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Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

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Functions of the pharyngeal tonsil

The nasopharyngeal tonsil, like the rest of the tonsils, is part of the human immune system. Their main function is protective. It is the tonsils that are the first to get in the way of bacteria and viruses that enter the body and destroy them. The adenoids are located directly at the respiratory tract to respond quickly to the presence of pathogens. During the penetration of the infection, the pharyngeal tonsil begins to vigorously produce immune cells to fight the external enemy, increasing in size. For children, this is the norm. When the inflammatory process “comes to naught”, the nasopharyngeal tonsil returns to its original size.

If the child is often sick, the adenoids are constantly in an inflamed state. The amygdala does not have time to shrink, which leads to an even greater proliferation of adenoid vegetations. The situation reaches the point that they completely block the nasopharynx, full breathing through the nose becomes impossible.

Causes of adenoids

The proliferation of adenoid vegetation can lead to:

  • heredity;
  • persistent colds;
  • “Childhood” diseases affecting the nasal cavity and pharynx: scarlet fever, measles, rubella;
  • weak immunity;
  • non-compliance with ventilation standards, indoor humidity, dust;
  • allergic manifestations;
  • unfavorable ecology (exhaust, emissions).

The baby’s body constantly attacked by viruses, in combination with undeveloped immunity, leads to hypertrophy of the nasopharyngeal tonsil, as a result of which a complex violation of the process of nasal breathing occurs, mucus stagnates in the nose. Pathogenic microorganisms that penetrate from the outside “stick” to this mucus, and adenoid vegetations themselves turn into a focus of infection. From here, bacteria and viruses can spread to other organs.

What causes the development of adenoids

Adenoids are compensatory hypertrophy of the pharyngeal tonsil, its enlargement in response to chronic or frequent acute inflammation.

The amygdala is a large accumulation of lymphoid tissue in the nasopharynx, encased in an epithelial capsule. This formation protects the upper respiratory tract from infection, so it takes the first blow. In conditions of insufficiently developed immunity in children, the tonsils do not always cope with their function, they often become inflamed. Constant stimulation (infectious or allergic inflammation) increases the volume of lymphoid tissue. So the child’s body compensates for the functional insufficiency of the amygdala, therefore they speak of compensatory hypertrophy.

You can use the ready-made Strelnikova respiratory gymnastics complex, which was developed for singers with voice problems, but has demonstrated its effectiveness in the case of other respiratory diseases, including in children.

Normally, after an immune response, the amygdala returns to normal size. But often in conditions of excessive activity, the tissue is depleted and remains hypertrophied.

Separately, it is worth highlighting the inflammation of the nasopharyngeal tonsil – adenoiditis. This condition develops faster than the adenoids, but responds well to treatment with antibacterial and anti-inflammatory drugs. Differential diagnosis is carried out by the doctor, but the difference can also be seen in systemic manifestations – increased body temperature, deterioration of the general condition of the child with adenoiditis.

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!In order to increase the effectiveness of home treatment of adenoids, it is advisable to supplement with physiotherapy.

Classification of adenoids

Grade I adenoids: the initial stage, characterized by a small size of vegetation. At this stage, the top of the opener (posterior nasal septum) overlaps. The child is uncomfortable only at night, when breathing becomes difficult during sleep.

In children with adenoids of the II degree of vegetation, more than half of the opener is closed. They are medium in size. Distinctive features of this stage: the child constantly snores at night, and breathes with his mouth open during the day.

At stage III, the growths reach their maximum size: they occupy most of the gap between the tongue and palate. It becomes impossible to breathe through the nose. Children with inflamed grade III adenoids breathe exclusively through the mouth.

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

Adenoids: what are they and why do they develop in children

Overgrown, enlarged pharyngeal tonsils are called adenoids. If the adenoids become inflamed, the condition is called adenoiditis. The pharyngeal tonsil is a small gland that sits on the back of the larynx and is made up of several lobes. The task of this organ related to the immune system is the production of lymphocytes, cells involved in the body’s defense against bacteria and viruses. But with pathological growth, the pharyngeal tonsil itself becomes a threat to health.

Adenoids are a typical childhood problem. They are rare in children under 1–2 years of age, as in adolescents. The peak incidence is between 3 and 10 years of age.

There are about 27 cases of adenoiditis per 1000 children.

Adenoids in children arise for several reasons:

  • frequent colds and other infectious diseases (measles, mononucleosis, rubella, etc.) affecting the mucous membranes of the nasopharynx;
  • poor ecology in the area of ​​residence;
  • genetic predisposition;
  • a tendency to allergic reactions, as well as bronchial asthma – these diseases are present in 65% of children suffering from adenoiditis;
  • certain unfavorable climatic and microclimatic conditions – gas pollution, dry air, the presence of a large amount of dust – all this leads to the fact that the mucous membranes dry out and become especially vulnerable.

The degree of development of the disease

There are several stages in the development of adenoids:

Grade 1: the tonsil grows slightly and overlaps about a quarter of the lumen of the nasal passages. The main symptom of the disease at this stage is somewhat difficult nasal breathing, especially at night.

Grade 2: the adenoids increase in size and cover two-thirds of the lumen. Nasal breathing is significantly difficult even during the day, the child can snore at night, his mouth is open all the time.

Grade 3: the amygdala completely blocks the lumen, making nasal breathing absolutely impossible.

Symptoms of adenoiditis in children

In the early stages, it can be difficult to notice adenoids in children, the symptoms of this disease are nonspecific. Parents either do not pay attention to them at all, or they think that the child has a common cold. Here are the signs you should look for in order to identify the disease at the very beginning:

  • Difficulty nasal breathing, snoring during sleep;
  • pallor and lethargy as a result of lack of air and sleep disturbances due to snoring;
  • violation of the sense of smell;
  • the child has difficulty swallowing food, often chokes;
  • the child complains of the sensation of a foreign object in the nose, but when blowing his nose, there is no liquid;
  • the voice is low, deaf, in the nose;
  • the child constantly breathes through the mouth;
  • constant fatigue and irritability.

If the overgrown tonsil becomes inflamed, there are clear signs of adenoiditis:

  • heat;
  • runny nose, which does not respond well to treatment with ordinary drops;
  • weakness, headache, drowsiness, decreased appetite and nausea – this is how the general intoxication, characteristic of many infectious diseases, is manifested;
  • chronic cough;
  • sore throat, nose and ears, sometimes significant hearing impairment.

