Doctor Komarovsky on the treatment of grade 3 adenoids without surgery

Modern parents quite often hear the diagnosis "Adenoids" from children's doctors. And if in the initial stage of the disease the question of a surgical method of treatment is not, as a rule, in general, then this cannot be said about third-degree adenoids.

Moms and dads, whom the doctor gave a disappointing verdict and recommended surgical treatment, are desperately looking for information about whether it is possible to avoid surgery and cure a neglected adenoid in other ways. There are a lot of opinions of both doctors and parents, and they differ greatly. What does Yevgeny Komarovsky, a pediatrician known in Russia and abroad, think about the likelihood of doing without surgery for third-degree adenoid?

Here is the actual cycle of transmission of Doctor Komarovsky about the treatment of adenoids.

Reference

Evgeny Komarovsky is a well-known pediatrician, pediatrician of the highest qualification category. Was born in Ukraine. He is widely known on the territory of Russia, the former Soviet states, after a series of scientific publications in the field of pediatrics and a non-standard, sometimes contrary to the usual canons, view of the treatment of children.

Komarovsky has published several books on child health for parents. He is the host of the popular TV program "School of Doctor Komarovsky" and the radio project "Russian Radio" "Medicine Show". Twice dad - he has two adult sons. And more recently, twice a grandfather - Komarovsky has a grandson and a granddaughter.

What it is?

It is a common childhood inflammatory disease of the upper respiratory tract.... During a long disease process in the nasopharynx, the adenoid tonsil increases significantly in size. There is an overgrowth (hypertrophy) of the lymphatic tissue on the posterior pharyngeal wall.

Adenoids are most often inflamed in children aged 4 to 7 years. The older the child, the less chances of an increase in the palatine tonsil, since the tissue of the adenoids is no longer growing so actively.

According to medical statistics, about 10-12% of children suffer from adenoids in varying degrees of severity.

Symptoms

Any mother, even very far from medicine, can see an adenoid in her child. When you look closely at the child, it is striking that the baby breathes mainly through the mouth, since his nasal breathing is impaired. A gray-green discharge may flow from the nose and nasopharynx, sometimes with impurities of pus. The child develops night snoring, he has a hearing loss, the baby begins to ask again and hear worse, often complains of headaches. All this is an undoubted reason to see a doctor.

In addition, often with adenoid in a child, otitis media, dysfunction of the speech apparatus, and enlargement of lymph nodes are observed. The face of a sick child takes on a special expression, which doctors call "adenoid mask". It is characterized by absent expression, constantly half-open mouth, malocclusion, deformation of the facial skeleton.

In a child with advanced inflammation of the adenoid, mental processes are disturbed, attention, memory, learning ability decrease, he gets tired quickly and often feels "overwhelmed" for no apparent reason.

With acute adenoid, the temperature may rise. Laboratory blood tests will certainly show a decrease in hemoglobin - anemia, since breathing only through the mouth pretty soon leads to oxygen starvation of the body.

Causes

Postponed complicated viral infection, as well as frequent colds of a viral nature.
Postponed severe infections (scarlet fever, rubella, measles).
Hereditary factor. If a child has one of the parents who suffered from adenoid in childhood, the probability that he will also develop this disease is more than 70%.
Bronchial asthma.
Allergic lesions of the respiratory system.
Congenital problems and birth trauma. If the child experienced hypoxia during intrauterine development, or this condition accompanied him during the birth process.
Unfavorable living conditions of the child. This includes poorly ventilated rooms, malnutrition rich in vitamins, minerals, proteins and fatty acids, occasional walks, and a sedentary lifestyle.
Long-term toxic exposure - an excess of household chemicals, unsafe toxic (usually cheap, questionable origin) toys.
Unfavorable environmental factors of the area in which the child lives (strong air pollution, industrial "emissions", increased radioactive background).

The degree of the disease

There are three degrees of adenoid:

First. In the initial stage, the child has slightly difficulty breathing through the nose, this is especially noticeable at night, during sleep, when the nasopharynx is completely relaxed. The adenoids at this stage are inflamed, but insignificantly, they cover the nasal passages only slightly, only by a third.
Second. The inflammatory process in the adenoids is significantly pronounced, the baby snores during sleep. During the day, the baby has a rather serious violation of nasal breathing. The enlarged and inflamed adenoids already close more than half of the lumen of the nasal passages.
Third. At this stage, the child's nose almost constantly “does not breathe,” the baby begins to breathe through his mouth around the clock, even in sleep. His voice changes, he becomes nasal. The palatine tonsil is quite impressive in size and almost completely, by more than two-thirds, and sometimes completely overlaps the nasal passages.
There is also a conditional fourth stage, which is recognized so far only by doctors from the countries of the West and Europe. They say about it if the nasal lumen is closed 100%, and the auditory tube is closed by at least 50% with overgrown adenoids.

At any stage of the disease, a child may experience hearing loss.

Difficulties in diagnosis

The diagnosis of the adenoid is carried out by an otolaryngologist (ENT). He uses two methods - instrumental and manual. First, he will insert a special instrument through the mouth, which will allow you to see the palatine tonsil located far inside. And then he will conduct a manual examination of the nasopharynx. This procedure is rather unpleasant, but it does not last long.

The adenoids, which are composed of lymphatic tissue, have an important immune function. They protect the pharynx, nasopharynx and oral cavity from various pathogens. Healthy tonsils cope with this successfully. But the inflamed can themselves cause damage to various organs and systems. That is why, with adenoid, otitis media, tonsillitis, bronchitis, sinusitis often occur in a child.

Doctors and parents diligently treat all these ailments, time after time, several times a year, and they are very surprised that the ailments appear again. The true cause is often in the adenoids.

