Grade 2 adenoids in children: symptoms, diagnosis and treatment

The topic discussed in this article, “Adenoids of grade 1 and 2 in children: treatment,” continues to remain topical. First, let’s dot the i’s, as they say. What “adenoids” are for the general parent audience, unfortunately, is more than clear. Especially in families where the child has been diagnosed with adenoviral enlargement of the nasopharyngeal tonsils.

And, this is what “grades 1 and 2” mean in pediatric ENT medicine, in particular, adenoid pathogenesis in children. And, most importantly, what treatment is used for these degrees? These questions concern parents, and they are interested in receiving comprehensive, useful information.

Drugs for the treatment of adenoids 1, 2 degrees

Looking at the pharmacy windows filled with numerous medicinal products, we understand that the pharmacological industry is moving forward. This fact is especially encouraging when it comes to the development of new, truly innovative nasal products in the field of pediatric ENT. Drugs for the treatment of adenoids in children of grade 1 and 2 severity of the disease occupy a significant part of the production sector. Compared to the amount of cardiac and stomach medications for children, this is approximately 7 pharmaceutical units. drugs out of 10.

Antranasal antiseptics, antibiotics, semi-synthetic and purely artificial corticosteroids. How can parents avoid getting confused in such a large variety? Of course, responsibility for prescribed medications for the treatment of adenoiditis in children rests with the attending otolaryngologist. But it is also not uninteresting for the relatives of a sick child to somehow be informed themselves - “What was attributed to the baby’s adenoids?”

Epilogue closing the topic of consideration

Adenoids of 1st and 2nd degree in children , their treatment requires patience, constant attention and care. Because the disease “adenoiditis” in children of kindergarten age, in primary school, and even in adolescents, occurs differently.

Some guys go through pain, long months of continuous medical manipulations, but still experience despair before surgery to remove the adenoids.

If they live in small towns, in the outback of the province, where it is not possible to carry out the innovative cryo-freezing technique “extreme burn with liquid nitrogen”. Or be cured with the help of super modern equipment “Stiatron”, which treats adenoids using pulsed irradiation. Such village children most often have their nasal and pharyngeal hyperplastic decomposed glands removed using the old surgical method - cutting out with an adenotomy or curette.

But, fortunately, children from these regions have strong adenovirus immunity and good health from birth. Therefore, the 1st degree of adenoids is recorded here more often than the 2nd and severe 3rd degree. The same cannot be said about small urban residents of overpopulated megacities.

Here, on the contrary: primary degrees of adenoid pathogenesis are much less common than the stages of adenoids, which are subject to urgent adenotomy. And it is no longer possible to save them. The conclusion suggests itself - monitor the condition of the nasopharynx in children. Not just once, from time to time, but constantly, every day. Instill in the nose, rinse the nasal canals, gargle, not when the disease is at its peak, but in a healthy state. This is called prevention of adenoids of both 1st and 2nd degrees. And your children will have healthy nasopharyngeal glands!

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For mild 1st degree of adenoid pathogenesis - drugs with lightweight pharmacokinetic properties

You don’t need to be a certified specialist in medicine to understand a simple concept: the initial periods, minor phases of diseases cannot be treated with massive use of potent medications. At this stage, for example, of adenoidopathogenesis, the lymphoid glandular tissue of the nasopharyngeal tonsils is just beginning to hypertrophy. The mucous epidermis in the nose and throat of children (at the gene-cellular level), as a rule, is not subject to catastrophic destruction from pathogenic microflora. Therefore, pediatric otolaryngologists are tasked with performing several tasks:

• ! – Preserve the nasopharyngeal glands as a physiological congenital organ, the protective sector of the child’s immune system;
• ! – Return to the previous (healthy) state the external and visceral structures of the nasopharyngeal parenchyma - the nose (adenoid glands) and throat (tongs);
• ! – Apply a gentle medicinal technique that will least likely cause negative consequences on the functionality of vital organs - the heart, lungs, kidneys, liver and gastrointestinal tract;
• ! – Strengthen the implementation of preventive, prophylactic measures to prevent the transition of adenoid vegetation of the 1st degree to a “higher” turn, in the pathogenic reduction of pathogens - strains of viruses, bacteria, microbes and pathogens, to the 2nd degree of severity of the disease.

To the parents’ question: “Which drugs for the treatment of adenoids in children are considered the most acceptable: for the same 1st degree (or 2nd degree ) ? “, the best answer will be our information materials on the website adenoidy.com.

We suggest using a kind of table - a route.

