokes the development of fever and sore throat. The latter, in turn, can cause complications on the kidneys and heart. So in the case of a “double set” of illness, it may be wiser to undergo surgery rather than expose the child’s health to serious risk.

In conclusion, I would like to note that enlarged tonsils are a very delicate issue. Here a lot depends on the competence of the doctor and the sanity of the parents. The decision about treatment should be made by a competent specialist. Not grandmothers who “raised you healthy and will take care of your grandchildren,” not friends who had “exactly the same situation,” and certainly not numerous forums with virtual mothers.

The doctor has a thorough knowledge of the problem and experience. Believe me, he will fight to the last to bring the tonsils “to life” without a scalpel. But if treatment does not help, and the adenoids continue to undermine the child’s health, then surgical intervention should not be postponed.

Colds and an ever-sniffing nose are unique symbols of childhood. Inflammatory phenomena that often occur in the nasopharynx lead to pathological growth of the tonsils (adenoids), which cause many unpleasant disorders.

The tonsil, even if greatly enlarged, is not visible from the outside, and therefore only a doctor with special equipment can see it. Often the only way to get rid of the problem is to remove the adenoids in children surgically.

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How is the nasopharyngeal tonsil removed?

Many parents, especially young ones, are understandably afraid to take their child to the surgical department. And all because they do not know how adenoids are removed in children, how the operation is performed, and whether it is painful. All these worries are groundless - as a rule, no negative consequences are observed after a well-performed removal procedure.

Modern medicine considers several methods for removing adenoids in children:

• traditional;
• endoscopic;
• using a laser.

Each of them is quite effective, but also has its inherent disadvantages. Read on to learn how adenoids are removed in children.

Traditional operation

The traditional method is based on the use of conventional surgical instruments. It is simple and does not require expensive equipment, is performed on an outpatient basis, but has one important drawback. It consists of slow healing of the wound surface, which sometimes reaches a large area and bleeds. Rehabilitation in this case requires time and regular treatment with antiseptics.

Using endoscopic equipment

This method is considered very effective. Excision of the overgrown tissue in the traditional way, using conventional means, including a speculum for visual inspection, is not the only way to perform the procedure.

An endoscope inserted through the nose or mouth allows the doctor to clearly see the surgical site, which facilitates complete removal of overgrown tissue. As a result, re-growth is extremely rare.

There is no doubt about the effectiveness of laser surgery. It is completely painless, does not cause bleeding, but relieves the patient of adenoids almost completely, with minimal time. Effective at any stage.

Review of reviews about the operation

Some parents doubt for a long time whether it is necessary to remove the child’s adenoids. However, many reviews about this procedure have been published on the Internet, left by those parents who decided to undergo it. Most of them are positive.

Almost all reviews of adenoid removal in children speak of the effectiveness of surgical methods, especially if the intervention was timely.

Most adults note a significant improvement in the child’s well-being and rapid normalization of his condition. After excision of the tonsils, children stop snoring in their sleep, their voice becomes clearer, and their speech becomes clearer. The most important thing is that children begin to get sick much less often. And even the hearing of children suffering from deafness is completely restored.

In one of the typical reviews, a mother spoke in detail about the operation to remove the adenoids of her five-year-old daughter, when the conservative treatment prescribed by the doctor was unsuccessful. The doctor diagnosed the girl with third-degree adenoiditis, her eardrums were deformed, and her hearing had deteriorated. The operation was performed under general anesthesia and took about an hour. As a result, nasal breathing was completely restored, hearing improved, and the girl became healthy and cheerful.

Parents of young patients also note in their reviews that it is impossible to delay the operation, as this leads to very unpleasant consequences.

As parents say, the adenotomy procedure is painless, since modern anesthesia methods are used. Removing adenoids takes little time, and there are practically no complications.

Is surgery necessary?

Practice shows that surgical intervention is not always necessary. Adenoiditis of the first and second degrees is treated with conservative methods, which often give good results. But with severe tissue growth, tissue excision surgery is necessary.

Indications

Many parents are concerned about when it is necessary to remove adenoids from a child, what signs indicate the time has come for surgery.

