How to treat adenoids in children: doctor's recommendations

Adenoids is the enlargement of the pharyngeal tonsil located in the vault of the nasopharynx. In case of inflammation, the adenoids increase in size and block nasal breathing. Adenoids are most common for preschool children. The disease has vague symptoms. The first and the second degree of inflammation are treated conservatively. The third one requires surgical intervention. You will learn more about how to treat adenoids in children further.

As mentioned above, the disease progresses slowly. The main symptom of adenoiditis is the inability to breathe through the nose and snoring during sleep. Irritation and unreasonable anxiety, as well as constantly open mouth are manifestations of enlarging adenoids. Many children have headaches in the morning and a nasal twang. If these symptoms occur, parents should consult a pediatrician, who, after examination, will prescribe the treatment.

Classification of adenoid vegetations:

• the first degree - the child has heavy breathing at night, sometimes "snores" (adenoids cover the third part of the nasopharyngeal lumen);
• the second degree - nasal breathing disorders at the day time (50% of the nasopharynx is closed by adenoids);
• the third degree - a child cannot breathe through the nose and his speech is impaired.

Among the most common causes of inflammation of the adenoids, doctors identify childhood infections, frequent ARI, decreased immunity, chronic tonsillitis, hereditary factors.

The choice of therapy and treatment regimen is determined by a doctor with taking into consideration the degree of the enlargement of tonsils and the condition of a child. Recall that adenoiditis of the first and the second degree is treated conservatively. However, the treatment needs the individual approach. The need of adenoidectomy is raised only if conservative therapy fails. Treatment of adenoids includes the use of immunomodulators and antihistamines, homeopathic remedies, anti-inflammatory and vasoconstrictor drops, and saline nasal washout. Nasal quartz treatment and laser therapy are recommended as the physiotherapeutic methods, Cryotherapy of adenoids is effective for treatment of the first and the second degree of the disease. Cryotherapy for a child is performed under local anesthesia.

Absolute indications for the removal of pathological pharyngeal tonsils are round-the-clock nasal breathing disorder, diminished hearing, improper jaw development and sleep apnea. In each specific case, the decision should be made by a specialist.

• Operation with an adenotome (a special knife used to remove adenoids). The disadvantages of this surgery include insufficient visual field and bleeding.
• Removal by laser - the low-traumatic and extremely accurate operation.
• Endoscopic adenoscopy in children - the most common method of high effective surgery.
• Coblation - the operation performed by means of the cold plasma instrument. Its advantages are painless, no bleeding and quick recovery after surgery.

The operation to remove the adenoids may be performed under local anesthesia and under general anesthesia, each of which has its advantages and disadvantages. For local anesthesia, the solution of lidocaine or ultracaine in the form of a spray is used. The sedative shall be given to the child 30 minutes before the operation. The local anesthesia is managed directly before the operation. Its advantages include the absence of emergence from anesthesia and aspiration, as well as the minimum time of surgery. Generally, local anesthesia is recommended for children from 8 years of age.

Adenoidectomy under general anesthesia is used for preschool children. The advantages of this method include total pain relief. The prolonged emergence from anesthesia, the danger of aspiration (getting food into the airways), the impact of toxic drugs are its disadvantages.

After removing adenoids, it is necessary to turn a child on the side and put a towel under his head to spit saliva. At this time, parents need to monitor the nature of the discharge and the general condition of the child. During the first days after the operation, the child is under the doctor’s supervision of a doctor. When emerging from anesthesia, the child may vomit, feel nauseous and shaky. Young children often cry and scream. Because of this, it is important for parents to stay with their child. They can feed and give to drink to a small patient only with a doctor's permission. After discharging from the hospital (with general anesthesia - in three days, with local anesthesia - in a day), the doctor prescribes the treatment regimen for full recovery and recommends an appropriate diet to the child after adenoidectomy. If you have any questions, please contact us as we are always ready to help.

Article writer - Sergey Tereshchuk

Publication date: 26.04.2021