In a baby

Newborn children are not able to assess their condition and formulate complaints, therefore, it is possible to assume the presence of pathology by indirect signs. A small child becomes moody, does not sleep well, tries to breathe through his mouth. In the later stages, children have a cough. The child may choke while eating or refuse to eat, as he has to hold his breath in the process. When adenoids develop in children, there are delays in mental and physical development due to oxygen starvation.

Children are older

In children over infancy, the appearance of adenoids is accompanied by irritability and mood swings. The child may complain of insomnia and nightmares. At an older age, you can find a change in the structure of the face.

Diagnostics

Diagnostics is carried out in an ENT office under the guidance of an otorhinolaryngologist. The doctor conducts a general examination of the patient and asks the parents for complaints and the appearance of pronounced symptoms.

Additionally, the following types of examination are used with the help of:

  • pharyngoscopy – examination of the oropharynx;
  • rhinoscopy – examination of the nasal cavity;
  • x-ray;
  • endoscopy of the nasopharynx is the most informative method that provides a complete picture (the results of the study can be recorded on a digital medium).

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

How to treat adenoids in a child

Since the presence of adenoids and their inflammation is very easy to confuse with a common runny nose or cold, you should not try to diagnose yourself and treat your child with home or over-the-counter medicines – they can provide some relief for a very short time, but then the symptoms will return. In the meantime, the disease will continue to develop. Do not hold out until the moment when the adenoids completely block the nasal lumen – consult a doctor at the first suspicion of adenoids.

In order to make an accurate diagnosis, the doctor will prescribe an endoscopic examination, blood and urine tests; in some cases, an x-ray of the nasopharynx is required.

Treatment of adenoids in children, especially in the early stages, includes mostly conservative methods. With 1 and 2 degrees of development of the disease, removal of adenoids in children is not shown – at this stage, the disease can be defeated with the help of drug therapy and physiotherapy procedures. Surgical intervention is necessary only if no other methods of dealing with adenoiditis have the desired effect.

Algorithm of therapy

If we are talking about hypertrophy of the adenoids, then the following algorithm is applied:

  1. Finding out if there is snoring: no snoring – watching the child.
  2. Snoring is present, but rare and / or quiet, while the child does not have obstructive sleep apnea – conservative treatment under the supervision of an otolaryngologist.
  3. Snoring is loud and / or frequent (more than three days a week) and / or there is respiratory arrest during sleep – additional examination is necessary – consultation of an ENT doctor, if necessary, polysomnography. Polysomnography calculates the frequency of episodes of delayed or disturbed breathing during sleep in 1 hour – the apnea / hypopnea index (AHI), which allows you to determine the severity of obstructive sleep apnea:
  • light (AHI 1-4.9) – conservative therapy is used;
  • medium (AHI 5-9.9) – the decision is made jointly, conservative treatment under the supervision of a specialist is permissible;
  • severe (AHI more than 10) – surgical intervention is recommended.

In addition to AHI, the choice of tactics is also influenced by clinical manifestations, such as the presence and frequency of otitis media, sinusitis, as well as the quality of life in general. For this reason, when treating adenoid hypertrophy, it is important to focus on the symptomatology as a whole, and not only on the severity of the disease.

Conservative treatment

With adenoids, a course of antihistamines, immunomodulators, vitamin complexes and drugs that activate the body’s defenses are usually prescribed. Nasal drops with anti-inflammatory components and vasoconstrictors will help relieve inflammation and facilitate breathing through the nose (however, the latter are used with caution and no more than 3-5 days). A good result is obtained by rinsing the nose with slightly salted water or special medicinal solutions.

From physiotherapeutic procedures, medicinal electrophoresis with potassium iodide, prednisolone or silver nitrate is most often prescribed, as well as UHF therapy, high-frequency magnetotherapy, ultraviolet treatment and mud applications.

Respiratory gymnastics is also important – with adenoids, the child gets used to breathing through the mouth and it is required to re-develop the habit of breathing through his nose.

Usually, the combination of these methods is enough to cure adenoiditis. However, in some cases, especially if the disease has already reached stage 3 and does not respond to conservative treatment, surgical removal of the adenoids is prescribed.

Adenoiditis and its treatment regimens

When deciding how to treat adenoids in children and what drugs will be effective, we will consider the cause of the pathology. Adenoids are the first barrier to the spread of a pathogen in a child’s body. They are located in the nasopharynx and are thickened ridges of lymphatic origin.

When an infection enters the body, the adenoids counteract the provocateur, filling with lymph and increasing in size. This is a normal situation: after recovery, the tonsils return to their original state.

And so on until the next illness. The process of resizing upwards and then decreasing indicates the correct functioning of the baby’s protective system. But with reduced body resistance, frequent respiratory and viral infections, the adenoids do not have time to shrink to their normal size. Swollen tonsils provoke breathing problems, hearing impairment and general well-being. This is how adenoiditis develops.

Otolaryngologists distinguish 4 stages of the disease, prescribing a drug for the treatment of adenoids in children. The protocol of therapy at each stage is its own, depending on the patient’s condition and the size of the proliferation of the adenoids.

Medical treatment of adenoids in children is most effective in grade 1 adenoiditis. In this case, therapy is designed to reduce the signs of hyperemia and discomfort in the nasopharynx. Pediatricians consider stage 1 as harmless, they believe that it does not require intensive therapy, especially if the child’s age is close to 11-12 years old (when the natural process of adenoid dying off begins). This approach is not applicable to babies, since it is fraught with the development of complications and excessive proliferation of tonsil tissues.

Choosing a medicine among medicines for the treatment of adenoids in children of the 2nd degree, the ENT specialist relies on the results of diagnostics, which make it possible to assess the progress of the pathology. The second degree of adenoiditis is subject to drug therapy, but in exceptional cases, parents are offered removal.

The third stage (and especially the fourth) requires surgery with complete or partial removal of the tonsils. Medication prescriptions are applied before and after surgery during the preparation and recovery stages.