An increase in the size of the tonsil does not mean that the procedure is mandatory - specialists will first insist on conservative therapy. Removal of adenoids in a child is performed only if therapy does not produce results, and it is no longer possible to do without surgery.

There are the following indications for adenoid removal in children:

• third degree of disease;
• frequent recurrences, which are difficult to treat and aggravate the situation with an enlarged tonsil;
• frequent;
• noticeable hearing loss;
• observation of speech disorders and developmental delays;
• difficulty breathing;
• malocclusion and changes in the appearance of the baby (the so-called adenoid face).

The main indication for surgery is the third degree of the disease, at which many of the problems listed above arise. In addition to them, the baby experiences constant psycho-emotional discomfort and lacks sleep due to difficulty breathing. The development of intelligence is also greatly delayed.

It is not difficult to identify severe adenoiditis, in which surgical intervention is highly desirable. The answer to the question of whether it is worth removing adenoids for a child will be answered unequivocally by frequent infectious diseases, heavy breathing, inability to breathe through the nose, and even occasional pauses in breathing during sleep.

It is especially important to carry out the operation in a timely manner - even before the development of irreversible changes and serious consequences. Lack of treatment or its delay can lead to disability. This means that in many cases there is simply no doubt about whether it is necessary to remove adenoids from a child.

Does the procedure hurt?

Sometimes adults, from the memories of distant childhood, highlight the operation they underwent, and therefore associate it with unpleasant sensations and pain. As a result, they refuse to subject their own child to adenotomy, protecting him from pain. However, it is worth understanding that in those distant times, adenotomy was carried out without any anesthesia, which caused those very unpleasant sensations. What about now? Is it painful to remove adenoids today, or are there painless ways?

In modern clinics, local or general anesthesia is used during adenoid removal surgery. The general one is preferable for a child, since the little patient falls asleep immediately after the injection and will not feel anything, and when he wakes up, all the doctor’s actions will have already been completed.

Before the operation, you should ask your doctor how the adenoids are removed and what form of anesthesia is used. In addition, general anesthesia has several contraindications, so sometimes the doctor is forced to use local anesthesia. It is no less effective, but a small patient may be frightened by something - the sight of strange sparkling instruments, for example. Therefore, along with local anesthesia, an injection of a sedative is often given, and the operation on the adenoids is successful. The procedure cannot be performed on a child without anesthesia, as it is very painful.

Existing methods and methods

There are different ways to remove adenoids in children:

• classic removal surgery;
• using an endoscope;
• laser cauterization.

The choice of one method or another depends solely on the patient’s condition, the severity of the existing problem and some other factors.

At what age is it done?

Adenoids are a phenomenon characteristic of children. They also occur in adults, but much less frequently, and operations are also performed:

• if adenoiditis is accurately diagnosed and is accompanied by frequent respiratory infections;
• for recurrent otitis and sinusitis;
• with breathing disorder during sleep and severe night snoring.

However, young parents are more concerned about the age at which adenoids are removed from children. The best time is from three to seven years. If you constantly delay the operation, serious troubles may arise:

• persistent and quite severe in some cases hearing impairment;
• chronic otitis;
• dental problems, including the formation of malocclusion;
• changes in the position of the lower jaw.

Knowing at what age it is most effective to remove adenoids, you can perform the operation on time and with the highest efficiency. At the same time, experts consider the age of a child under three years of age to be a contraindication. In general, the question of when is the best time to remove adenoids is decided individually based on a detailed examination. Perhaps the operation should be postponed, giving preference to conservative treatment methods.

Possible consequences

A timely adenotomy will allow you to completely get rid of serious problems. However, the removal of adenoids in children also has quite unpleasant consequences. Sometimes the growths appear again (due to a poorly performed operation), and you have to decide on a second operation.

Many parents think about the dangers of removing adenoids in children, and believe that with the removal of tonsils, the child’s body is deprived of the protective barrier to infections, which they, in essence, are. On the other hand, the highly overgrown tissue itself not only does not perform this barrier function, but also greatly worsens the patient’s general condition and reduces immunity.

In general, the consequences after removal of adenoids in children are positive. Parents who are well acquainted with the problem no longer doubt whether it is possible to remove adenoids in children, preferring adenotomy in cases where conservative treatment does not bring results.