For initial symptoms of adenoid vegetation (1st degree of comparative pathological characteristics), inflamed adenoids in the nose or enlarged tonsils, read the relevant articles:

Some of the works are devoted to descriptions of medications for use in initial forms of adenoid hyperplasis, some for the treatment of aggravated ones (grade 2 and stage II).

Important! If you want to learn in detail, get comprehensive information about the 1st degree of adenoid hyperplasia of the adenoids, advice: – pay attention to the information context about homeopathic and folk remedies. About preventive methods and health improvement for sick children. About treatment with herbal medicinal plants. It is with this kind of conservative therapy, traditional medicine, that otolaryngologists treat “primary” pathological adenoids!

First (1) degree of adenoids in terms of disease state

A short extract from Wikipedia (dictionary of philological terms) will help explain what the word means:

1. Βαθμός (degree), this is how the word is written in Greek. Denotes comparison with something: size, type, type, condition. In medicine it is used as a definition of pathological homeostasis in the human body. It is classified according to clinical characteristics - mild, moderate, aggravated and severe.

For example. Upon final diagnosis, in terms of adenoid vegetation in children, the otolaryngologist can make the following entry in the medical history: “Adenoid pathogenesis begins in the initial phase of the disease. Pathogenic clinical laboratory testing of microflora in the nasopharynx (strains of pathogens) confirms the 1st degree of severity.”

Visually (externally) and viscerally (internally) similar symptoms in children are expressed in the following signs:

• frequent runny nose caused by seasonal colds;
• a stable increase in temperature, especially in the evening (above 37.8), with chills, general malaise;
• purulent transparent blisters appear on the lips or the area around the nose (sometimes in the ears), the so-called “cold” is a herpes virus;
• congestion of the nasal canals causes difficulty breathing through the nose, as a result - a specific nasal tone appears in the voice;
• in the context of the disease pharyngeal adenoiditis, symptoms manifest themselves in hyperemia, pastiness of the palatine arches (tonsils);
• an increase in the throat tonsils and adenoids in the nose narrows the lumens in the parenchyma of these organs, which causes insufficient air passage.

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Important! At this first “step” of adenoid disease, the lymphoid picture of destruction is minimal. But this is already an unhealthy situation that requires urgent treatment. The nasopharyngeal glands must, without any doubt, be returned to healthy parameters, size, and condition.

A comprehensive program has proven to be the best and most successful treatment method. In which, harmoniously and reasonably, they combine: medicinal nasal agents together with intensive physiotherapeutic procedures.

With a parting word at the end of the topic under discussion

Treating adenoids, who argues, is not easy. You shouldn’t even hope for quick and lasting deliverance (once and for all). Well, it’s necessary to tune in to the patient, methodical, punctual fulfillment of all the instructions of the treating otolaryngologist!

Both the first and second degrees will require concentration and attentive attitude towards the sick child from professional doctors, care and love from relatives. This is the only way it is possible (and there is a full guarantee) to defeat adenoid disease, and for your children to enter the age of youthful manhood with preserved nasopharyngeal adenoids and tonsils!

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Features of treatment of grade 2 adenoids in children

If your child often sniffles, his mouth is slightly open and nasal breathing is difficult, then you should definitely consult an otolaryngologist to check the condition of the adenoids.
If an accumulation of lymphoid tissue is detected, the doctor diagnoses “Adenoiditis” or “Hypertrophy of the pharyngeal tonsil.” Adenoids are grade 1, 2 and 3. If the doctor has diagnosed it as stage 2 adenoids, then it is too early for you to sound the alarm, since this stage is most often easily treated with conservative treatment and the adenoids go away on their own with age.

Adenoid grades

As already mentioned, there are 3 degrees of the disease:

1. 1st degree - adenoids cover 1/3 of the nasopharynx. This is enough for the child to breathe normally through his nose during the daytime. At night, the tonsils enlarge and partially block nasal breathing.
2. 2nd degree - there is a more significant increase in tissue. The tonsils occupy half of the free space.
3. 3rd degree - there is almost complete closure of the nasal space. The child does not breathe through his nose at all.

Causes

Most often, pathology occurs in children between the ages of 3 and 7 years. Adenoids of 1-2 degrees easily go away by the age of 12-13 years.

Stage 2 adenoids are most often an advanced form of stage 1.

Remember! It is not recommended to start the course of the disease, so as not to worsen the situation to the point of requiring surgical intervention.

Adenoids are the result of an inflammatory process in the nasopharyngeal tonsil. As a result, the tonsil increases in size and blocks free nasal breathing. Often this condition is accompanied by the presence of discharge from the nasal passages, as well as along the back wall of the throat.