Drugs for adenoids in children are prescribed based on the mandatory therapy regimen:

  • elimination of inflammation and removal of tissue hyperemia;
  • antibiotic therapy as needed;
  • medicines that restore nasal breathing;
  • means that increase the body’s resistance.

In addition to these, the otolaryngologist prescribes vitamins, natural and homeopathic medicines for the treatment of adenoids as ancillary measures.

The following technique is supposed:

  • drug therapy;
  • traditional medicine as complementary means;
  • physiotherapy to consolidate the effect.

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

Medicines for adenoids

As mentioned above, drug treatment of adenoids is effective at 1-2 stages of the disease, productively as a preliminary and fixing protocol at 3-4 stages (before and after surgical intervention). The otolaryngologist conducts diagnostic measures, according to the results of which he offers effective means for the treatment of adenoids in a specific situation.

Drug therapy for adenoiditis involves an integrated approach using the means:

  • antiseptic prescriptions;
  • anti-inflammatory antibiotic therapy;
  • nasal sprays for vasoconstriction;
  • immunomodulators;
  • auxiliary means (dietary supplements, homeopathic medicines).

The choice of drugs for the treatment of adenoids in children is carried out by the pediatrician after the primary and secondary examination of the patient. Self-prescription of drugs is unacceptable, especially without visiting a doctor and on the basis of a child’s complaints: only diagnostics using a laryngoscope can accurately determine the stage of adenoiditis and develop the correct treatment protocol.

Antiseptic group of drugs

Medicines in this group are designed to:

  • sanitize the oral and nasopharynx,
  • neutralize pathogens,
  • reduce flushing,
  • reduce inflammation.

Among the drugs for the treatment of adenoiditis in children, the following medicines have proven themselves on the positive side:

Protargol. Available in the form of nasal drops. Silver ions included in it have a strong antiseptic effect in the fight against a bacterial provocateur. It is a gentle medicine with a minimum set of side effects. To achieve positive dynamics, Protargol is instilled into the nasal passages of children twice a day, three drops. The course of therapy is at least 14 days.

Miramistin. A unique broad-spectrum preparation available in the form of a spray with a nozzle for deep penetration into the oropharynx. Acting on pathogenic microflora, it blocks the reproduction of bacteria, destroying the cell membrane, acting against strains that are not sensitive to antibiotics. Promotes rapid regeneration of damaged tissues and pain relief.

Collargol. A medicine that is a solution of silver ions in albumin. Like Protargol, it is effective in neutralizing pathogens on the mucous surface of the tonsils, healing wounds and inflammations. Applied in the form of nasal drops at a dosage of 1 drop in each passage, 3-4 times a day. Suspends the process of adenoid vegetation. With adenoiditis of 1 degree, he alone is able to cope with the disease with prolonged therapy. However, prolonged use of the drug provokes argyria – an irreversible darkening of the skin and epithelium due to the accumulation of silver deposits.

Derinat. The active ingredient is sodium deoxyribonucleate. It is used both in the form of nasal drops and as a component for inhalation. Reduces inflammation, increases resistance to the pathogen, reduces hyperemia of the integument, increases immunity. Dosage – 4-5 drops in each nasal passage, frequency – 5-6 manipulations per day. For treatment and prevention, use for at least 2 weeks. When inhaled with a nebulizer, 3-5 drops are injected into clean water or saline.

These medicines are recommended for home use. Before carrying out manipulations, it is necessary to clear the nose of exudate. Usually, a weakly salt water mixture or factory sea salt solutions sold in pharmacies are used for this.

Antibiotics in the treatment of adenoids

The otolaryngologist calls the primary goal in the treatment of adenoiditis in children to eliminate inflammation in the tonsils, which is achieved by using antibiotics. Their main goals:

  • counteraction to a bacterial agent;
  • improve breathing by reducing swelling;
  • promote the return of the adenoid to its original size.

Today, the best remedies for adenoids in children are:

  1. Augmentin, Amoxicillin and Flemoxin-Solutab. Antibiotics of the penicillin group. Assign to babies from 3 months (Augmentin, Amoxicillin). They are produced in the form of a powder for reconstitution into a syrup using boiled water, tablets with longitudinal division into 2 doses and liquid for injection. Effective against gram-positive and gram-negative organisms, the clavulanic acid included in the composition prevents the development of resistance and addiction to the drug in the pathogen. Flemoxin-Solutab is a new generation of penicillin antibiotic with the same active substance (amoxicillin). Positive dynamics from the application is observed for 2-3 days.
  2. Azithromycin and Macropen. Antibiotics of the macrolide group. Prescribed when allergic incompatibility with penicillins is detected. They have a narrow range of side effects in children.
  3. Panzef and Zinnat. Preparations of the cephalosporin group are recommended in the absence of results in the treatment of the above means. Otolaryngologists consider cephalosporin antibiotics to be the most effective, but they have an impressive list of adverse reactions. Not prescribed for babies under 6 months (Pancef) and up to 3 years old (Zinnat).

Practicing pediatricians are reluctant to prescribe antibiotics for adenoid vegetations, appealing that the funds are effective, but toxic, negatively affecting the weak child’s body. In addition, antibiotic therapy is reasonable only for a bacterial pathogen, and every fourth case of adenoiditis is caused by a viral provocateur. Therefore, the appointment of an antibiotic will be present in the treatment protocol in the case of severe bacterial lesions with an increase in temperature up to 39 degrees, pain syndrome, the addition of a secondary disease (otitis media, laryngitis, sinusitis). If the symptoms do not indicate the need for an antibiotic, sparing drugs that can relieve inflammation (Sofradex, Isofra) are prescribed. But even in this case, the otolaryngologist chooses pills for adenoids for children,

Vasoconstrictor drugs

They are necessary to restore nasal breathing by narrowing the vessels and expanding the airways, partially blocked by hyperemic adenoid vegetations. To achieve a quick result, glucocorticosteroid drugs are used, which not only reduce edema, but also relieve inflammation.

Nazonex. Available in the form of a spray and nasal drops. Quickly relieves hyperemia of epithelial integuments, especially of allergic origin. Dosage – 2 times a day, in accordance with the prescription of the otolaryngologist. Not prescribed for children under 2 years of age. Signs of improvement are observed immediately after manipulations and persist up to 12 hours. Side effects include bleeding from the nasal passages, dizziness, increased pressure. Accepted only as directed by a doctor.