Treatment

Conservative methods of treatment give results in the early stages of the disease, doctors usually recommend surgery for children with the third degree of adenoid. Conservative methods are quite simple - this is the use of vitamins, rinsing the nasopharynx with special solutions, instilling antihistamines, anti-inflammatory drops, and sometimes antibiotics. Surgical intervention becomes relevant if therapy has been unsuccessful. The operation is called adenotomy.

Komarovsky makes a special emphasis on the fact that the indications for surgical intervention will not even be the stage of the disease, and not the size of the proliferation of the adenoids, but the symptomatic features that the disease gives.

So, with a third-degree adenoid with impaired nasal breathing, in some cases, you can do without surgery, and with a first-degree disease with persistent hearing loss, you will have to take drastic measures. Sometimes it happens. Therefore, Evgeny Olegovich recommends that you listen more closely to the opinion of the attending physician, do not hesitate to ask questions, including about the advisability of an operation to remove the adnoid tonsil.

The operation is performed under local or general anesthesia, its purpose is to remove the enlarged pharyngeal tonsil. Such an operation is not urgent and urgent; the child can be prepared for it normally and methodically. At the time of the surgical procedure, he must be symptomatically healthy. Adenotomy does not last long - only two to three minutes, no more than 5 minutes, but it cannot be considered safe and harmless.

Rarely, but there are complications - bleeding, damage to the palate, the negative effect of anesthesia on the child's body, although now in ENT hospitals they are trying to use new modern means of anesthesia for such a procedure, which are characterized by a rather mild and gentle effect.

Komarovsky draws attention to the fact that complete removal of the pharyngeal tonsil is impossible for anatomical reasons, and a small fragment of it is still preserved, so there is always a real risk that the tonsil will grow again. The doctor who performed the operation should not be blamed for this. Rather, the parents, according to the famous pediatrician, should blame themselves for the relapse. The repeated hypertrophy of the palatine tonsil is greatly influenced by the baby's lifestyle.

In his recommendation, Evgeny Olegovich focuses on the rejection of passive entertainment in front of the TV. A child who has already had adenoids once needs to play sports, walk a lot, breathe fresh air. The apartment should not have a lot of dust, "stale" air, stuffiness. The baby cannot be force-fed, stuffed with a lot of sweets.

In addition, as we have already found out, the adenoids have a very important protective function and their removal can negatively affect the child - he will become sick more often, his immunity will weaken. Therefore, Evgeny Komarovsky does not recommend immediately rushing into the operating room, as most doctors who adhere to the traditional fundamental medical school advise, the decision to remove the palatine tonsil should be an extreme measure. In most cases, the doctor stresses, even the third degree of adenoid can be treated conservatively.

Most often, Komarovsky recommends that parents approach the treatment of third-degree adenoids in a comprehensive manner.: Combine physiotherapy with taking medications prescribed by a doctor, undergo a course of laser therapy, and also take the child to the sea more often, since the sea air has an incredible healing and restorative effect on a child with adenoids. And only if all these measures turn out to be ineffectual, decide the issue of surgical intervention.

Alternative ways

Laser therapy. This method is used after the operation to remove the tonsil, and instead. Non-invasive laser therapy allows you to relieve swelling in the area of inflammation, eliminate the inflammation itself, and stimulate the immune system. This method is perfect for children with the first and second degree of adenoids, but it can also have a very beneficial effect on the third. The forecasts, however, in this case, are not too optimistic - laser therapy cannot reduce the advanced stage of the adenoid to a normal state, and there are quite a few procedures to go through, but the child's condition stabilizes.
Folk remedies... In the treatment of adenoids, according to parents, the most effective are the instillation of drops based on anise tincture, St. John's wort oil, beetroot juice, propolis alcohol tincture solution, rinsing the nose with a solution of sea pharmacy salt. Yevgeny Komarovsky does not object to folk methods of treating adenoids, but at the third stage of the disease he does not advise to rely entirely on “grandmother's” recipes. Since some forms of adenoid, and the third degree of diagnosis, in particular, requires more serious treatment. And folk remedies can be a good "accompaniment" to traditional treatment.

When is surgery imminent?

Komarovsky points out conditions in which the operation is inevitable:

If the third degree of inflammation of the adenoids is accompanied by deformation of the facial skeleton. If the baby's "adenoid mask" does not come off the face, surgical intervention cannot be avoided.
If nasal breathing is completely disturbed for a long time.
If the child has a hearing loss. When overgrown adenoids close the auditory tube. You can verify your hearing loss by visiting a pediatric audiologist, who will conduct a simple and fairly accurate audiometry procedure. If the hearing is reduced by more than 20 dB from normal values, you will have to do an operation to remove the adenoid tonsil.
If the child often has otitis media against the background of inflamed third-degree adenoids. Doctors usually consider 2-3 episodes in six months a frequent repetition.

Komarovsky's advice

If a child has recently had a viral disease, it is not worth sending him to school or kindergarten immediately after recovery, where he can again "catch" another virus. It is better to take a week's break in training and during this time provide the baby with long walks in the fresh air in the park, away from highways and industrial enterprises. This will help prevent overgrowth of the adenoid tonsil to a third-degree condition.
In case of ARVI and influenza in a child with enlarged adenoids, a doctor's consultation is required, the drinking regimen should be doubled compared to other children.
The best sport, according to Evgeny Komarovsky, for children with adenoids is athletics, because doing it, the baby will receive a lot of fresh air. Wrestling, chess, boxing are not recommended, as these sports are usually practiced indoors, which are rather dusty and stuffy. And this contributes to the deterioration of the child's condition.
Dr. Komarovsky advises not to be afraid of surgery to remove adenoids, and not to make it a great parental tragedy. However, if there is an opportunity to avoid an operation, according to Komarovsky, you should definitely use it.