In addition to surgery, there is also a conservative method of treatment, and, if possible, doctors try to avoid surgical intervention. Moreover, conservative treatment is considered a priority. Therefore, parents should first try to use conservative methods of treating the proliferation of pharyngeal tonsils, and only if they do not produce results, agree to adenotomy.

Sometimes they try to cure adenoiditis with folk remedies or widely advertised drugs. One of them is Thuja Edas-801 Oil, which is positioned as the most effective remedy for conservative treatment. In fact, homeopathy, as has been repeatedly proven by scientists and confirmed by practice, cannot cure anything at all, and adenoiditis is no exception. Therefore, do not succumb to the beautiful deception, but contact a specialist.

Useful video

For useful tips for parents on adenoid removal, watch this video:

conclusions

1. Adenoiditis is an extremely unpleasant disease. If left untreated or delayed, it can lead to very serious, sometimes even irreversible, consequences.
2. Timely treatment or surgery will completely relieve the patient of the problem.
3. Today, there are very effective methods for surgically removing adenoids. They do not cause relapses, the baby’s health is completely restored.

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Adenoids in children are a “scourge” almost as common as frequent acute respiratory viral infections. Moreover, one is closely related to the other. How and why do adenoids occur in babies? Is there a cure for this? And how are adenoids removed in children? We'll tell you in detail!

Adenoids in children are directly and very closely related to nasal breathing. More precisely, with its absence. However, these difficulties have nothing to do with a runny nose. And you will notice it right away - the child will desperately try to blow his nose, but still will not be able to breathe through his nose...

What are adenoids and where to look for them

If you, sitting at the mirror, open your mouth wider and look, literally, into yourself, you will see two plum-shaped growths on the edges of the nasopharynx. These are tonsils (sometimes called tonsils), special accumulations of lymphoid tissue.

It is believed that the tonsils perform a certain protective function (prevent various pathogens from entering the body), and also participate in the development of immunity. Although medical scientists have not yet achieved clarity on the last question - that is, how exactly the tonsils behave when creating immune defense in a person is still unknown to anyone.

When inflammation of the tonsils, which we see in the mirror, occurs, the disease tonsillitis occurs (the bacterial version of which is well known to everyone under the code name “”). Most often the tonsils become inflamed.

We are used to thinking that tonsils are the two “cream” that we can see in our mouth. But in fact, every person has not two tonsils, but six! And they are all located in the nasopharynx. Three of these tonsils are very small and few people are interested in, but the other three are rather large clots of lymphoid tissue that very often make themselves felt.

Two of these three large tonsils are paired palatine tonsils (the same ones that we see in the mirror and on which sore throat usually “thrives”), the third is the so-called unpaired nasopharyngeal tonsil. That's when this nasopharyngeal tonsil in children becomes inflamed and grows, increasing in size - this is usually called adenoids.

Adenoids (sometimes adenoid growths) are a pathological enlargement of the nasopharyngeal tonsil due to the proliferation of lymphoid tissue. In young children, adenoids appear quite often, and in children after 6-7 years of age - much less often. Adults do not have adenoids at all.

The most important facts about adenoids in children

• 1 When a baby gets sick with ARVI, the nasopharyngeal tonsil increases in size, growing with lymphoid tissue. In medicine, this phenomenon is called acute adenoiditis. Most often, after recovery, this tonsil gradually shrinks back to its normal state. But sometimes the nasopharyngeal tonsil grows so large that it prevents the child from breathing, or causes permanent severe illness (for example, otitis media), in which case the adenoids are surgically removed. But don't be scared! The operation to remove adenoids lasts about 10 minutes and is one of the simplest and safest operations in medicine.
• 2 To the greatest extent, adenoids are characteristic of frequently ill children. Simply due to the fact that the child is infected again and again with one or another respiratory virus, and at the same time the nasopharyngeal tonsil simply does not have time to shrink to a normal state, thus the adenoids become larger and larger over time.
• 3 Until the age of 6-7 years, adenoids in a child can appear several times. It turns out that even after the adenoids are removed from a child under 6 years old, they may well grow back. And it is not uncommon for children to then have to undergo the procedure of adenoid removal again.
• 4 And only after the age of 7, the growth and activity of the nasopharyngeal tonsil drops sharply.... Now the adenoids are no longer able to increase in size as rapidly as before, even if the child continues to get sick often. After 8 years, lymphoid tissue completely loses its ability to grow - even if by this time the adenoids were dangerously large, from now on they will gradually decrease.
• 5 To refer a child for adenoid removal, the doctor’s opinion alone is not enough! There are specific indications that clearly regulate the reasons and conditions for surgical intervention. We will list them below.