Avamis. The principle of action is similar to Nasonex, as well as the list of side effects. It is also not used in the treatment of adenoiditis in children under 2 years of age due to the hormonal component included in the drug.

These funds are popularized due to their quick effect and prolonged action, but they are advisable in the case of an acute form of adenoiditis, when a quick result is required and the patient’s age allows the use of glucocorticosteroids. Otherwise, local decongestants are enough – Vibrocil, Sanorin, Nazolin and Rinosept.

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

Immunomodulators

Means that increase the immune defenses for adenoiditis include vitamins and medications containing minerals. Immunomodulators help speed recovery by stimulating the production of natural protective chemicals. Modern pediatricians recommend such medications that stimulate the production of natural interferon:

  • Ergoferon
  • Amixin;
  • Immunal;
  • Anaferon;
  • herbal stimulants (containing extracts of ginseng, rhodiola rosea, echinacea, milk thistle, eleutherococcus);

The listed drugs are prescribed both during the treatment of adenoiditis and for prophylactic purposes. Despite the obvious benefits, immunomodulators cannot be taken without the permission of a pediatrician, since, like most medicines, side effects are characteristic.

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

Removal of adenoids in children (adenotomy)

In modern clinics, the removal of adenoids in children is a simple and low-traumatic operation, but still, if you can do without it, the doctor will try to go exactly this way.

Indications for the removal of adenoids in children are: ineffectiveness of drug and physiotherapy, severe difficulty breathing through the nose, which leads to persistent colds, frequent otitis media and hearing impairment. The operation also has contraindications: it is not performed for pathologies of the structure of the palate, some blood diseases, cancer or suspicion of oncology, acute inflammatory diseases (they must be cured first), within 30 days after any vaccination and for children under 2 years of age.

Removal of adenoids in children is carried out in a hospital under local or general anesthesia. There are several ways to perform this operation.

With the aspiration method, the adenoids are removed with a vacuum pump with a special nozzle, with the endoscopic method – through a rigid endoscope (this operation is performed under general anesthesia). To remove adenoids, a microdebrider is also used, which is sometimes called a shaver. The rehabilitation period after such methods takes about 2 weeks.

The most modern and low-traumatic method is laser removal of adenoids. The tonsils are cut off with a directed laser beam, and the blood vessels are cauterized, eliminating the risk of bleeding and infection. The rehabilitation period with laser removal of adenoids is also significantly reduced.

The entire operation takes no more than 15 minutes and is a fairly simple intervention, after which complications are very rare. However, this is still a surgical operation with all the attendant risks, and it must be carried out in a proven clinic.

Why are adenoids dangerous?

The proliferation of adenoid vegetation can lead to hearing problems, even to the point of hearing loss. The human hearing aid has several sections. In the middle section there is an auditory tube, it is also the Eustachian tube, which is responsible for the regulation of external (atmospheric) pressure with pressure in the nasopharynx. The pharyngeal tonsil, increasing in size, blocks the mouth of the Eustachian tube; air cannot circulate freely between the nasal cavity and the ear. As a result, the eardrum becomes less mobile, and this negatively affects the ability to hear. In severe cases, such complications do not respond to treatment.

When normal air circulation is not possible, an infection develops in the ear and inflammation (otitis media) occurs.

Constant breathing through the mouth leads, as mentioned earlier, to deformation of the facial skeleton, as well as to a decrease in the saturation of the brain with oxygen: the child quickly gets tired and cannot withstand the school load, and his performance decreases sharply.

The constant concentration of infection in the nasopharyngeal tonsil leads to general intoxication of the body and the spread of viruses to other organs. The baby is exposed to frequent bronchitis, laryngitis and pharyngitis.

The unpleasant consequences can also include problems with the gastrointestinal tract, urinary incontinence at night, and coughing.

How to properly rinse a child’s nose

Most children dislike and even fear this method of treatment. Therefore, it is important to approach the issue delicately, to explain to the child that this is necessary for his health – so that the nose breathes better. It is good if the process is carried out in a playful way or if one of the parents shows by his own example that rinsing the nose is absolutely painless. A visual demonstration of the procedure by dad or mom should convince the child that it is not at all scary to do it.

Many parents are interested in the question, at what age can a child’s nose be rinsed at all? The answer is simple. From the moment you can explain to him the procedure for the procedure and you will be sure that the baby will be able to understand you correctly. Doctors advise to do this no earlier than 4 years. Until this moment, special baby drops are used to cleanse the nasal cavity, which soften thick mucous secretions, cotton wicks and aspirators.

For washing, you can use ordinary boiled water, decoctions of medicinal herbs (chamomile, eucalyptus, calendula, sage, St. John’s wort), sea water, isotonic solution or special ready-made formulations that are sold in a pharmacy. It is allowed to alternate between different means: to use one or the other. Solutions are selected in conjunction with an otolaryngologist, based on the history of allergic reactions in the child. The finished product should be slightly warm (temperature 34-36 °). A volume of 100-200 ml will be enough for one procedure.

It not only removes accumulated mucus very well, but also relieves swelling and seawater has a bactericidal effect. It can be prepared from dry sea salt (1/2 tsp. Diluted in a glass of water) or, in the absence of it, from ordinary food (1/3 tsp. Dissolve in a glass of water and add 2 drops of iodine).

Before starting the procedure, make sure that the baby’s nose is not obstructed. Otolaryngologists advise you to pre-clean the cavity from secretions either with an aspirator or by carefully removing the mark. If after this the patency of the nasal passages remains difficult, it is allowed to drip vasoconstrictor drops to the baby (one drop in each nostril). After that, rinsing can begin.

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

The procedure is performed while standing over the sink. The solution is taken into a small syringe with a thin nose or a special pharmacy device is used (it is also called a “nasal shower”). The child needs to bend forward 90 °. The head should be kept strictly vertical, it is impossible to tilt it to the right and to the left during the procedure. Ask your child to take a deep breath and squeeze a small amount of the solution into one of the nostrils. The liquid will completely fill the nasal passage and flow out of the other.

If water gets into the mouth, you can advise the child to pronounce a drawl “and-and” while injecting. At the same time, the soft palate rises and delimits the nasopharynx. After that, you need to blow your nose and repeat the procedure from the second nostril. And so – several times. The lavage is completed by blowing the nasal passages, which will remove the remnants of the solution from the mucous membrane.

