Adenoids are enlarged tonsils that play a role in the body"shield" immune system, preventing the penetration of pathogenic microorganisms. With inflammation of the nasopharyngeal tonsils, a phenomenon occurs such as adenoid growths, which belong to the group of pathological ones. In some situations, adenoid removal in children is the only treatment option.

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Do I need to remove the adenoids?

Adenoiditis is typical only for children and can appear from 3 years old to 8-9 years old. In adults, tissue growth does not occur. But while the child is small, the main question must be resolved: is it worth removing the adenoids or can we do it in more gentle ways.

Opinions are divided into pros and cons of the procedure:

1. Opponents of the operation insist that removal of adenoids in children reduces protective properties immune system. After surgery, your baby will get sick more often and be more exposed to colds.
2. Proponents of removal (this includes most medical specialists), they believe that getting rid of tonsils is a way to alleviate the child’s condition when it is not possible to cure the disease by other methods.

Conservative treatment methods

Conservative treatment methods can be effective if you follow the recommendations of the doctor, who, after diagnostic measures will be able to determine a treatment regimen and choose the most appropriate method.

The most common conservative methods are:

1. Washing. You can rinse your nasal passages with infusions medicinal herbs or water with dissolved in it sea ​​salt or soda. The procedure should be carried out for a couple of weeks up to 3 times a day. Additionally, your doctor may prescribe the use of antiallergic drops. The disadvantage of the method is the short duration of the effect. After completing the procedures, the signs of adenoiditis return.
2. Antibiotics. Treat with antibiotics directly inflamed adenoids is useless, since lymphoid tissue has a low ability to absorb the active substances of medications. They are prescribed for secondary treatment infection that occurs against the background of inflammation of the tonsils.
3. General strengthening therapy. As prescribed by a doctor, herbal medicine, a complex of vitamins, ultraviolet irradiation, electrophoresis, breathing exercises or hardening. This method is a way to prevent the development of complications.
4. Homeopathy. The use of this method will be effective if monotherapy and the course of taking the drug are observed. Distinctive feature The method is the duration of therapy, which can take several months.
5. Cryotherapy. The essence of the method is to spray nitrogen onto the inflamed adenoids, after which their size decreases. Treatment is carried out only in modern clinics with necessary equipment. In this case, the probability of a positive result when using the method is 50 to 50%. Also, when using the method, it is possible side effects in the form of redness of the throat, rhinitis, swelling of the mucous membranes.

Whether treatment is possible without removing the adenoids can be found out from the video presented by specialists from the Echinacea Clinic. Ehinaceyaclinic channel.

Diagnosis of adenoids and indications for surgery

Removal of adenoids in a child is carried out exclusively on the recommendation of an ENT doctor. It is prescribed when the use of conservative methods has not led to a positive result.

The main indications for removal are:

• lack of results from the use of conservative methods;
• presence of grade 3-4 adenoids;
• more frequent relapses of the disease against the background chronic problems with kidneys, heart or joints;
• a sharp proliferation of lymphoid tissue, which leads to deformation of the jaw bones;
• increased frequency of apnea attacks (temporary cessation of breathing during sleep) and inability to breathe through the nose;
• chronic form of sinusitis.

Most often, the disease is diagnosed in children aged 2 years and older. It is recommended for a child to remove growths no earlier than 3 years. This is explained by the need to preserve the protective properties of the immune system of a growing organism.

At the first signs of the disease, you should contact a specialist who will carry out a diagnostic procedure. It includes a visual examination and medical history.

To assess the degree of adenoids, the following methods are used:

1. Pharyngoscopy. External inspection pharynx, pharynx and tonsils to determine the degree of hypertrophy.
2. Anterior rhinoscopy. Inspection of the nasal passages.
3. Posterior rhinoscopy. The doctor checks the condition of the nasopharynx through the mouth. This method is one of the most informative, but is complicated by gagging that may occur in the child.
4. Endoscopy. Viewing the internal state by inserting a tube with a camera.
5. Radiography. Method not used in modern medicine due to its harmfulness.
6. Audiogram. If there is a hearing impairment, the doctor may additionally send the child for testing.