Adenoids in children: symptoms

A doctor can see a child’s adenoids (and assess the degree of their growth) using a special mirror - dentists also use something similar when counting holes in our teeth. Parents, as a rule, do not have such mirrors, so for mothers and fathers there are other ways to detect adenoids in children.

The very first and most obvious symptom of adenoids in children is the child’s lack of nasal breathing.

The diagram of the location of the organs shows that the nasopharyngeal tonsil is in close proximity to two extremely important “paths” - the nasal passages and the so-called Eustachian tube, which connects the nasal cavity and the ear cavity. As long as the nasopharyngeal tonsil is normal, these pathways are free. But as soon as adenoids appear, their mass blocks either the nasal passages, or the Eustachian tube, or both at once.

Considering this circumstance, it is quite understandable why the following symptoms indicate dangerous adenoids:

• the child has no nasal breathing (without signs of a runny nose or nasal congestion);
• the child has ear pain and hearing has deteriorated (as with incipient otitis media);
• the child experiences relapses;
• The baby's voice becomes nasal.

These phenomena in themselves are symptoms of adenoids in children. But you can also add several accompanying signs to them:

• the child began to snore in his sleep;
• the child constantly breathes through his mouth, which makes it difficult for him to eat - he loses his appetite;
• the child experiences pauses in breathing during sleep;
• the baby suffers from headaches;

What circumstances contribute to the appearance of adenoids in children?

Scientists have identified several factors that, to varying degrees, influence whether a child will be prone to developing adenoids or not. These factors include:

• Heredity (if one of the baby’s parents himself “suffered” from adenoids in childhood, then with a high degree of probability the same problem will affect the child);
• Frequent respiratory viral infections, as well as past diseases such as measles, whooping cough, scarlet fever, tonsillitis and the like;
• Predisposition to allergic reactions (although in this case adenoiditis will be allergic in nature, and it can be completely “defeated” with the help of antihistamines);
• Systemic overfeeding of a child.

Adenoids in children: treatment

The severity of adenoiditis in a child (inflammation and increase in size of the nasopharyngeal tonsil) is directly related to the severity of ARVI. If you treat your child correctly and promptly for viral infections, then the adenoids will not bother you unnecessarily - the child’s ARVI will go away, and the adenoids will gradually decrease in size.

It is important to remember that lymphoid tissue is extremely sensitive and responds to two factors:

• 1 ARVI diseases (during viral infections, lymphoid tissue begins to grow - these are the adenoids);
• 2 The quality of the air that a child prone to adenoiditis breathes (by inhaling moist and cool air, the child helps the adenoids enlarged due to ARVI to quickly decrease to normal).

As in the treatment of ARVI, air parameters are of great importance. Humid, fresh and cool air promotes rapid recovery; dry and warm air, on the contrary, will cause the mucous membrane to dry out and cause additional mucus formation in the nasopharynx.

Alas, for the treatment of adenoids in children as such, there are no “magic” drops, syrups, tablets or any other means - it is in no way possible to “spur” the lymphoid tissue to shrink.

There is only one exception to this rule - allergic adenoiditis. That is, when the adenoids increase in size not due to the growth of lymphoid tissue, but due to swelling in this tissue. In this case, antihistamines can help reduce swelling and restore the nasopharyngeal tonsil to its previous size.

There are only two treatment options for adenoids in children: remove them surgically or not remove them. There are clearly defined indications for removal.

Indications for adenoid removal in children

All over the world, adenoids are removed according to strict indications - if they are present, then the child needs to have their adenoids removed and this is not disputed. If there are no such indications, then there is no need for removal either.