If this – the flow method of flushing (from one nostril to the other) – causes difficulties, you can try an easier way: inject a small amount of liquid into the child’s nose and ask him to blow his nose immediately. Make sure that the head is again in an upright position and in no case is thrown back. The solution should not get into the mouth, much less into the ears. Even a small amount of fluid trapped in the middle ear cavity will provoke serious otitis media, which will be very difficult to cure later.

After 15 minutes after washing, it is the turn of the aniseptic or antibacterial agents prescribed by the doctor. Antiseptic includes colloidal silver preparations, in particular protargol.

Unlike vasoconstrictor drops, which need to be buried on the side of the baby so that they do not get into the mouth and only act on the nasal mucosa, Protargol is buried on the back. This is done so that the substance glass from the nasal cavity into the nasopharynx and reaches the surface of the tonsil. Silver ions contained in protargol kill all pathogens, and also dry out the inflamed lymphoid tissue a little, reducing it in size. 2-6 drops of the drug are instilled into each nostril (depending on the patient’s age and the severity of the disease).

It is recommended that the child then lie on his back for some time without raising his head. Ideally – 15 minutes. But if the kid is capricious, you can limit yourself to 5 minutes. Instillation is carried out on the recommendation of a doctor, as a rule, 2 times a day for 2 weeks. A second course of treatment can be prescribed in a month. Do not forget that the shelf life of a 2% solution of Protargol is very short. Only 30 days from the date of manufacture. Therefore, the old bottle with the drug for the new course will no longer be used.

Do not neglect breathing exercises, which are recommended by experts for the treatment of adenoids. It is better for mom to accompany her at the same time with the baby, turning the process into a fun game. Gymnastics strengthens the respiratory muscles, stimulates blood circulation in the sinuses, and helps prevent sinusitis. In addition, in the process of exercise, the sick body is saturated with the oxygen it lacks.

In what cases can the operation be avoided?

There are only 2 treatment options:

  • surgical;
  • conservative.

It is possible to cure adenoids in a child without surgery only if there are no complications. The patient should be seen by an otolaryngologist. The doctor determines the extent of the inflammation. Disease in the first stage and the second (without complications). Timely and correctly selected therapy brings results. Various methods of treatment have been developed, but it is recommended to follow an integrated approach to achieve a positive effect.

Folk remedies

Folk remedies are good, but as an addition to what the doctor prescribed. Far for every inflammation can be cured with decoctions, but they are good for rinsing the nasal cavity and relieving the condition.
Most often, celandine juice, Kalanchoe and aloe, decoctions of lingonberry leaves, St. John’s wort, sea buckthorn infusion are used.
For example, celandine juice has a moxibustion effect, so this treatment will not work for the smallest. For older children, 4 drops of juice are instilled into each nostril three times a day.
You can rinse the nasopharynx with a decoction of lingonberry leaves. Pour two tablespoons of chopped leaves with a glass of boiling water and let it brew for half an hour in a water bath. When the broth has cooled, it can be applied.
A decoction of St. John’s wort is prepared in the same way. You need to take 10 grams of grass and pour a glass of boiling water over it. The broth should be infused for half an hour at room temperature. Then strain it and, when it cools down to a comfortable temperature, rinse your nose using a rubber bulb.

Salt

To prepare the solution, you will need table salt (1 tsp) and boiled water (1 glass), cooled to room temperature. If the child is not allergic to honey, you can add ½ tsp. of this product. Stir the liquid until the crystals are completely dissolved. Filter the liquid through a double layer of gauze. To enhance the effect, iodine (2 drops) is added to the solution. Rinsing the nose with room temperature saline should be done every 2-3 hours.

When using iodine, the number of procedures should not exceed 2 times a day. Without this component, you can do up to 4 washes per day. The treatment lasts 10 days.

Washing methods:

  1. Inhale the liquid in each nostril in turn. Spit it out as soon as the solution drains down the back of the nasopharynx.
  2. Use for nasal instillation. Tilt your head back and put a little liquid in each nostril.
  3. Bend over the sink, turn your head to one side, open your mouth, drip the solution into the upper nostril with a syringe. Wait for fluid to drain out of the second nasal passage. Repeat the procedure on the other side.

For washing, not only saline solution is used, but also decoctions of medicinal herbs.

Eucalyptus

Eucalyptus-based recipes help get rid of the disease. To prepare the infusion, dry plant leaves (2 tbsp. L.) Should be poured with boiling water (2 cups). It is recommended to infuse the liquid in a thermos for 2 hours. Before rinsing the throat, the infusion should be diluted with hot water. The course of treatment is about six months. The finished product can be stored for 2 days.

On the basis of this plant, a means for instilling into the nose is being prepared. The following ingredients are required:

  • vegetable oil – 1 tsp;
  • tea tree oil – 3 drops;
  • eucalyptus oil – 3 drops.

To prepare the product, mix the ingredients. After instillation, the child should lie down for 5 minutes with his head thrown back. The frequency of application is 1-2 times a week.

Celandine

The plant is used in 2 ways:

  1. Squeeze out the juice and put 2 drops into each nostril. Repeat the procedure 2 times a day. The duration of treatment is about 2 months.
  2. Pour boiling water (500 ml) over a dry plant (20 g). Strain the solution after 30 minutes. The infusion is used for washing the nasopharynx 2 times a day for 10 days.

It is not recommended to use this method if the child is under 6 years old. Do not use both at the same time.

Herbs

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

You can treat adenoids in children with the help of various medicinal herbs. Among them, you can distinguish pharmacy chamomile. Combine herbal tea (1 tsp) and water (100 ml). Place in a water bath for 15 minutes, then cover and allow to cool. Before use, it is recommended to strain the broth to prevent plant particles from entering the nasal cavity.

