Removal of the adenoids. Indications and contraindications to adenotomy. The effectiveness of adenotomy

Pathologically enlarged adenoids are called nasopharyngeal tonsils that causes difficulty breathing, disorders of hearing and other complications. Most often corrupting tonsils occurs in children from 3 to 7 years as a result of inflammatory diseases of the upper respiratory tract, as well as measles, scarlet fever and influenza. But if you want to remove adenoids and when it is better to adenotomy child? Commenting on the problem the doctor-the otolaryngologist Kolpakova Marina Anatolievna.

  • SYMPTOMS OF ADENOTOMY
  • CAUSES OF ADENOIDS
  • THE SHAPE OF THE ADENOIDS
  • THE ACUTE FORM
  • SUBACUTE FORM
  • THE CHRONIC FORM
  • THE EFFECTS OF ADENOIDS
  • HOW IS THE OPERATION TO REMOVE THE ADENOIDS?
  • INDICATIONS AND CONTRAINDICATIONS TO ADENOTOMY
  • HOW EFFECTIVE ADENOTOMY?
  • THE PRICE OF ADENOIDECTOMY IN KIEV

What adenoids (tonsils) is immunostimulatory on it is absolutely true and today we are trying to preserve. Up to 3 years possible removal of the adenoids with frequent otitis, and if the adenoids are really too large. But in the absence of these symptoms up to 3 years it is advisable not to touch them.

Symptoms of adenotomy

Adenoiditis may be accompanied by the following symptoms:

  • violation of nasal breathing;
  • intermittent fever;
  • dry cough;
  • the appearance of a mucous or purulent discharge from the nose.

The degree of inflammation of the tonsils of the nasopharynx

Causes of adenoids

The development of adenoiditis occurs due to the impact of different kinds of factors such as:

  • feeding artificial mixtures;
  • too monotonous diet;
  • the predominance of carbohydrates in baby food;
  • deficiency of vitamin D and as a consequence the development of rickets;
  • diathesis exudative (pus);
  • frequent hypothermia;
  • with chronic allergic rhinitis;
  • poor environmental background (polluted air or too dry climate).

The shape of the adenoids

Adenoiditis can occur in 3 different forms:

The acute form

The acute form of adenoiditis may occur due to frequent respiratory illness or strep infections. This disease is often accompanied by inflammation of the tonsils, but found in an isolated form.

Symptoms of the acute form of adenoiditis are:

  • high fever (39 degrees and above);
  • bruised pain when swallowing in the area of the nasopharynx;
  • nasal congestion;
  • pain in the area of the soft palate, extending to posterior part of the nasal cavity as much for the ears;
  • night asthma cough.

When viewed at the ENT acute form is manifested by edema of the mucosa of the throat, as well as its redness. Also from the nasopharynx can be allocated purulent mucus. The tonsils are also red and covered with white purulent grooves. The most effective method of detecting adenoids acute form is rhinoscopy or endoscopy.

This is the most dangerous form of inflammation of the adenoids is for infants. This is due to difficult diagnosis of this disease because of the controversial symptoms.

Adenoiditis acute newborns are most similar to poisoning and appears:

  • difficulty sucking;
  • disorders of swallowing;
  • perinatal disorder of digestive (poor appetite, nausea, accumulation of gas in the epigastric region, too long delay of food in the stomach).

Also often a sign of inflammation of adenoids in infants is enlargement of lymph nodes (submandibular and back neck) and pain in their polerowanie.

The acute form usually occurs within 5-7 days, but even a short period of the disease acute adenoids are prone to recurrence with a number of complications such as:

  • acute otitis media;
  • sinusitis;
  • diseases tear ducts;
  • disease of the lower respiratory tract (laringotraheobronhit, pneumonia, etc.).

In addition, toddlers may develop a retropharyngeal abscess.

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Subacute form

Compared with the acute form subacute, much longer runs of 15-20 days. This form of adenoiditis is often accompanied by diseases such as:

  • hypertrophy in the area of lymphadenoid pharyngeal ring;
  • lacunar tonsillitis.

The main symptoms of the transition of the acute form of the adenoids in subacute is:

  • lingering low-grade fever, which tends to spike;
  • purulent rhinitis for a long time;
  • swelling of the lymph nodes in the neck;
  • ear acute otitis average degree;
  • persistent cough likely to relapse.

The course of the disease may be replaced by improvements and deterioration of the body and last for several months.