Diagnosis is carried out in a “healthy” period, when at least 2 weeks have passed since the complication of the disease.

Preparing for surgery to remove adenoids

Before surgery is scheduled, the patient is admitted to the hospital for testing and evaluation. general condition health.

The following tests are carried out in advance:

• urine test;
• drawing blood from a finger;
• electrocardiogram;
• blood test for hepatitis;
• BAK culture of the nasal and oral cavity;
• biochemical blood test;
• Ultrasound examination of the nasal sinuses.

Contraindications

Contraindications to surgical intervention are:

• congenital anomalies of the hard or soft palate;
• tendency to bleed;
• blood diseases;
• pathologies of the cardiovascular system of severe form;
• inflammatory process occurring in the adenoids.

Also, operations are not prescribed during a flu epidemic and for a month after the child has undergone routine vaccination.

Methods of pain relief

Before surgery, many parents are concerned about the pain of the future intervention. Previously, no types of anesthesia were used when performing adenotomy, which led to severe stress both the child and the parent. Modern ENT clinics use anesthesia during surgery.

There are two types of pain relief:

1. Local. The local anesthesia procedure is mainly used for adenotomy in adolescence or adulthood. Under local anesthesia, during the surgeon’s manipulation the patient remains conscious, can observe the procedure, but he does not feel painful sensations. Anesthetic drugs are Lidocaine or Ultracaine, which are applied by spraying or dabbing with a cotton swab.
2. General. This type of anesthesia has found wide application in ENT practice. It is more often used during surgery in childhood. Under general anesthesia, the child is unconscious, which relieves him of stress, and gives the doctor the opportunity to remove excess tissue with microscopic precision. Contraindications to the use of general anesthesia are the presence mental disorders, pathology internal organs, severe forms of neurology.

Most clinics for adenotomy use “gentle” compounds for general anesthesia, after which the child returns to consciousness quickly. But every parent should prepare themselves that after waking up, the child may experience a slight increase in body temperature, drowsiness, lethargy, and loss of appetite.

Removal methods

Modern surgery offers several ways to remove adenoids in children. The choice of a specific method depends on individual characteristics body little patient and the level of equipment of the clinic.

Instrumental (traditional)

The most common is classic way, in which the adenoids are removed with a special device, a Beckman knife. At this method local anesthesia is used. If the removal occurs in the nose, then the anesthetic solution is applied with a cotton swab; if the location is the oral cavity, then in the form of a spray.

A Beckmann knife is a special type of ring-shaped scalpel, shaped like a loop, one part of which has sharp edges. During the operation, the lymphoid tissue is not cut, but torn, which reduces bleeding.

Advantages and Disadvantages

The advantage of the method is that there is no need to place the child under general anesthesia and the possibility of removing even grade 3 adenoids. But the method has more serious disadvantages, highlighted by specialists and pediatricians. Since the operation is performed under local anesthesia, the child sees and feels the surgeon’s actions. This leads to severe psychological stress, which can cause serious injury.

The second disadvantage of this method is the “blind” method of cutting tissue. If the surgeon does not remove all the damaged areas, then there is a high probability of re-growth.

Radio wave

The essence of the method is to use a special device, Surgitron, which leads to the melting of the affected tissue. The operation is performed under general or local anesthesia. For patients younger age The first method of pain relief is used; older children are prescribed the second.

Advantages and Disadvantages

This method causes minimal discomfort to the child while the tissue heals quickly after surgery. The downside is high cost a procedure that makes it unaffordable for most parents.

Among the contraindications for radio wave adenotomy are:

• presence of cancer;
• age under 3 years;
• congenital deformation of the facial bones;
• problems with blood clotting.