Horsetail (fresh or dry) will help cure adenoids in children without surgery. The plant can be prepared by yourself or purchased at the pharmacy. Types of treatment:

  1. Pour the herb (2 tsp) with hot water (300 ml) and bring to a boil. Keep the broth in a water bath for 7 minutes. Let it brew for 2 hours. Take 100 ml 3 times a day. The course of admission is 10 days. Such therapy is contraindicated in children under 3 years of age.
  2. Mix equal amounts of echinacea and horsetail herb. Collection (1 tsp), pour boiling water (1 glass) and leave for 1 hour. After straining, take 50 ml 3 times a day, adding honey (½ tsp). The duration of the course is 10 days.
  3. Combine horsetail (1 tsp) with chamomile (1 tsp) and boil with boiling water (500 ml). Let it brew for 2 hours. Strain the finished broth and rinse the nose with it once a day for 2 weeks. During treatment, it is recommended to take vitamin B1, since the plant contributes to its rapid consumption.

Lingonberry (its leafy part) helps to remove inflammation. Pour the crushed plant (2 tbsp. L.) With boiling water (200 ml). Put the container with the liquid in a water bath for half an hour. Rinse the nasopharynx with a filtered solution up to 3 times a day until the inflammation is completely removed. For quick results, it is recommended to take the broth inside. Children are allowed to use this remedy from the age of 5. It should be taken 4 times a day for 1 tbsp. l. 20 minutes before meals. The duration of the course is about 5 days.

Sea buckthorn oil

The oil of this plant is considered a natural antibiotic, it has wound healing properties. With regular nasal instillation, inflammation decreases and the symptoms of the disease are alleviated. The oil is used in its pure form. It is recommended to inject a few drops of the substance into each nostril 2 times a day.

With oil diluted with water (1 tablespoon per 1 liter of liquid), you can gargle and rinse your nose. In the postoperative period, it is recommended to put turundas with this substance.

Honey

Honey with beetroot juice, when instilled in the nose, reduces inflammation. At 1 st. l. beekeeping product requires 2 tbsp. l. fresh juice, previously boiled in a water bath (to destroy possible infections). The agent is recommended to be instilled 3 times a day, 2 drops in each nostril. A contraindication to use is an allergic reaction to honey.

Chamomile has anti-inflammatory properties. When combined with honey, its effectiveness is increased. Pour boiling water (500 ml) over dry grass (1 tablespoon), let it brew for 20 minutes. Strain the finished tea, add honey (1 tsp). The drink can be drunk up to 4 times a day. The tea can be used as a gargle and as an instillation aid.

Carnation

Pour boiling water (200 ml) over cloves (10 pcs.) And let it brew. The finished infusion takes on a chocolate shade. It is recommended to instill 2 drops of this product in each nostril.

Aloe

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

The juice of this plant has an antibacterial effect, therefore it effectively copes with inflammation. For best results, the nasal cavity is pre-washed with saline or soda solution. This procedure will allow the juice to be absorbed faster into the affected tissues. At the initial stage of the disease, the juice should be diluted with boiled water (1: 3).

Cut off a leaf of the plant and place in the refrigerator for several hours. Then make several cuts and squeeze out the juice using cheesecloth. In each nasal passage, instill 3-5 drops 3 times a day. For small children, juice is diluted with saline or boiled water in a 1: 1 ratio. A fresh portion is prepared for each procedure. The duration of treatment is about 4-5 days. The juice causes an intense sneezing, so that all phlegm comes out of the nose, and inflammation is reduced.

For treatment, honey with aloe is used. The juice squeezed out of the fleshy leaves is mixed with the beekeeping product in a 1: 1 ratio. The agent is used for nasal instillation. This composition is also useful for internal use (1 tsp. Half an hour before meals).

Oils

Thuja helps in the treatment of the disease. It has a positive effect on infectious diseases, inflammation and the common cold. The oil of this plant has a vasoconstrictor effect. It strengthens the protective properties of the body and promotes active regeneration of the mucous membranes.

Oil is instilled before going to bed in each nostril (2 drops). The duration of the procedures is 3 weeks. After a week break, you can repeat the course. Homeopathic oil should be used for treatment, not essential oil.

Fir oil is able to suppress the adenoidopathological microflora almost instantly. Regular lubrication of children’s tonsils with this substance has a positive effect:

  • the swelling of the mucous membrane decreases;
  • nasal congestion decreases, the amount of mucous secretions decreases;
  • pain sensations decrease;
  • damaged tissues are restored;
  • the discharge of pus stops.

The congestion disappears, the children begin to breathe freely through their noses. Oil can be used to rub a child’s feet. They contain neurosensory points that are responsible for the health of the throat and nose. The oil is used for inhalation with a nebulizer. In this case, it has a tonic effect. Useful substances penetrate into the mucous epithelium and are carried by the circulatory system throughout the body.

The maximum effect is given by therapeutic massages and compresses with the complex use of homeopathic oils (juniper, peach and eucalyptus).

Budra

Pour boiling water over the grass (2 tsp) (½ l). Keep on low heat for 10 minutes. Do steam inhalation: breathe over the liquid for 5 minutes, covering your head with a towel. It is recommended to carry out this procedure 4 times a day.

A mixture of a string with oregano

Ingredients:

  • sequence – 1 tbsp. l .;
  • oregano – 1 tbsp .;
  • mother-and-stepmother – 1 tbsp. l .;
  • boiling water – 2 glasses.

Cooking technology:

  1. Mix herbs.
  2. Take 1 tbsp. l. this collection.
  3. Add boiling water. Insist in a thermos for about 9 hours.

Add 2 drops of fir (or thuja) oil to the strained broth. Use the solution to rinse the nasopharynx.

Mint with St. John’s wort

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

For cooking, you will need the following ingredients:

  • oak bark (in powder form) – 1 tbsp. l .;
  • mint leaves – 1 tbsp. l .;
  • St. John’s wort – 1 tbsp. l .;
  • boiling water – 2 glasses.

Mix dry ingredients, take 2 tbsp. l. received collection, pour boiling water. Put the liquid on medium heat for 4 minutes. An hour later, the infusion can be used to rinse the nasopharynx. The minimum duration of treatment is 10 days.

Mummy

To prepare the product, you will need the following ingredients:

  • mummy – 1 g;
  • warm water – 5 tbsp. l.

Mix the components until a homogeneous solution is obtained. The number of drops and the frequency of use depend on the individual characteristics of the organism. For maximum effect, it is recommended to take a solution of the following concentration: 0.05 g per 1 glass of water. It is important to use not tablets, but natural gum resin.

