Ade­noids are one of the most com­mon ENT patholo­gies in child­hood. From a mor­pho­log­i­cal point of view, this dis­ease is man­i­fest­ed by hyper­tro­phy (exces­sive growth) of the lym­phoid tis­sue of the nasopha­ryn­geal ton­sil. In the vast major­i­ty of cas­es, this phe­nom­e­non is diag­nosed in chil­dren aged three to ten years, but there are excep­tions. In this arti­cle, we will look at ade­noids in the nose of a child in terms of symp­toms and treat­ment.

How do adenoids appear in children?

First of all, we note that the sever­i­ty of con­comi­tant symp­toms will depend on the degree of pro­lif­er­a­tion of lym­phoid tis­sue.

The pri­ma­ry clin­i­cal sign is a vio­la­tion of nasal breath­ing. It is dif­fi­cult for chil­dren with this dis­ease to breathe through the nose, some­times nasal breath­ing becomes almost impos­si­ble (with the third degree of hyper­tro­phy). Often this pathol­o­gy is com­pli­cat­ed by sec­ondary per­sis­tent rhini­tis, which fur­ther impairs the res­pi­ra­to­ry func­tion.

As a result of dif­fi­cul­ty breath­ing through the nose, such chil­dren sleep with their mouths open, usu­al­ly snore, and often wake up. Due to inad­e­quate sleep, a child with ade­noids becomes lethar­gic dur­ing the day­time, gets tired quick­ly, has dif­fi­cul­ty per­ceiv­ing new infor­ma­tion, begins to lag behind in learn­ing, and often suf­fers from headaches.

In the event that time­ly treat­ment is not car­ried out, ade­noids can cause var­i­ous dis­or­ders of the facial skele­ton and den­ti­tion, for exam­ple, the occur­rence of mal­oc­clu­sion.

In addi­tion, chil­dren with ade­noids have a nasal tone of voice — a nasal tim­bre, untoned speech.

In the absence of nec­es­sary med­ical care, ade­noids can lead to hear­ing prob­lems, impaired smell and swal­low­ing func­tion, and the devel­op­ment of chron­ic inflam­ma­to­ry process­es, for exam­ple, in the paranasal sinus­es.

Basic principles of treatment of adenoids in childhood

Basic principles of treatment of adenoids in childhood

As a rule, with the first or sec­ond degree of ade­noids, con­ser­v­a­tive tac­tics are rec­om­mend­ed. Note that all treat­ment should be car­ried out only under the super­vi­sion of a physi­cian.

Such chil­dren are advised to reg­u­lar­ly rinse the nasal cav­i­ty with saline solu­tions, use vaso­con­stric­tors (no more than 5–7 days). Local anti-inflam­ma­to­ry, antibac­te­r­i­al, anti­sep­tic agents may also be pre­scribed.

In addi­tion, inhaled glu­co­cor­ti­cos­teroids can be used. In 2020, sci­en­tists from the Nation­al Med­ical Research Cen­ter for Otorhi­no­laryn­gol­o­gy of the Fed­er­al Med­ical and Bio­log­i­cal Agency pub­lished a paper that proved the pos­si­bil­i­ty of using inhaled glu­co­cor­ti­cos­teroids in the treat­ment of chil­dren with nasal breath­ing dis­or­ders due to hyper­tro­phy of the nasopha­ryn­geal ton­sil.

Addi­tion­al­ly, var­i­ous phys­io­ther­a­peu­tic meth­ods are shown, for exam­ple, UHF ther­a­py or mag­ne­tother­a­py.

In the absence of the effect of con­ser­v­a­tive treat­ment, as well as in the third degree of hyper­tro­phy, the pres­ence of oth­er indi­ca­tions, for exam­ple, a pro­nounced vio­la­tion of nasal breath­ing, sur­gi­cal inter­ven­tion is per­formed — removal of ade­noids in chil­dren. It can be car­ried out using both clas­si­cal and min­i­mal­ly inva­sive meth­ods.

Oto­laryn­gol­o­gy / Palchun V.T., Kryukov A.I. - 2001

Inhaled glu­co­cor­ti­cos­teroids in otorhi­no­laryn­gol­o­gy / Garashchenko T.I., Taraso­va G.D. // Med­ical advice - 2020 - #1