Laser removal of adenoids

Laser therapy is increasingly used during surgical operations. The principle of the method is to use a directed light flux of a certain frequency, wavelength and degree of polarization. Lasers can be high-frequency and low-intensity. During removal, the tissue is cut off with a laser. This method is used for younger children.

There are two varieties:

• coagulation used to remove large growths;
• valorization, when you need to get rid of minor inflammations, which are cut off gradually, in layers.

Advantages and Disadvantages

Among the advantages of the method are its bloodlessness, absence of pain, and rapid healing. The operation is performed under general anesthesia. The disadvantages of this method are its high cost and low distribution.

The technology also has contraindications:

• purulent diseases of the mouth or nose;
• anemia;
• open tuberculosis;
• oncology;
• pathologies of the heart muscle or blood vessels.

Removal of adenoids with a shaver (microdebrider)

This method of surgical intervention, according to many pediatricians, is the most in an effective way treatment of adenoids in children. The essence of endoscopic removal is the use of a special device, a microdebrider, which is an instrument with a rapidly rotating head equipped with a blade. During the procedure, the overgrown tissue is excised, which is aspirated into the suction. Manipulations are performed under general anesthesia with parallel endoscopic control.

Advantages and Disadvantages

The advantages of the method are the ability to remove adenoid vegetations as completely as possible without damaging healthy areas of the mucosa, and minimizing the risk of relapse. Due to its effectiveness this method The treatment has virtually no drawbacks and is considered one of the best removal methods.

Postoperative care

Modern methods of removing adenoids are low-traumatic, practically bloodless and occur with minimal complications. This allows the little patient to return to his normal life a short time after the operation.

Staying in hospital

During the first few hours after completion of the operation, the child is placed in the ward intensive care, where doctors monitor his condition. This is required to carry out timely measures in the event of a complication, such as bleeding, surges in blood pressure, cardiac dysfunction, or difficulty recovering from a state of general anesthesia.

In the absence of side effects, the body can cope with the relief on its own surgical field, which occurs just a couple of hours after surgery. If no complications are observed, the child may be sent home.

At home, parents need to follow a set of measures to prevent relapse:

• taking vasoconstrictor medications prescribed by a doctor;
• restriction of physical activity for at least two weeks;
• exclusion of hot solid foods from the diet;
• avoiding exposure to open sun;
• restrictions on visiting large gatherings of people;
• refusal to take a bath for 4 days after surgery.

Possible consequences

Very often, after an operation to remove adenoids, parents complain that the child has mucous discharge from the nose and cough. Doctors say that similar phenomenon- the norm, since over the course of several days there is an outflow of mucus from the vacated nasal sinuses.

But any operation can have complications. In the case of adenotomy, they can be as follows:

1. Manifestation of fever. A slight increase in temperature after resection should not worry parents. It usually goes away within a couple of days. If the temperature lasts longer than 4 days, you should consult a doctor. This may be evidence of a viral disease.
2. Snore. The appearance of snoring after surgery is a reason to consult a specialist. The causes of impaired breathing may be incomplete resection of damaged tissue, enlarged tonsils, or non-compliance with recommendations in the postoperative period.
3. Disruption of the gastrointestinal tract. Diarrhea, nausea, vomiting are natural reaction of the body to the drugs used for adenoidectomy. Children with poor health react more acutely to medications.
4. Ascites of surgical tissues. If painful swelling occurs in the nasopharynx area, which does not go away throughout the day, it indicates ascites. Physician intervention is necessary, since with the growth of the visceral epidermis there is a risk of asphyxia.

Cost of the operation

The cost of the operation will depend on the severity of the disease and the pricing policy of a particular medical institution.

The average price of the service is:

• laser removal of adenoids – 10-25,000 rubles. In some clinics the cost can reach 40,000 rubles;
• radio wave adenotomy – 20-25 thousand rubles;
• endoscopy – 30-40,000 rubles.