Why are the adenoids enlarged? Coping with the cause – avoiding surgery to remove the adenoids

Adenoids, like tonsils (tonsils), are a peripheral organ of immunity. And an increase in adenoids is a sign that they are actively involved in work and, possibly, inflamed. More information about the treatment of tonsils – section of our website about the treatment of chronic tonsillitis without removing tonsils

Why is there an increase in adenoids?It is the adenoids that are the first to meet the infection that enters the body with the inhaled air, where the infection is captured by the cells of the immune system, followed by the formation of an immunological memory for the incoming microbes. Largely due to the work of the adenoids, with repeated contacts with microbes, the body already copes with the infection much easier. And if the immune system is not just weakened, but does not remember the infection well (the formation of “memory T-cells” is inhibited), then it is quite logical that the load on the adenoids and tonsils (tonsils) grows exponentially. It is clear that at the same time the child often begins to suffer from the same infection several times, and the adenoids increase in size. Removing the adenoids will help you breathe more freely, but may interfere with normal immune function. There is a solution, in our opinion, that is more acceptable in many cases.

Solution to the problem. If the immune system begins to respond more quickly to the incoming infection and forms immunological memory correctly, then there will be no need for such an active work of the adenoids. The adenoids will begin to gradually decrease, and nasal breathing will recover. Therefore, our treatment will be based on two basic principles:

  1. Helping the immune system in the formation of acquired immunity;
  2. Elimination of the overload of the nasopharynx by bacteria, fungi and viruses, i.e. reduction of microbial load on the adenoids

Complications

Complications are associated with the spread of infection to other ENT organs and parts of the respiratory system. In chronic adenoiditis, the disease is often complicated by otitis media, sinusitis (sinusitis, frontal sinusitis), bronchitis, laryngitis, pharyngitis, tonsillitis, pneumonia. Disturbances of speech, hearing and changes in the dentoalveolar system are also characteristic.

Against the background of adenoiditis, bronchial asthma, eczema, allergic rhinitis, allergic conjunctivitis also often develop.

Long-term hearing impairment and impaired nasal breathing lead to impaired general development of the child.

Prevention at home

– For the prevention of adenoiditis in children, it is necessary to ensure the rational stay of the child in the fresh air, more often take him out to sea. The formation of the immune system is also influenced by the sleep and rest regime, therefore it is very important that the child’s nighttime sleep occurs no later than 22:00. We must not forget about airing the premises and timely wet cleaning, especially during the autumn-winter period, – says children’s ENT Reseda Sattarova.
You should avoid contact with people suffering from ARVI, as well as not run your own cold and other ailments associated with the ears, throat and nose.

When adenoids are removed in children, at what age

If conservative treatment is ineffective, then surgical intervention is indicated – removal of infected adenoids – adenotomy.

Parents often ask: “When are adenoids removed in children, at what age?”

If removed at 3-4 years of age, there is a chance that the adenoids will grow back. Therefore, whenever possible, doctors are trying to save time. But if, nevertheless, adenoiditis brings many health problems to the baby and there are clear indications, then the question of age is not discussed.

The author of adenotomy W. Meyer, who proposed such a method in 1868, was erected a monument in his homeland in Copenhagen, as a token of gratitude from the doctors and parents of the operated children.

In what cases are adenoids removed:

 Grade III adenoids, due to which there is a persistent lack of breathing through the nose,

 Conservative treatment is absolutely ineffective and brings even temporary improvement,

 Sleep disturbance, snoring and respiratory arrest during sleep,

 Speech disorders, nasal voice,

 Complications from the middle ear, paranasal sinuses, bronchopulmonary system,

Deformity of the facial skeleton (adenoid face).

The operation to remove the adenoids is not difficult, the time is 5-10 minutes. A few hours later, sometimes the next day, the child is sent home. A special regimen is not required, the only thing that is required is the use of grated and cool food in the first three days.

What does x-ray of the nasopharynx show in children

X-rays of the nose and throat in children do not provide much information. With its help, you can identify the following features:

  • enlargement of the pharyngeal tonsils;
  • accumulation of pus.

The study is rarely used, since it is characterized by a high error. With an increase in the tonsils, a purulent complication is often observed. When an X-ray image is taken, an increase in the pharyngeal tonsils is visualized due to the presence of purulent contents.

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

Photo: x-ray of the nasopharynx – cyst in the left maxillary sinus

You should not be guided by the results of radiography. The examination will add one or two degrees to the pathology. On the basis of X-ray diagnostics, it is difficult to answer the question of how to cure adenoids without surgery, since examination is not enough to study the structure of the tonsils.

When it is required to determine how to treat adenoids without surgery in a child, doctors perform an external examination, a probe examination of the condition of the upper respiratory tract, and do laboratory blood tests.

X-ray diagnostics of adenoids in children with the 3rd degree of enlargement of the pharyngeal tonsils shows only a general increase in the tissues of the nasopharynx. The information content of the survey is low, so it is practically not used.

The effectiveness of the research method in pathology

X-ray of the nasopharynx with adenoids is often prescribed, but such a procedure is not very informative and is inferior to other diagnostic methods. Moreover, such a procedure is quite harmful, especially for the child’s body. Therefore, it is worth considering before exposing your baby to harmful radiation.

It is important not to expose the baby to repeated irradiation for at least 6 months after performing the X-ray. It is allowed to take x-rays no more than 2 times a year. Otherwise, the child’s immunity may weaken, and the likelihood of developing cancer will increase.

Moreover, the effectiveness of radiography in adenoids is quite low. X-rays of adenoids in children may show nothing at all or provide little information. And everything will depend on the qualifications of the radiologist, since not every specialist will be able to determine the correct degree of the pathological process.

Many are interested in the question of whether adenoids are visible on x-rays. Of course they are a little visible. And if they are increased, then the doctor even sees the degree of the pathological process. But this procedure has a number of significant disadvantages:

  • Does not provide information on what reasons provoked the onset of the pathological process. And this is very important to establish, since the effectiveness of subsequent treatment will depend on identifying the exact cause. Therefore, additional diagnostic procedures may be required.
  • The x-ray does not show mucus and pus on the surface of the tonsils. Therefore, the results of the procedure may be inaccurate. It may seem that there is a 2 or 3 degree enlargement of the adenoids, while their size is normal, but they are simply showing purulent accumulations.
  • To get more or less accurate results, a person must remain motionless during the study. But it’s hard to keep a small child from moving.

