Adenoids in children - proliferation of tissues of the pharyngeal tonsil, provoked by hyperplasia of lymphadenoid tissues. A pathological increase in the size of the immune organ causes difficulty in nasal breathing, rhinophonia, hearing impairment, frequent relapses of colds, lingering rhinitis and asthenic syndrome.
Adenoid vegetations are often diagnosed in young children from 3 to 8-9 years old, since it is during this period that the development of the nasopharyngeal tonsil is observed. Diagnosis of ENT pathology consists of endoscopic rhinoscopy, computed tomography of the nasal cavity, digital examination of the hypertrophied organ and posterior rhinoscopy. Treatment involves taking medications of antibacterial and anti-inflammatory action, as well as carrying out surgery in case of critical proliferation of adenoid vegetations.
About anatomy
Where are the adenoids in the child? The nasopharyngeal tonsil is a local immune organ located in the fornix of the nasopharynx. Excessive hyperplasia of lymphadenoid tissues leads to blockage of the auditory and nasal canals, which entails complications in the form of catarrhal otitis media, lingering rhinitis, eustachitis, etc.
In otolaryngology, an increase in adenoids is diagnosed in about 30% of children under the age of 12. After puberty, the immune organ degrades and almost completely disappears by the age of 16-18. However, in about 2% of cases, the nasopharyngeal tonsil does not atrophy even after puberty, which can cause organ hypertrophy and inflammation.
What are adenoids and what are they for? Adenoids are an enlarged nasopharyngeal tonsil, which is located in the upper part of the nasal cavity. Together with other lymphadenoid components, it forms the Valdeyer-Pirogov ring. The immune organs prevent the reproduction of opportunistic microorganisms in the upper respiratory system.
Normally, the pharyngeal tonsil looks like a small tubercle under the pharyngeal mucosa. However, in the case of the development of inflammatory processes, the number of structural elements in the lymphadenoid tissue increases, which leads to the proliferation of the organ. Adenoid vegetations partially or completely block the pharyngeal openings of the auditory tubes and choans (nasal canals), which entails functional disorders in the ENT organs.
Causes of hypertrophy
What are the reasons for the formation of adenoids in a child? Hyperplasia of adenoid tissues is often caused by endocrine diseases, lymphatic-hypoplastic diathesis and autoimmune disruptions. Very often, pathology is found in patients aged 3-4 years, since it is during this period that the active development of the nasopharyngeal tonsil begins.
Organ hypertrophy may be associated with the adverse effects of intrauterine infections on the functioning of the immune system.
The toxic effect of medicines and ionizing radiation leads to a decrease in immunity and, as a result, allergization of the child's body. Excessive growth of adenoid vegetations is promoted by frequent inflammation of the mucous membranes of the laryngopharynx and nasal cavity.
Most often, hyperplasia of lymphadenoid tissues is caused by the influence of the following factors:
- poor nutrition;
- childhood diseases (whooping cough, scarlet fever, measles);
- chronic rhinitis;
- unfavorable ecology;
- hypovitaminosis;
- fungal invasions;
- secondary immunodeficiencies;
- instability of hormonal levels;
- irrational intake of medications;
- tendency to allergic reactions.
The proliferation of adenoid tissues in children is associated with the natural formation of the immune system.
The failure of adaptive immunity, along with persistent microbial contamination, is one of the key causes of lymphocytic-lymphoblastic hyperplasia of glandular tissues. An increase in the volume of lymphoid tissues is associated with the formation of a compensatory mechanism in response to an excessive infectious load. An overgrown immune organ can be located directly above the vomer and choans, provoking a violation of nasal breathing and the ventilation function of the Eustachian tubes.
The degree of development of adenoids
The clinical picture largely depends on the degree of tissue proliferation of the nasopharyngeal tonsil. Enlarged adenoids negatively affect the patient's quality of life, and in some cases interfere with the normal mental and physiological development of the child. In otolaryngology, 3 degrees of proliferation of adenoid vegetations are distinguished, depending on the severity of organ hypertrophy:
- Grade 1 - hypertrophied adenoid tissue covers only 30% of the vomer and nasopharynx; the symptoms of pathology appear only at night and are characterized by a slight disturbance of breathing through the nose and puffing during sleep;
- Grade 2 - hyperplastic lymphadenoid tissue overlaps about 50% of the vomer and nasal canals, as a result of which the baby may complain of severe difficulty breathing, dry cough and constant accumulation of mucus in the laryngopharynx;
- Grade 3 - the hypertrophied amygdala almost completely blocks the nasal passages and the vomer, which prevents breathing through the nose.
