Adenoides – pathological growth of lymphoid fabric of a nasopharyngeal almond, are more often at children of 3-10 years. Is followed by difficulty of free nasal breath, snore during sleep, twang of a voice, nasmorka. Leads to frequent catarrhal diseases and an inflammation on average to fish soup, decrease in hearing, change of a voice, the muffled speech, an arrest of development, formation of the wrong bite. The diagnosis is exposed by the otolaryngologist on the basis of data of a faringoskopiya, rinoskopiya, X-ray analysis of a nasopharynx, an endoscopic research of a nasopharynx. During surgical removal of adenoides (an adenotomiya, cryodestruction) the recurrence of their growth is not excluded.
Adenoides – pathological increase in a nasopharyngeal almond. The disease comes to light at 5-8% of children aged from 3 up to 7 years, equally often affects boys and girls. At children of advanced age the frequency of incidence decreases. At patients 15 years are aged more senior the hypertrophy of a nasopharyngeal almond comes to light seldom though also adults in some cases can be ill.
Together and food, water and air the huge number of microbes gets into a human body through a mouth. In a drink there are lymphoid educations (almonds) which interfere with penetration of an infection and protect an organism from pathogenic microorganisms. Almonds form a pharyngeal ring (Valdeyra-Pirogov's ring). The nasopharyngeal almond is a part of a pharyngeal ring and settles down on the nasopharynx arch. The almond is well developed at children, with age decreases and often completely atrophies.
Reasons of adenoides
There is a hereditary predisposition to growth of a nasopharyngeal almond caused by a deviation in a structure of endocrine and lymphatic system (limfatiko-hypoplastic diathesis). At children with this anomaly along with adenoides decrease in function of a thyroid gland which is shown by apathy, slackness, puffiness and tendency to corpulence quite often comes to light.
Violation of food (overfeeding) and toxic influence of a number of viruses can be the contributing factor in development of adenoides. The secondary inflammation and increase in adenoides can develop after such children's infectious diseases as whooping cough, measles, scarlet fever and diphtheria.
Classification of adenoides
Allocate three extents of increase in adenoides
- 1 degree – adenoides close a third Joán and a soshnik. During the day the child breathes freely. At night, because of transition to horizontal position and increase in volume of adenoides breath is complicated.
- 2 degree – adenoides close a half Joán and a soshnik. The child breathes mainly through the mouth also day and night, often snores in a dream.
- 3 degree – adenoides entirely (or almost entirely) close a soshnik and Joana. The same symptoms, as at the 2nd degree, but are expressed more sharply.
Symptoms of adenoides
The child's nose constantly or is stuffed periodically up, plentiful serous separated is characteristic. The child sleeps with an open mouth. Because of difficulties with breath the dream of the patient becomes uneasy, is followed by loud snore. Children often dream nightmares. During sleep the suffocation attacks caused by a language root zapadeniye are possible.
At adenoides of the big size the fonation is broken, the voice of the patient becomes nasal. Openings of acoustical pipes are closed by the expanded adenoides that causes decrease in hearing. Children become scattered and inattentive. Because of adenoides stagnant hyperaemia of surrounding soft fabrics develops (back palatal handles, a soft palate, a mucous membrane of nasal sinks). As a result trouble breathing are aggravated, the rhinitises over time passing into chronic catarrhal rhinitis often develop.
Growth of adenoidny fabric quite often becomes complicated adenoidity (an inflammation of adenoides). At an aggravation of an adenoidit symptoms of the general nonspecific infection (weakness, temperature increase) appear. And especially adenoidit adenoides often are followed by increase in regionarny lymph nodes. The long course of disease leads to violation of normal development of a facial skeleton. The lower jaw becomes narrow, is extended. Because of violation of formation of a hard palate, there are violations of a bite. The face of the patient takes a peculiar "adenoidny form".
Adenoides can influence the breath mechanism. When passing a current of air through a nasal cavity there is a reflex formation of character of a breath and exhalation. Therefore the person always breathes through a nose more deeply, than through a mouth. Long breath through a mouth causes insignificant, but noncompensated shortage of ventilation of lungs.
Blood of the child is worse saturated with oxygen, there is a chronic unsharply expressed brain hypoxia. Because of chronic violation of oxygenation at children with the long course of adenoides some intellectual backwardness sometimes develops. Patients often complain of headaches, badly study, experience difficulties with storing of a training material.
Reduction of depth of a breath during the long period of time becomes a cause of infringement of process of formation of a thorax. At the child such deformation of a thorax as "a chicken breast" develops. At a number of patients with adenoides the anemia, violation of activity of digestive tract (deterioration in appetite, vomiting, a lock or a diarrhea) comes to light.
Diagnosis of adenoides
The diagnosis is exposed on the basis of detailed survey, carefully collected anamnesis and these tool researches. The following tool techniques are used:
- Faringoskopiya. During the research assessment of a condition of a rotoglotka and palatal almonds is carried out. Existence of the separated mucopurulent character on a back wall of a throat is defined. For survey of adenoides the soft palate is lifted the pallet.
- Forward rinoskopiya. The doctor examines the nasal courses. The research allows to reveal hypostasis and existence separated in a nasal cavity. In a nose of the child dig in vasoconstrictive drops then the adenoides closing Joana become visible. The child is asked to swallow. The arising reduction of a soft palate causes fluctuation of adenoides at which light patches of light on a surface of almonds are visible.
- Back rinoskopiya. The doctor examines the nasal courses through a rotoglotka by means of a mirror. At survey adenoides which represent a semi-spherical tumor with furrows on surfaces or group of the hanging-down educations in various departments of a nasopharynx are visible. The research differs in high informational content, however its carrying out represents certain difficulties, especially – at children of younger age.
- Nasopharynx X-ray analysis. The roentgenogram is carried out in a side projection. When carrying out a research the child opens a mouth that adenoides were more accurately contrasted by air. The roentgenogram allows to diagnose reliably adenoides and to precisely define their degree.
- Endoscopy of a nasopharynx. The high-informative research allowing to make detailed survey of a nasopharynx. At survey of children of younger age anesthesia is required.
Treatment of adenoides
Tactics of treatment is defined not so much by the size of adenoides, how many the accompanying frustration. Indications to operation are defined by the otolaryngologist. At small children adenoides operations are performed under the general anesthesia. At children of advanced age they are often carried out under local anesthesia. Carrying out cryodestruction of adenoides or their endoscopic removal is possible.
At patients, inclined to an allergy, adenoides often recur therefore expeditious treatment should be combined with the desensibilizing therapy. At growth of nasopharyngeal almonds of 1 degree and poorly expressed violation of breath conservative therapy (an instillation of 2% of solution of a protargol) is recommended. To the patient appoint the all-strengthening means (vitamins, calcium medicines, cod-liver oil).