So, in what cases is surgical intervention to remove adenoids for a child necessary and mandatory:

• prolonged absence of nasal breathing;
• snoring during sleep;
• sleep disturbances (they are also associated with the fact that the child cannot breathe freely through his nose during sleep);
• shortness of breath during sleep;
• hearing impairment;
• recurring otitis media;
• chronic;
• deformation of the facial skeleton in a child (the so-called “adenoid face”).

The main indicator among this “bouquet” is a persistent lack of nasal breathing.

If the child continues to breathe through the nose, the need to remove the adenoids is negligible.

If adenoids are removed before the age of 3-4 years, there is a high chance that they will grow back. If the operation is performed on a child aged 6-7 years or older, then the adenoids are unlikely to reappear - the activity of the lymphoid tissue by this time is already significantly reduced. But if a child has indications for surgery to remove adenoids, his age does not matter! It is criminally dangerous not to perform the operation, for example, at 4 years old, and wait until the age of 6 (so that the adenoids do not grow back after the operation). If there are indications for surgery, it should be removed as soon as possible. Otherwise, you can “earn” a lot of dangerous complications, including hearing loss, chronic otitis media, deformation of the facial skeleton and others.

What is an “adenoid face” in a child? Doctors use this term to designate a specific facial deformation in children who have been unable to breathe through their nose for a long time. In the vast majority of cases, such a transformation occurs precisely because of enlarged adenoids, which block the nasal passages with their mass. Such children begin to sleep differently, eat differently, speak differently, their bite gradually changes and their facial features acquire characteristic features. If the adenoids are removed and the baby’s nasal breathing is restored, in most cases it is possible to “return” the child’s previous face, but sometimes the changes become irreversible - the facial skeleton not only transforms, but also strengthens as the child grows older.

How to remove adenoids in children: nuances of the operation

Removal of adenoids in children became common practice around the beginning of the 19th century. Of course, in those days there was no talk of any anesthesia. Over the years, doctors began to use local anesthesia (a special solution was instilled into the nose, which temporarily “froze” the nasopharynx area. But no local anesthesia can relieve children from the fear of a doctor with a “knife” in his hands.

Therefore, in our humane times, they practice short-term general anesthesia when removing adenoids in children, which allows the baby not to be scared and not remember the operation itself, and for the doctor to carry out all the manipulations as accurately and quickly as possible.

How long does it take to remove adenoids in children? The operation itself to remove adenoids (adenotomy) in children takes 5-7 minutes maximum. Moreover, laser and endoscopic removal are becoming increasingly widespread these days. In the first case, a laser beam acts as a “tool”; in the second, the cutting of the adenoids itself is carried out using a scalpel, but then the cut sites are “cauterized” in a special way (this is called electrical coagulation), which helps to avoid severe bleeding and the reappearance of adenoids in the same place place.

Modern surgical operations to remove adenoids in children are extremely low-traumatic and do not threaten children with any negative consequences for health or psyche. This is confirmed by millions of similar operations that are carried out annually all over the world.

Theoretically, after the operation, the child can almost immediately return to his everyday life and normal diet - the fact of removal of the adenoids does not imply any special dietary restrictions.

If your child has difficulty swallowing some time after surgery, paracetamol or ibuprofen can be given as a pain reliever. But if you believe the statistics, this problem (pain after adenoid removal) affects only 25% of operated children. Everyone else feels no pain or discomfort when swallowing.

Often, after surgery to remove adenoids, doctors recommend giving the child something soft and cold to eat - ideally ice cream is suitable for this purpose.

It's hard to imagine a more suitable occasion to allow a child to eat ice cream to his heart's content than an operation to remove adenoids. On the one hand, ice cream has a slight anesthetic property, on the other hand, it helps healing (the cold product causes the blood vessels to constrict and thus minimizes possible bleeding), and finally, ice cream perfectly compensates for all children’s fears and worries about the surgery.

At the age of 3-4, adenoids bother many children - this is a very common childhood disease. The main reason for the occurrence of adenoids is frequent viral diseases, in everyday vocabulary - “endless colds.”

And despite the fact that the most common result of the “struggle” with children’s adenoids is surgery, there is no point in being afraid and avoiding removal. If there are indications, you need to cut! Moreover, it is difficult to imagine a simpler and less traumatic pediatric “surgery”...