Violation of nasal breathing leads to oxygen starvation of the brain and, as a result, mental abnormalities.
If treatment is not started on time, the nasopharyngeal tonsil will enlarge until it completely blocks the mouth of the Eustachian tubes and nasal canals. Airway obstruction leads to the development of serious local and systemic complications, leading to persistent hearing loss (conductive hearing loss) and chronic inflammation of the nasopharynx.
How to recognize pathology?
Can adenoids be recognized in a 2-year-old child? The clinical manifestations of adenoid vegetations are often confused with the symptoms of rhinitis, so many parents are in no hurry to seek help from specialists. Late diagnosis and treatment often entail the development of side diseases such as otitis media, sinusitis, bacterial pharyngitis, etc.
A hypertrophied immune organ located in the fornix of the nasopharynx prevents the outflow of mucus from the nasal passages and tympanic cavity. If the patency of the airways is not restored, this will inevitably lead to inflammation of the paranasal sinuses, middle ear, laryngopharynx, etc. It should be understood that a 3-year-old child is unlikely to independently complain to his parents about the deterioration of health. In time, adenoids can be identified in young children by the following symptoms:
- lingering rhinitis;
- dry cough after sleep;
- swelling of the nasopharynx;
- frequent mouth opening;
- memory impairment;
- lethargy and depression;
- headache;
- mucous nasal discharge;
- rhinophonia (nasalized voice);
- enuresis;
- fast fatiguability.
Shallow breathing through the mouth leads to deformation of the chest, as a result of which it takes the form of a ship's keel.
As a rule, hypertrophy of the adenoids leads to pathological changes in the shape of the dentition and bones of the facial skull. Subsequent narrowing of the alveolar ridge and abnormal development of incisor teeth entails malocclusion and lengthening of the face.
As a result of the overlap of the auditory tube openings by adenoid vegetations, the ventilation of the tympanic cavity is disturbed. Over time, this leads to the accumulation of serous effusion in the ear and, as a result, the development of conductive hearing loss.A decrease in local immunity increases the risk of infection of the mucous membranes of the upper respiratory tract and the development of respiratory diseases.
Inflammation of the adenoids
Septic inflammation of the adenoids in children (adenoiditis) is an infectious disease that occurs due to the development of pathogenic flora in the hypertrophied pharyngeal tonsil. The inflammatory process in the ENT organs is provoked by pathogenic viruses, fungi or microbes. Most often, adenoiditis is preceded by influenza, acute tonsillitis, pharyngitis, rhinitis, sinusitis and sinusitis.
In otolaryngology, two forms of ENT disease are distinguished:
acute adenoiditis (retronasal tonsillitis) - acute inflammation of adenoid vegetations, resulting from a decrease in local immunity;- chronic adenoiditis is a sluggish inflammation of the hypertrophied tonsil, which most often appears as a result of a previously transferred retronasal sore throat.
acute adenoiditis (retronasal tonsillitis) - acute inflammation of adenoid vegetations, resulting from a decrease in local immunity;Important! Airway obstruction due to the development of adenoiditis can lead to asphyxia and death.
The pharyngeal tonsil can become inflamed due to a violation of the outflow of mucus from the nasopharynx. The composition of the viscous secretion includes proteins, which are a suitable substrate for the development of opportunistic microorganisms. It should be understood that inflamed adenoids in children provoke the melting of soft tissues and the accumulation of pathological exudate in the nasopharyngeal cavity. Over time, this can lead to the formation of abscesses that make it difficult for air to pass through the larynx.
Symptoms of adenoiditis
How to determine the development of adenoiditis in a child aged 3 years? It is possible to suspect the development of an ENT disease by the characteristic symptomatic picture. High fever and lingering runny nose are the first signs of the development of retronasal angina in a child. Very often, inflammatory processes involve not only the pharyngeal, but also the palatine tonsils, which can lead to the development of complications.
Typical manifestations of adenoiditis include:
- nasal congestion;
- suffocating cough;
- chronic rhinitis;
- a sharp decrease in hearing;
- heat;
- swollen lymph nodes;
- Difficulty nasal breathing;
- pain in the larynx, radiating to the nose and ear;
- dryness of the mucous membrane of the oropharynx.
