Contents
The most common pathological condition that occurs in children of the age category from 3 to 7 years is hypertrophied adenoids. Adenoids in medical circles mean nasopharyngeal tonsils, which, when hypertrophied, can make it difficult for a person to breathe, upset hearing and cause other complications. Adenoiditis is a disease, the main characteristic of which are hypertrophied adenoids. At the same time, the physical, psychological and mental state of the child can suffer greatly.
Pathology develops due to possible past infections, such as influenza, scarlet fever, measles, or due to the fact that at the described age in humans, these tonsils grow much faster than all other cells of the body. If it is not possible to effectively treat adenoiditis with conservative means, specialists offer, in modern conditions, an operation to remove adenoids.
Signs of adenoiditis
Adenoids themselves are a formation of lymphoid tissue, which is located in the nasopharynx. They can also be called nasopharyngeal tonsils.
Such lymphoid formations represent organs of local immunity in the human body, and they are present in every person from birth. Under the influence of inflammatory processes, such tonsils tend to increase.
At the same time, due to the rapid growth, the adenoid tissue begins to close the gaps in the upper respiratory tract, which ultimately makes it difficult to breathe, limiting the penetration of oxygen into the lungs.
Such processes lead to fatigue in babies, high fatigue, and a low level of concentration. The most severe consequences of adenoiditis are neurological disorders.
Externally, the occurrence of adenoiditis can be manifested in the fact that the child stops breathing through the nose, and during sleep, his breathing often turns into snoring. These processes can greatly influence the formation of a growing facial skeleton, which in the future will lead to the emergence of the so-called specific “adenoid face”.
Also, not far from these tonsils in the nasopharynx, there are also the mouths of the auditory tubes connecting the middle ear with the nasopharyngeal cavity. Enlarged tonsils can also block the organs of hearing, which will lead to severe otitis media or to a decrease in hearing itself.
Adenoiditis can occur in the following forms:
- acute;
- subacute;
- chronic.
Other complications caused by hypertrophied tonsils include sleep apnea or snoring during the night, when breathing may stop completely for a short time. Such processes adversely affect the development of a rapidly growing child’s body. During the day, the child can cough with a dry cough, he may experience jumps in body temperature, and purulent discharge from the nasal passages can also be constantly observed. If the above signs are found in a small child, it should be urgently shown to an otolaryngologist in order to avoid unnecessary difficulties and complications in the future.
Methods for diagnosing and treating the disease
During the traditional rhinoscopy procedure, adenoids are very difficult to visualize, which is why otolaryngologists need to perform fluoroscopy to diagnose adenoiditis, which can reveal the stage of adenoid hypertrophy, as well as endoscopy, which is performed to clarify all the details of the pathology existing in the child. In addition to the direct size of the tonsils, for a specialist, their location is important so that the most effective method can be chosen for treatment.
If the use of conservative methods of therapy does not bring any results, or the results are unsatisfactory, experts recommend surgical removal of the adenoids in order to avoid hearing loss.
The decision on adenotomy should be made individually, depending on the condition of a particular child, since it is not advisable to remove the tonsils simply because there are signs of the disease – before the age of seven they will grow again and it is possible that the operation will have to be repeated.
Adenotomy is traditional and endoscopic. Removal of adenoids by the traditional method involves surgical excision of the tissue with special surgical instruments. Such an intervention can be carried out both under local anesthesia and under general anesthesia – it all depends on the condition and age of the child. With this method of removing adenoids, an annular specialized knife is inserted into the nasopharynx, pressed against the arch, captures the adenoid tissue and is sharply cut off. In this case, frequent complications are damage to the sky, the occurrence of bleeding.
Endoscopic removal of adenoids is performed with a video endoscope under general anesthesia. Visualization of the entire space on which the intervention is carried out allows you to completely eliminate the lymphoid tissue and avoid all sorts of complications or relapses.
Endoscopic removal (it is also called laser) is carried out within an hour, after which the child is under the supervision of medical personnel until the end of the day and goes home. The recovery period in this case is only 1 week. At the same time, nasal breathing improves in the child almost immediately after the operation, although nasal or nasal congestion may also occur, which should disappear a week after the operation.
Indications and efficacy of tonsil removal
The indications for the removal of the tonsils are not their overgrown size, but the symptoms that are observed in the patient and interfere with normal life. Often there are situations when the anatomical features of a child allow adenoids of the third degree to exist normally in the body and moderately interfere with breathing. In this case, it happens that even with the first degree of growth of lymphoid tissue in a person, hearing is reduced.
On the eve of the operation, it is necessary to be fully examined. Surgery is not recommended during periods of seasonal exacerbations of diseases and epidemics in order to avoid complications.
After the surgical intervention, there are practically no contraindications, among the most common restrictions there is only a ban on the use of hot and hard food in the first days after the intervention.
With classical surgery, it is impossible to completely remove the entire tissue of the tonsil, so the adenoids can begin to grow again (moreover, this will definitely happen when the child is in the range of 3 to 7 years). Therefore, it is better to prefer the endoscopic method of surgery. It is important to understand that the role of adenoids in the body is protection from the penetration of pathogens. When removing the tonsils, the damage to the immune system will be very noticeable, which is why surgery in this matter is an exceptionally last resort.