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

Therefore, to make a diagnosis, it is recommended to use other, more informative diagnostic methods. But if it is nevertheless decided to conduct an x-ray of the nasopharynx of a child with adenoids, it is necessary to study the features of the diagnostic study.

Preparing a child for examination

As you might guess, you shouldn’t go directly to X-ray diagnostics yourself. You need to go for an initial examination by an otolaryngologist who will examine you, advise and draw preliminary conclusions about the problem. Perhaps the specialist will give preference to some other diagnostic method, there is no need to argue, since the doctor has much more detailed information about your health condition and can draw conclusions based on a set of factors. In no case should you postpone the diagnosis if you have been given a test coupon.

It is very important to prepare your baby early morally. Be sure to talk to him the day before the examination, and it is important to keep a friendly and calm tone. Your task is to convey to the child the essence of the upcoming examination. In no case yourself should you show anxiety or excitement with your behavior, since children can feel this and begin to worry themselves.

You yourself must understand that it is the X-ray result that can significantly simplify the treatment plan, since the diagnosis will provide a huge amount of useful information for this. If a surgical operation is still required, then its safety will noticeably increase due to the fact that doctors will already know especially the adenoids in your case. Yes, X-rays are harmful to the body, but this method is still one of the leading methods due to its cheapness and accuracy.

X-ray degree of enlargement of the nasopharynx with adenoids

There are 4 degrees:

  1. At this degree, enlarged tonsils occupy 1/3 of the nasopharynx. In such a situation, the child begins to snore at night. Prolonged rhinitis with pathology is practically not treated with drugs.
  2. In the second degree, enlarged tonsils occupy 1/2 of the nasopharynx. Snoring is observed in the child’s sleep. The baby’s conversation becomes incomprehensible. X-rays at this stage can reveal enlarged tonsils.
  3. The tonsils occupy the entire lumen of the nasopharynx. The condition makes it difficult to breathe through your nose or talk. Clinically, this condition is accompanied by a decrease in hearing and smell. Doctors at the 3rd stage of the disease recommend surgical treatment.
  4. Note that the 4th degree does not exist. If the radiologist puts the 4th degree of pathology, he does not have sufficient qualifications.

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

X-ray of the nasopharynx in children: the location of the adenoids is indicated

What are the benefits of a sinus x-ray?

The benefits of a sinus x-ray include minimal radiation exposure and the ability to detect inflammation. A child with inflammatory changes in the nasopharynx may have maxillary or frontal sinusitis (sinusitis, frontal sinusitis).

Radiography well shows inflammatory changes in the paranasal sinuses. X-ray examination is the only and irreplaceable in the diagnosis of the disease.

Pus in the pictures is visualized as light spots. They disappear during the treatment of the disease and are monitored on dynamic radiographs. In the nasopharynx, bags on radiographs can be traced in the form of white darkening. When they are found, doctors prescribe antibacterial drugs. With the 3rd degree of enlargement of the pharyngeal tonsils, an operation is indicated.

Indications for x-rays of the nasal bones

Considering the causes of the appearance of adenoids, it should be noted that radiography is not always advisable. There are indications for an X-ray of the nasopharynx:

  • injuries to the bones of the nose;
  • adenoids;
  • curvature of the nasal septum;
  • suspicion of sinusitis
  • congenital anomalies of the sinuses of the nose.

X-ray of the adventitious cavities is more informative when contrast is introduced into the chambers.

With low information content of contrast methods, even tomography can be used. Some radiologists believe that the use of x-ray examination of the nasal bones is rational wherever there is a suspicion of inflammatory or neoplastic diseases.

Adenoids, symptoms, causes of inflammation, treatment and removal of adenoids. Symptoms and treatment of adenoiditis in children: recognize and neutralize!

X-ray image: cyst on the left (dimensions indicated)

According to the recommendations of the Ministry of Health, radiography of a child should not be performed without special indications. When it comes to health and life, you should evaluate the harm and benefits of the procedure and choose the lesser of evils.

All means are good to diagnose a disease. Without X-ray, it is impossible to detect inflammatory processes and prescribe timely therapy.

X-ray of the nasopharynx is an important and necessary diagnostic procedure. Trust the doctors who will prescribe x-rays of the nasal bones and paranasal sinuses when they are really needed.

Decoding of the obtained results

When decoding of the received X-rays is performed, the doctor analyzes the following indicators:

  • The walls and edges of the nasal bones. It is necessary to assess how clear their boundaries are, whether their thickness is normal.
  • Airspace in the sinuses. It is important to assess the size of this space, the symmetry.
  • Cells on the ethmoid bone. It is necessary to evaluate how well they are visualized, what their structure and size are.

A written medical opinion is issued to the patient, who forwards it to the attending physician.

Sources used and useful links on the topic: https://dr-zaytsev.ru/articles/adenoidy-v-nosu-u-detey-simptomy-i-lechenie.html https://www.neboleem.net/stati-o -zdorove / 18610-kak-lechit-adenoidy-u-detej-v-domashnih-uslovijah-bez-operacii.php https://www.pravda.ru/navigator/adenoidy-u-detei.html https: // VipLor .ru / gorlo / adenoidy-u-detej https://yandex.ru/health/turbo/articles?id=4922 https://nasmork.net/lekarstva-ot-adenoidov/ https://www.polyclin.ru / articles / udalyat-ili-ne-udalyat-adenoidy / https://nosoved.ru/zabolevanija-nosa/drugie/kak-umenshit-adenoidy-bez-operacii.html https://www.kp.ru/putevoditel/ sovety-dlya-roditelej / adenoidit-u-detej / https://diagnost-mk.ru/rentgen/adenoidy-na-rentgene.html https://nasmork.one/mamy-deti/adenoidy-u-detej-simptomy-i-lechenie/ https://zdorovyenadom.ru/adenoidit-u-detej-chto-eto-za-bolezn/ http: // x-raydoctor.ru/rentgen/lor/snimok-nosoglotki-rebenka.html https://s-voi.com/zabolevanie-legkih/rentgen-pri-adenoidah-opravdyvaet-li-sebya-ego-provedenie

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