Children who have enlarged adenoids get infections even more often and more easily, which leads to a significant enlargement of the tonsils. The tonsils do not have time to return to normal after the illness before they again encounter a new infection.

Second-degree adenoids are the source of various chronic diseases. It is necessary to regularly sanitize the nasal cavity to prevent the spread of infection into the respiratory tract.

So, we can summarize: the cause of the proliferation of lymphoid tissue is any chronic disease of the respiratory system or untreated inflammation, which leads to stagnation of lymph and blood in the nasopharynx.

Symptoms of the second degree

In a normal state, adenoids help the body cope with pathogenic microflora. They take the entire “blow” upon themselves. But if the immune system weakens and the lymphoid tissue begins to grow, the adenoids increase in size and are no longer able to cope with attacks. Microorganisms begin to settle, multiply and spread throughout the body.

The most basic symptom of second-degree adenoids is difficulty breathing through the nose. Inflamed tonsils block 2/3 of the nasal passage. In the first degree, difficulty breathing through the nose is observed only at night, and in the second and third degrees, breathing is difficult during the daytime.

Other signs include:

• poor sleep;
• dry cough in the morning;
• prolonged runny nose;
• frequent colds;
• nasal voice;
• hearing loss;
• night snoring;
• breathing problems in the absence of a runny nose.

Clinical picture

According to international doctors, the first signs of adenoids can appear as early as one year of age. However, most often the disease becomes more complicated at the age of 3, when the child begins to actively contact other children. It is during this period that the child’s body suffers from infections, germs and viruses. This situation concerns not only Russian preschoolers, but also children all over the world.

To understand this topic, you need to identify the main criteria for the clinical picture:

1. Enlarged adenoids create a lot of problems for the child’s health, in particular, breathing is impaired and snoring appears. The condition can also be affected by restless sleep and nightmares.
2. When the phase of the disease becomes more complicated, breathing problems appear not only at night, but also during the day. According to doctors, adenoid tissue fills the airways by 55%.
3. The second degree is also characterized by compensatory breathing through the mouth.
4. The child becomes inattentive, distracted and irritable. At school there may be problems with memorizing subjects and academic performance.
5. Dizziness, headaches.
6. If the baby also suffers from colds, then other factors may arise: mucous and purulent discharge from the nose, excessive weakness, elevated body temperature, poor appetite.

The clinical picture helps the doctor look at the problem from all angles and prescribe highly effective treatment.

Diagnostics

To prescribe the correct and effective treatment regimen, it is necessary to conduct an accurate diagnosis. To do this, choose one of the following methods:

1. Digital examination of the nasopharynx. Unfortunately, not all hospitals have special equipment, so the doctor can painlessly examine the nasopharynx using his hand.
2. Posterior rhinoscopy. The doctor conducts an examination through the mouth using a mirror. The procedure is painless.
3. Anterior rhinoscopy. The doctor examines the nasal passages.
4. Radiography. The examination will help rule out sinusitis, but if the adenoids are covered with plaque, they will appear enlarged on the image.
5. Laboratory study of microflora. Performed for frequent ARVI
6. Endoscopic examination. Diagnosis is carried out using a flexible or rigid endoscope. This method allows you to determine the degree of inflammation and the presence of discharge.

Important! Do not try to examine, much less examine, the pharyngeal tonsil with your fingers. Not only will you not see anything, but you will also hurt the child.

How to diagnose?

As soon as symptoms and signs of adenoids are detected in a child, it is necessary to immediately take him to a specialist. The sooner the disease is noticed, the faster it can be cured. Usually, the doctor at the appointment conducts diagnostics, which allows you to examine the tonsils in detail. Doctors use several diagnostic methods:

1. The patient can be examined using a medical mirror. In this case, it is very important that the doctor did not damage the instruments to the palate, since this causes a gag reflex in many children.
2. Using vasoconstrictor drops, the doctor examines the baby's nasal passages.
3. A painful procedure can be called a digital examination of the pharynx. The inspection is done using the fingers.
4. Before using a flexible endoscope, the specialist administers local anesthesia. Despite the complexity of the method, the doctor receives complete information about the adenoids.
5. Study of microflora in the laboratory.
6. X-ray.

Of course, it is almost impossible to examine the adenoids in the nose on your own, so the help of a specialist is simply necessary. The fact is that high-quality diagnostics helps the doctor prescribe more effective treatment.

How can second degree adenoids be cured?

Treatment can be either conservative or surgical if there are any complications.