The price includes anesthesia and postoperative observation in the hospital. For additional fee clinics offer more long stay in the room together with the parent.

In most cases, adenotomy is performed in an outpatient setting, mainly in the morning. The operation itself lasts no longer than 10 minutes, after which the little patient must remain under medical supervision for about 5 hours, then, if there are no complications, he is sent home. Less often, a child needs to be hospitalized in a hospital if side effects from anesthesia or bleeding occur.

When does conservative treatment fail?

Many parents postpone surgery, trying to find an alternative in . Today there are many treatment methods by medication, but, as practice shows, they rarely bring positive result. Complex cases require surgery. It is after adenotomy that many health problems can be avoided.

The decision on surgical treatment is made when the following symptoms and pathologies:

• the child is seriously impaired nasal breathing- he practically does not breathe through his nose;
• the child sniffs heavily during sleep, and attacks of apnea are observed - holding the breath for up to 10 seconds, which causes the development of constant hypoxia during sleep;
• slurred and nasal speech;
• hearing loss occurs due to the accumulation of mucus and inflammatory process in the middle ear - exudative;
• the child gets sick a lot and relapses of otitis media, bronchitis, and pneumonia often occur;
• overgrown adenoids cause the development of maxillofacial anomalies.

Medicines and folk recipes are not able to get rid of adenoids, the overgrown tissue of the tonsils will not go anywhere, on the contrary - in the absence surgical treatment it will grow even stronger. Therefore, adenoid surgery in children is a necessity.

Contraindications for surgery

Sometimes adenotomy can cause damage to the body.

The operation is not performed in the following cases:

• blood diseases;
• allergies in the acute stage;
• bronchial asthma;
• infectious diseases acute course- ARVI, influenza, intestinal infection etc.;
• heart and vascular diseases;
• age up to 2 years;
• congenital pathologies of the structure of the facial part of the skull (for example, cleft lip);
• the first month after vaccination;
• oncological diseases.

Features of the operation

All excited mothers and fathers whose children are scheduled for adenotomy are interested in the question of how adenoid surgery in children proceeds. Surgery is performed using anesthesia - local or general.

In the first case, the mucous membrane of the operated area is treated with an anesthetic, and a sedative is injected intramuscularly. In the second case, general anesthesia is used: the child is immersed in a medicated sleep, during which he does not feel pain and does not see what is happening.

How adenoid surgery in children proceeds depends on the equipment of the clinic and the characteristics of the pathology of the small patient.

Methods for removing adenoids in children:

• Classic adenotomy - the most common way. The operation to remove adenoids in childhood is carried out using an adenotop - a steel loop with a sharp edge. The procedure lasts several minutes, the technique is simple, but it has a significant disadvantage - the adenoids are removed by touch, there is no visual observation, and there is a possibility of partially damaging nearby tissues and organs.
• Aspiration adenotomy . In this case, the adenoids are removed not with a loop, but with a hollow tube, at the end of which there is a vacuum suction. The disadvantage is the same - the doctor cannot see the progress of the operation, so there is a risk of causing harm to another organ.
• Endoscopic adenotomy . The operation to remove adenoids in this case is carried out using an endoscope - a device that allows you to visually monitor the actions of the operating surgeon.
• . Laser removal of adenoids has several advantages - minimal blood loss and reduced risk of injury during the operation.
• Electrocoagulation . The adenoids are removed with a loop that has been exposed to heat.

How painful is the surgery?

Adenotomy is performed using local or general anesthesia. For example, in the West, any operation on the ENT organs is performed under general anesthesia. Our hospitals also practice this type of pain relief because it does not cause mental trauma to children. Removing adenoids in children under general anesthesia has a significant disadvantage - the risk of complications after surgery.

In other cases, adenotomy is performed using local anesthesia. The mucous membranes are treated with an anesthetic, and the procedure is almost painless. But local anesthesia has another disadvantage - the child is conscious and observes the entire surgical process.