The chronic form

As the name suggests, a chronic form of adenoiditis is one of the most long-lasting forms of the disease. It happened because of her mixed character, which can be applied not only to basic symptoms, but also the transformation into other types of pathologies. Basically it is a pathology of the ear type, lower respiratory tract, region okolonosovyh sinuses and others. In chronic adenoiditis is affected by several factors such as clinical symptoms, immune system response and the level of General allergic reactions. Given these factors, otolaryngologists divide the chronic form of the adenoids for several types:

  • catarrhal adenoiditis;
  • adenoiditis with purulent secretions of mucous;
  • exudative serous adenoiditis

Adenoiditis is also characterized by the occurrence of inflammatory reactions in the tissues of the adenoids, which leads to the formation of the following forms of this disease:

  • limfocitarnah-etofillina form with a weak degree of exudation;
  • lymphoplasmacytic form;
  • lymphoreticular form with serous exudate (fluid is released into the tissues or body cavity of small blood vessels during inflammation);
  • neutral-macrophage form with purulent substances.

In addition, there is a classification of the adenoids according to the degree of allergic reactions and immune protection of the body:

  • adenoids with marked allergic component;
  • adenoiditis with a predominant activity of the humoral system in immune defense;
  • adenoiditis with a pronounced decrease of immunity and the dysfunction of lymphocytes;
  • purulent exudative adenoiditis with a high level of activity of macrophages, T-lymphocytes and neutrophils and a parallel decrease in phagocytosis.

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The effects of adenoids

Delayed treatment of adenoids can cause many impairments of human health, for example:

  • the hearing impairment. An increase in nasopharyngeal tonsils gradually covers the course of the auditory tube. It does not give the opportunity to freely circulate the air inside it that is the cause of the weakening of the mobility of the tympanic membrane and hearing loss.
  • lingering colds. Due to insufficient air flow in the sinuses is hampered by the outflow of mucus. After a certain time in the nose occurs a favorable environment for bacteria to grow, which leads to frequent respiratory diseases and inflammatory diseases of the upper respiratory tract such as pharyngitis, laryngitis, tracheitis etc.
  • the loss of concentration. With constant shortages of oxygen in the body, primarily the brain, reduced concentration levels, memory worsens.Due to adenoids the human brain are not got 12-18% of oxygen that adversely affects his work.
  • periodic ear infections. Recall that adenoid education comprehensively violate the normal functioning of the middle ear. In such conditions it is very easy to develop different types of ear infections.
  • the diction. In the spread of adenoid formations in children can disrupt growth of facial bones of the skull. This, in turn, causes complications of speech: snuffling, swallowing certain sounds, etc.
  • prolonged chronic cough. Adenoids does not affect the state of the bronchi or lungs, but may cause coughing due to irritation of the nerve endings in the nasopharynx and the back of the throat. So cough adenoids belongs to the category of reflex. Removing the adenoids once a person get rid of unpleasant coughing.

How is the operation to remove the adenoids?

If conservative treatment is not successful, the patient can assign them surgically removed. This operation is called adenotomy. Surgery to remove adenoids is one of the shortest among all the possible types of surgery, and lasts only a few minutes under General or local anesthesia. Special ring-shaped knife (edentata) is injected into the area of the nasopharynx, pressed against her arch, and when the adenoid tissue is included in a ring, cut it off with one hand.

Traditional (surgical) scheme adenoidectomy.

But, despite the simplicity of the operation, it is not always safe. Complications can occur due to damage to the sky, bleeding or anesthesia. Fortunately, in modern hospitals, it is quite rare.

Cryotherapy and laser removal of adenoids does not solve the problem of the proliferation of adenoid vegetations. After these procedures, the adenoids, unfortunately, remain ongoing conservative treatment of this disease. The most effective are the standard method of removing (with the help of adenostoma) or gladkoplodnye method (method of kobiecie).

You can also replace the traditional surgical treatment of adenoids on more modern. In our days popular several types of innovative techniques of adenotomy:

  • endoscope into the nasal cavity of the patient, the endoscope is introduced with the camera, which gives direct and clear image on the computer screen right in the operating room. This provides a perfect overview to prevent minimal damage.
  • laser surgical knives in this case are replaced by modern laser of high power, which cuts and cauterizes the adenoids at the same time. This method is most favorable for removal of adenoids in children.
  • cryotherapy this kind of the opposite laser as removal of the adenoids is carried out by freezing them with liquid nitrogen. It is absolutely painless and fast: adenoid vegetations disappear by themselves, without affecting the nasal mucosa.

