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May 13, 2011
Adenoid growths (in use – "adenoides") – one of the most widespread LOR-pathologies at children's age. As a rule, meets at the age of 3-10. The disease is expressed in increase (hypertrophy) in a pharyngeal almond which is anatomically located on a back upper wall of a nasopharynx.
In view of that at this age there is an active growth and development of an organism of the child, this disease can have a number of negative effects. Adenoides can lead to development of chronic diseases which pursue the person for the rest of the life. Children who have adenoid growths can lag behind in development the peers.
As adenoides are formed
Pharyngeal almond – one of links of important anatomic education, a so-called, lymphoid ring of Pirogov-Valdeyera. It is some kind of barrier to penetration into an organism of a bacterial infection. The adenoid tissue of which the pharyngeal almond mainly consists interferes with penetration of causative organisms during a breath or meal.
The almond increases in sizes in proportion to growth of an organism for the purpose of ensuring its normal functioning. However, the high level of a bacterial obsemenennost, insolvency of immune system at children's age lead to the fact that there is a compensatory increase in quantity of immunocompetent cells which cannot qualitatively provide protection against invasion of an infection.
Further progressing of process of growth of a pharyngeal almond can lead to development of morbid condition. In this process allocate three stages which define the course of a disease and tactics of treatment. At the 1st stage the expanded almond closes only upper part of the nasal courses, at the 2nd stage there is a closing of the most part of the nasal courses, at the 3rd stage already full closing of the nasal courses is observed.
Symptoms of a hypertrophy of a pharyngeal almond and diagnosis of adenoides
At the initial stage when symptoms of adenoides only begin to appear, nasal breath is at a loss, there is snore at night, afterwards children begin to breathe only through the mouth. Also the timbre of a voice can change: to gain twang, to become very thin, unpleasant.
As a rule, allocations from a nose which can have mucous, and also purulent character are observed. Deterioration in hearing can be observed. Also the general condition of the child is broken: there are a fatigue, tearfulness, a sleep disorder and appetite, pallor. Also perhaps involuntary urination at night. With disease symptoms of adenoides become more noticeable.
If you found the described symptoms of adenoides in the child, it is desirable to address the specialist as soon as possible, in order to avoid complications further. It is necessary to define extent of growth of a pharyngeal almond for the solution of a question of a possible operative measure.
Exact diagnosis of adenoides is in most cases possible at usual survey at the ENT specialist and carrying out an indirect rinoskopiya – survey using a special small pocket mirror (often the increased almonds can be seen through a nose). Survey as a rule, does not cause discomfort or pain. Sometimes, if necessary, can resort to X-ray inspection of a skull in a lateral projection.
Reasons of emergence of adenoides
The increased pharyngeal almond which is carrying out a role of a barrier to penetration of bacteria turns into the center of persistent infection. It leads to increase of a susceptibility of an organism to various alien agents – both a bacterial, and not bacterial origin, so-called, to allergens.
Such "allergic readiness" leads to further development of inflammatory process, one of components of which, further growth of fabric of a pharyngeal almond is. There is "vicious circle" of persistent infection and an allergy.
Persistent infection has the systemic toxic effect on an organism. The increased pharyngeal almond blocks intake of air through openings in a nasopharynx. Nasal breath is replaced with breath through a mouth, at the same time the arriving air is not moistened any more, not warmed and not purified. It provokes development of frequent catarrhal diseases: sinusitis, tonsillitis (quinsies), pharyngitises, laryngitis, tracheitises.
Prevention of adenoides
The course of a disease in many respects depends on specific features of an organism. Therefore prevention of adenoides has, as a rule, nonspecific character. First of all, it is necessary to eliminate the centers of persistent infection (for example, antritis, rhinitis, tonsillitis). An important point is the correct performance of hygienic procedures.
So, during "smorkaniye" the child needs to clamp serially one nostril, and then another. Otherwise, at simultaneous closing of both nostrils during the strengthened exhalation, air with the microorganisms which are in it, gets through acoustical pipes into a tympanic cavity, and can become the reason of an inflammatory disease – average otitis.
After a clearing of the nasal courses, apply vasoconstrictive drops (for example Nazivin, Otrivinum, etc.) to improvement of nasal breath. Drops, as a rule, are not recommended to be accepted it is long.
One of methods which prevention of adenoides means is the hardening, and respiratory gymnastics. In order to avoid complications it is necessary to carry out systematically preventive actions and to carry out the appointments made by the children's otorhinolaryngologist.
Complications of adenoides
At adenoides children often have chronic vasculomotor rhinitis, antritis, an eustachitis, average otitis, bronchitis, bronchial asthma, but these are not the only complications of adenoides. Adenoides also lead to neurologic disturbances (headaches, dizzinesses, a sleep disorder, a night incontience, epilepsy, disturbances from cardiovascular system, a digestive tract).
It is explained by disturbance of nasal breath, emergence of the developments of stagnation complicating outflow of a venous blood and lymph from a head cavity, neuroreflex mechanisms, disturbance from a vegetative nervous system (development of vegeto-vascular dystonia).
Treatment of adenoides
Perhaps conservative (without surgical intervention) and operational treatment of adenoides. At insignificant increase in a pharyngeal almond and rare complications carrying out complex treatment which combines use of medicines, carrying out physiotherapeutic procedures, hardenings, respiratory gymnastics, washing of a nose special disinfecting solutions is possible.
The main objective which is pursued by treatment of adenoides, – normalization of nasal breath. It is possible to use short time of a drop in a nose (nazivin, Otrivinum, pinosol). It is necessary to be observed systematically at the otolaryngologist.
But often nevertheless it is necessary to resort to an adenotomy, this surgical removal of almonds. Operation can be carried out under local anesthesia or under the general anesthesia. The choice of a method of anesthesia depends on the chosen operation method (a cryolysis, the laser, endoscopy). The important aspect is "impressionability" and an emotional condition of the child.
The children with the expressed emotional or nervous lability feeling fear of the forthcoming intervention cannot carry out an adenoektomiya at all "I acquire" as it can put to the child a severe psychological injury. Removal of almonds is short operation which lasts only several minutes, and in opportunities of the little patient allow to go home already next day after the performed operation.
The most important in carrying out operation irrespective of a performance method (laser, endoscopic, traditional) is the most adequate removal of fabric of a pharyngeal almond since the remained adenoid tissue can recrudesce. It occurs because in the course of operation (as a shape of a nasopharynx all different) can have not remote some part of adenoides which begins to grow.
Section: Diseases of an ear throat-nose