Manipulation medical personnel, the sight of blood and surgical instruments causes stress in many children. To minimize its consequences, the child may be prescribed a sedative.

Sometimes adenotomy is performed without the use of any anesthesia if the child has contraindications to local and general anesthesia. From a physiological point of view, there is nothing critical in this, since there are no nerve endings in the adenoid tissue, and there should not be severe pain. But it’s still better to protect the child from stress as much as possible and numb the operating area with a local anesthetic.

Is surgery dangerous?

Adenotomy in children can have the following consequences:

• Complications after adenoid removal in children . Sometimes the operation is complicated or ends with intense bleeding, aspiration of the respiratory organs, injuries to the palate and complications of general anesthesia.
• Temporary decrease in immune defense . Most children, after adenotomy, forget what frequent colds, they really start to get sick less often. But sometimes the situation becomes reversed - the child begins to get sick more often against the background of reduced immunity. This is a temporary phenomenon; after a few months, the immune system returns to normal.
• Attachment of a secondary infection . Immediately after adenotomy, a postoperative wound surface remains in the nasopharynx, which can become susceptible to secondary infection, especially if the strength of the immune system is reduced. That is why, after surgery to remove adenoids in children, it is necessary to maintain a home regime and temporarily limit the child’s contact with peers.

Recovery period

Immediately after surgery to remove adenoids, the child is offered ice cream. A chilled treat helps constrict blood vessels.

Pain and discomfort during swallowing will annoy the child for several more days. To reduce pain, the doctor prescribes anesthetics and painkillers during the rehabilitation period.

After surgery to remove adenoids, children may vomit blood. This usually happens because the child swallowed blood during surgery. The same situation can happen with stool.

On the first day after surgery, body temperature may rise to 38°C. Use antipyretic drugs with acetylsalicylic acid in this case it is not recommended as this substance may cause bleeding.

For a while recovery period The doctor may also prescribe nasal astringents.

During the week it is forbidden to be in open sunlight, visit the bathhouse or take hot bath. For a month after surgery to remove adenoids in children, it is not recommended to swim in a pool or open water.

The child must stay at home for 2-3 weeks and is exempt from visiting kindergarten or schools. Can't study physical activity within a month.

The doctor may prescribe a gentle diet that excludes foods that irritate the mucous membranes: these are hot, hard, salty and spicy foods. In this case, the food should be fortified and high in calories.

The postoperative period after removal of the adenoids in children will be accompanied by nasal congestion and nasal sound. Similar signs go away on their own within a few days.

A month later, the ENT doctor should examine the child and determine the effectiveness of the adenotomy. As practice shows, in most children, improvements become obvious within a week after surgery to remove the adenoids.

Are there any guarantees that the operation will permanently get rid of adenoids?

Recurrence of adenoids is not uncommon after surgery.

The reasons for the regrowth of adenoids are:

• Incomplete removal of adenoid tissue, resulting from incorrect surgical intervention. If after adenotomy even a small fragment of pathological cells remains, adenoids may well appear again. In this case, a relapse can be eliminated by performing an adenotomy in a good clinic from an experienced specialist or by using general anesthesia, during which the child will not be able to prevent the doctor from grabbing the base of the adenoids with the adenotope. It is worth noting that after general anesthesia, the frequency of adenoid relapses is reduced to 30%.
• Early operation. Adenotomy can be performed in children over 3 years of age, of course, if there are no urgent indications for surgery.
• Allergic diseases in a child can also cause relapse of adenoids.
• Individual characteristics of the body determined by genetics.

In conclusion, I would like to say that unfounded fears on the part of parents before undergoing adenotomy for their child, most likely caused by personal unpleasant memories from childhood or horrifying stories from friends about this procedure.

Yes, several decades ago surgery was carried out without the use of any method of anesthesia, and the operation itself was accompanied by large blood loss. But these days, surgery to remove adenoids in children is performed efficiently and painlessly.