Conservative treatment

The first thing to do when adenoiditis worsens is to rinse your nose more often. This can be either a self-prepared saline solution (1 teaspoon of salt per 1 liter of water), a pharmaceutical saline solution, or sea water (Aquamaris, etc.).

First you need to rinse your nose from mucus, and only then instill vasoconstrictor drops (Nazivin, Naphthyzin, etc.). They will help relieve swelling and improve nasal breathing. Drops must be applied 3 times a day and for no more than 5 days.

After 30 minutes, you need to drip the medicine into your nose. It could be one of:

• 2% protargol solution;
• Nasonex;
• Oak bark;
• Isofra;
• 20% albucide solution;
• Polydexa.

If the disease is severe, the doctor may prescribe an antibiotic.

Important! The drug must be strictly prescribed by a doctor. Do not self-medicate.

Very useful in treatment and physiotherapy.

Laser therapy is quite effective in reducing overgrown tissue in grades 1 and 2 of adenoiditis. It improves immunity and blood circulation.

Using an electrophoresis procedure, drugs - diphenhydramine and calcium chloride - are injected into the nasal passages. The medical device helps to penetrate deeply into the tissue and have a positive effect.

Treatment of grade 2 adenoids without exacerbation does not require drug therapy and consists only of:

1. hardening;
2. annual stay at the sea for at least 2 weeks;
3. taking immunomodulatory drugs to prevent viral and bacterial infections.

Surgical treatment

The indication for removal of adenoids is not the degree of growth, but what complications they entail.

Among the most common complications:

• frequent pauses in breathing during sleep;
• hearing impairment, frequent otitis media and other diseases of the middle ear;
• deformation of the bones of the facial skull, the formation of an “adenoid face”;
• retardation in mental and physical development;
• frequent ARVI (more than 10 per year);
• lack of nasal breathing after conservative treatment methods.

The operation to remove adenoids involves complete or partial removal of the growths.

Surgical treatment of adenoids includes:

1. removal using an endoscope. All overgrown tissue is removed very quickly and accurately
2. traditional operation. The tonsil is removed using an adenotom (special knife). This operation is psychologically more difficult for the child.

Typically, adenoids grow until 6-7 years of age, and only then their size begins to decrease. If you can reach this age with the help of conservative therapy, that’s great. If not, don’t be afraid of surgery!

Remember! If conservative treatment does not produce results, do not be afraid and postpone surgery. It is better to quickly remove the pathologically overgrown tissue and allow your baby to breathe fully through his nose.

Second (2) degree of adenoid hyperplasia: symptoms, treatment

Yes, but doctors also record the opposite in children’s histories, which are already characterized by anxiety and threatening clinical manifestations. We are talking about a description of symptomatic signs of grade 2 in the nasopharyngeal epidermis of children:

• In an approximate context - “An additional instrumental examination (endoscopy) and repeated control laboratory studies of the nasopharyngeal biopsy confirm the assumptions that have arisen. The child’s adenoiditis is not grade 1, but has progressed to grade 2. Adenoidopathogenesis is determined in the moderate phase of the disease.”

What external and internal changes in children can parents notice the beginning of the 2nd degree of adenoiditis? Please note: if the baby begins to experience completely new, previously unobserved phenomena, such as:

• The child snores at night, breathes heavily through the nose, sudden stops (long pauses) in the breathing rhythm are recorded;
• Adenoids or tonsils in the throat significantly block the lumen, the space for the passage of air flow;
• Shooting pains appear in the ears, severe headaches occur;
• Children steadily acquire “soundness”, slurred words in pronunciation;
• Conservative, lightweight medication does not bring significant changes for the better.

The otolaryngologist will make an appropriate entry in the anamnesis in the “Recommendations for Treatment” section. It will substantiate the prescription of potent antibiotics, possibly using intensive inhalation. This technology has a faster effect, with the help of fine dispersion, of medicinal antiseptics on pathogenic adenoid tumors.

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Physiotherapeutic procedures will be enhanced by UHF, electrophoresis, high-frequency treatment and pulsed irradiation with the Green Wave laser. A pediatric ENT specialist will try to do everything possible to prevent adenoid hyperplasia from moving into the 3rd, operable phase of the disease.

Prevention

As a preventive measure, use all measures that are aimed at strengthening the child’s immunity and increasing the body’s resistance to viruses, namely:

• follow a diet and sleep schedule;
• spend as much time as possible outdoors;
• Take a bath every day, gradually reducing the temperature of the water;
• visit the pool;
• don't overeat;
• observe all rules of personal hygiene;
• promptly treat viral and bacterial infections;
• maintain optimal indoor air conditions: temperature 18-20 degrees and humidity 50-70%.

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