Septic inflammation leads to the appearance of general symptoms of intoxication. The child may complain of headaches, nausea, lack of appetite, fatigue, poor sleep, apathy, and myalgia. Untimely elimination of catarrhal processes leads to the appearance of suppuration in the lesions. The development of purulent adenoiditis is often accompanied by bacterial rhinorrhea and otitis media.
Important! With a sluggish inflammation of the pharyngeal tonsil, the temperature and symptoms of intoxication may be completely absent.
Treatment
What should be the treatment for a child with adenoids? At the initial stage of the growth of the immune organ, therapy is carried out with the help of drugs. When choosing suitable medications and methods of treatment, the following are taken into account:
- the degree of hypertrophy of the nasopharyngeal tonsil;
- the age of the patient;
- localization and prevalence of foci of inflammation;
- type of infectious agent;
- the presence of functional disorders of the immune organ.
In the case of a timely appeal to a pediatric otolaryngologist and undergoing drug therapy, inflammation regresses, and the size of the hypertrophied tonsil decreases. However, it should be understood that conservative treatment does not always give the desired therapeutic results.
In the absence of positive dynamics, the patient is prescribed an adenotomy, during which hyperplastic lymphadenoid tissues are removed using an adenotome or a laser.
Usually, the conservative treatment regimen includes:
- antibiotics;
analgesics;- antipyretic medications;
- antiallergic agents;
- local glucocorticosteroids;
- antiviral drugs;
- antiseptic solutions for nasal irrigation;
- anti-inflammatory aerosols for irrigation of the laryngopharynx.
analgesics;At the stage of resolving pathological processes, the child can be assigned physiotherapeutic procedures - UFO therapy, magnetotherapy, electrophoresis, etc. Apparatus treatment accelerates the regeneration of adenoid tissues and an increase in local immunity, which significantly reduces the likelihood of adenoiditis recurrence.
Prevention of adenoid hypertrophy
What should be the prevention of adenoids in children? Hypertrophy of the pharyngeal tonsil promotes inflammatory reactions in the upper respiratory tract. To prevent the proliferation of lymphoid tissues, it is necessary to treat the emerging respiratory diseases in time and increase the body's resistance.
Preventive measures to prevent hypertrophy of adenoid vegetations and adenoiditis are reduced to compliance with the following rules:
- hardening the body - walking in the fresh air, a contrast shower, playing sports;
- nutritional adjustment - including cereals, fresh fruits and vegetables in the diet;
- strengthening of immunity - the annual passage of vitaminized and immunostimulating therapy.
Chronic diseases greatly increase the risk of adenoid vegetation. It should be understood that at the third stage of proliferation of lymphadenoid tissues, conservative treatment will be ineffective. Only surgical treatment will help to facilitate nasal breathing and restore the functions of the nasopharynx. To prevent the development of pathology, it is necessary to timely treat respiratory diseases and, if necessary, rinse the nasopharynx with saline solutions and antiseptics.
Vitamin therapy
Vitamins are an important component that affects the resistance of the child's body to infections. A deficiency of biologically active substances often leads to a decrease in tissue reactivity and, as a consequence, the development of pathogenic flora in the respiratory organs. Replenishment of vitamins and minerals in the body helps to activate biochemical processes and strengthen immune defenses.
To reduce the likelihood of developing an ENT disease in a child, the following vitamins must be present in the body in sufficient quantities:
- retinol (A) - accelerates the epithelialization of the mucous membranes of the upper respiratory tract;
- thiamine (B1) - normalizes metabolic processes, as a result of which tissue reactivity increases;
- pyridoxine (B6) - stimulates the synthesis of immunocompetent cells in the body;
- cobalamin (B12) - takes part in hematopoiesis, restores the nervous system;
- ascorbic acid (C) - prevents allergization of the body and promotes the elimination of free radicals;
- tocopherol (E) - increases immune activity and promotes the synthesis of red blood cells.
Improper intake of vitamins can lead to hypervitaminosis and the development of dermatitis.
To strengthen the child's immunity, vitamin therapy should be taken 1-2 times a year on the eve of seasonal ENT diseases. The most effective vitamin and mineral complexes include "Kinder Biovital", "Multi-Tabs Baby", "Pangexavit", "Pikovit" and "Alphabet".