Useful video about performing an operation to remove adenoids in a child

Parents whose children are scheduled for adenotomy are often concerned about its outcome. No less worrying is the doctor’s message about what anesthesia the operation will be performed under. Doctors suggest performing this procedure using general anesthesia. This operation is not recommended for children with local anesthesia. But some doctors still use the old method of surgically cutting off adenoid growths without pain relief, and this often causes mental trauma from pain.

Surgical intervention requires an examination of the baby, a history study, and a history of hereditary diseases in the family. The condition of the little patient during the operation depends on this. It is necessary to exclude any problems that may result from the use of the type of anesthesia used.

The question of which pain relief is better and safer is always controversial. Severe pain, as well as general anesthesia is stress for the body. But still, this will avoid mental negativity. But local anesthesia is also used during such operations.

Classic removal method

This is an old method of adenotomy, without the use of anesthesia. In this procedure, a numbing drug may be injected through the nose and an excision may be performed. The operation is quick and has no complications. Its only drawback: the child can get mental shock from the pain.

Local anesthesia

This anesthesia is more often used when operating on children over 7 years of age, who can control their behavior. If a child is afraid of the sight of blood or is afraid of instruments, he needs to take sedatives before the procedure.

The positive aspect of local anesthesia is:

• absence of “side effects” after it;
• .low cost.

The negative point is that it is impossible to predict the child’s behavior, because he has never been in an operating room before or experienced such discomfort. The child may become hysterical.

Types of general anesthesia

The use of anesthesia during adenomectomy ensures small child blackout during surgical procedures.

Removal of adenoids under general anesthesia, carried out using an endotracheal tube, the respiratory organs are reliably protected, but the patient awakens after this method of anesthesia longer and wakes up more difficult. Fluorothane and nitric oxide are injected through the tube. This procedure is performed by an anesthesiologist. To perform the operation, the child is placed on his back.

A laryngeal mask is also used. After this anesthesia, the patient usually feels better and regains consciousness faster.

During adenoid removal surgery, various drugs eg isoflurane or sevoflurane. Desflurane or sevoran can be used.?

The most effective anesthesia is endotracheal. It is used for long surgical procedures and is complex because several drugs are used here.

After using a general anesthetic, it is suggested to use drugs that are introduced into the body through inhalation or other routes. To quickly bring a small patient out of unconsciousness, Propofol or anesthetics such as Sevoflurane and others are used. The baby's body perceives general anesthesia differently than an adult. In pediatric medicine, only proven medications are used that have undergone many tests. clinical trials. They are quickly eliminated, almost do not cause allergies, and have no negative consequences.

Children “come out of anesthesia” after a couple of hours. It all depends on the dose of the drug administered. After the baby wakes up, he is observed by an anesthesiologist for several hours.

Advantages and disadvantages of anesthesia

Removing adenoids in children under general anesthesia has many advantages. It allows you to:

• relieve the baby from pain during surgical procedures;
• reduce risk psychological trauma after surgery;
• there is no chance of inhaling pieces of the removed adenoids;
• low risk of bleeding;
• the surgeon works calmly.

General anesthesia is preferable if the child is unsteady. It is also used if the baby cannot tolerate the drugs used for local anesthesia. When the nasopharynx of a small patient has deviations in the anatomical structure and a special approach is required. In this case, surgery may take longer than usual.

The child is sleeping under anesthesia. He doesn’t see what the doctor is doing, he doesn’t see the bloody instruments. And when he wakes up after the operation, he does not feel the same acute pain, which children experienced in the years when such pain relief was impossible.

The anesthesia method is safe, with a low rate of complications during the operation. At the same time, the time for surgical adenotomy is reduced.

The main advantage of such anesthesia is convenience for the surgeon and the baby. The doctor does not have to divert his attention to the patient’s behavior - he will sleep, immobilized. That's why doctors prefer general anesthesia.

It is, of course, not difficult to cut off adenoids under general anesthesia, but such anesthesia also has disadvantages. The main one is the risk of complications. And chief among them is the danger of bleeding. But this happens extremely rarely.

In addition, the disadvantages of such anesthesia include:

Possible fluctuations in the baby’s body temperature, which may distract the doctor;

There is a risk of sleep and speech disturbances after anesthesia;

After the anesthesia wears off, the child may experience vomiting and headache.

Although up to 99% of operations take place without complications. There is zero damage to teeth and infection during surgical procedures.

When performing adenotomy under anesthesia, the problem of maintaining normal temperature body, hypothermia will occur. To prevent such a complication, the doctor, when performing procedures, pays attention to the temperature.

Important!

General anesthesia is considered to have a negative effect on the child's central nervous system and brain cells. When using anesthesia during the process of cutting off the adenoids, children are slowed down in development for some time. Hearing and sleep patterns are disrupted, and hallucinations appear. For this reason, it is better for older children to have the operation performed under local species pain relief.

Contraindications for general anesthesia

Any anesthesia has contraindications. Risks of complications during general anesthesia and its contraindications for the following diseases:

• chickenpox and other acute infections;
• chronic digestive disorders;
• heart pathologies;
• manifestations of rickets;
• pathology upper organs breathing;
• elevated temperature;
• mental disorders;
• on skin pustules were found;
• congestion of blood vessels;
• oncological diseases;
• bleeding disorders;
• Less than six months have passed since the vaccination.

General anesthesia is contraindicated for children under two years of age.

Popular question

How long does it take to remove adenoids in children?

The surgical procedure lasts no more than half an hour. The adenomectomy operation is a short surgical operation.

What anesthesia is best to use when removing adenoids?

The type of anesthesia depends on many things. This is decided by the doctor.

Is it painful to have adenoids removed?

Under general anesthesia, the patient does not feel anything. With local pain, no pain is felt, but the person is conscious. It only hurts when the operation is performed without anesthesia.

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 sit next to the mirror, open your mouth wider and look into literally words, into yourself, you will see two plum-shaped growths at 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 in last question Medical scientists still have not yet achieved clarity - 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 are of little interest to anyone, 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 constant serious illnesses(for example, or otitis media), in which case the adenoids are removed surgically. But don't be scared! The operation to remove adenoids lasts about 10 minutes and is one of the simplest and most safe 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 the very obvious symptom adenoids in children - the child lacks nasal breathing.

The diagram of the location of the organs shows that the nasopharyngeal tonsil is in close proximity to two extremely important “pathways” - 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 dangerous adenoids The following symptoms indicate:

• 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 a large share most likely the same problem will affect the child);
• Frequent respiratory viral infections, as well as such previous diseases like measles, whooping cough, scarlet fever, tonsillitis and the like;
• Predisposition to allergic reactions(although in this case the adenoiditis will be allergic in nature, and it will be quite possible to “defeat” it 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 baby correctly and promptly when 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 play a role great value. Moist, fresh and cool air promotes quick recovery, dry and warm - on the contrary, it will cause the mucous membrane to dry out and cause additional education mucus 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 it is necessary for the child to have the 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 surgery To remove adenoids, it is necessary and mandatory for a child to:

• prolonged absence of nasal breathing;
• snoring during sleep;
• sleep disorders (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 most dangerous complications, including hearing loss, chronic otitis, 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 long time there is no nasal breathing. 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 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 up.

How to remove adenoids in children: nuances of the operation

Removal of adenoids in children became common practice around early XIX 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, these days laser and endoscopic removal. In the first case, the “tool” is laser beam, 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 heavy bleeding and reappearance of adenoids in the same place.

Modern surgical operations to remove adenoids in children are extremely low-traumatic and do not pose any threat to children. 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 the 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 3-4 years of age, adenoids bother many children - this is very common childhood disease. Main reason the appearance of adenoids - 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”...