Indications and contraindications to adenotomy

It is important to know that not the size of the adenoids, and the specific symptoms of the disease may become an indication for adenotomy, because sometimes, due to anatomical characteristics of the child, even 3 adenoids (chronic) extent moderately difficult nasal breathing, whereas in another case the adenoids 1 (acute) degree can become a cause of hearing loss. It is therefore necessary to remove the adenoids in the presence of 2-3 symptoms:

  • the inability to breathe through the nose (mouth breathing);
  • strong snoring;
  • violations of the breathing cycle (sequence inhale-exhale);
  • twang;
  • periodic ear infections;
  • hearing loss;
  • odor from the nasal cavity;
  • persistent purulent discharge from the nose;
  • impenetrable headache;
  • causeless weakness.

As adenotomy not emergency surgery, it is recommended to prepare carefully, passing the complete examination. Surgical methods are undesirable for use during seasonal influenza epidemics, as well as after infectious diseases, when the immune system is particularly weak.

Adverse reactions after adenotomy no. Within a week after surgery can be a bit of sore throat, edema of the mucosa occur, but these symptoms are transient. The past really were different side effects after removal of adenoids, but at this stage of development of otolaryngology it’s all gone.

The surgery can be done at any age. But there are a number of recommendations, which should postpone the operation until the elimination of certain factors:

  • age up to 2 years;
  • disease in an acute form;
  • the recent vaccination of the child;
  • cancer;
  • diseases of the blood;
  • worsening allergic reactions.

Recovery after adenoidectomy in children usually takes much time, and most importantly, that it is recommended the patient not to eat hot and hard food for the first few days.

How effective adenotomy?

Don’t forget: no matter how skilled wouldn’t be a surgeon, pharyngeal amygdala cannot be completely removed by classical surgery. Some part of it still remains intact, and therefore we cannot exclude the possibility that the adenoids will grow back. In developed countries, doctors use a method of endoscopic adenotomy, but in Ukraine, this technology is inferior to traditional.

If timely treatment many children are amenable to conservative treatment of adenoids. Conservative treatment includes pulmonary, therapy, dried adenoids, nasal rinses with a decoction of oak bark. NAT procedures well removes swelling laser and magnetic-laser therapy. In addition, for the treatment of inflammation of the adenoids children are encouraged to swim.

It should be emphasized that the adenoids protect the respiratory tract from the penetration of pathogens, and thus their removal would cause serious damage to the immune system. That is why the operation is considered an extreme measure, and in the treatment of adenoiditis are trying to use conservative means.

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The price of adenoidectomy in Kiev

The adenoidectomy is a simple surgery, which is performed in many ENT clinics of Kiev.

Public hospitals, where they conduct the removal of the adenoids.

The name of the institution

Address

Contact phone

State institution Institute of otolaryngology named. Professor A. I. Kolomiychenko of NAMS of Ukraine

ul. Zoologicheskaya, 3

(044) 483-73-67

(044) 483-29-68

Kiev Regional Clinical Hospital

baggovutovskaya str., 1

(044) 237-02-86

Otolaryngic private clinics that provide a service to remove inflamed adenoids.

The name of the institution

Name of service

The cost

Address

Contact phone

Clinic Boris

Adenotomy (without the cost anesthesiological intervention)

From 3635 UAH

hospital street, 12-A,

Vasilkovskaya str., 55-A

(044)238-00-00

MC Dobrobut

Adenotomy

From 6710грн

street of Lomonosov, 52/3

street, 21-A

Geroev Stalingrada Ave., 4, building 5

building Family Idzikowski (M. Mishina), 3

mishugi street, 12-G

prosp Geroev Stalingrada, 16-V

Tatarskaya str, 2nd

Svyatoshinskaya str., 3-B

(067)219-5-204

(044)490-5-204

Plastic surgery clinic Certus

Adenotomy (without anesthesia)

From 6500 UAH

St. Peter Zaporozhets, 26

(044) 512-1516

(067) 233-7103

Mediland Clinic

Adenotomy

From 7000 to 9000 UAH

Kopernyka street, 12-D

(095) 365-00-04

(044) 355-55-31

KLINIKA Nove Tilo

Adenotomy shaver with endoscopic control

400.e.

Ul. Schekavitskaya 7/10 (entrance from St. Cyril (Frunze))

(068)90-60-90-1

(044)22-89-86-0

Center Crileria

The cryotherapy of adenoid vegetations and chronic adenoiditis

A comprehensive treatment of adenoids and chronic tonsillitis

From 450 to 700 UAH

From 1000 to 1350 UAH

St. Valery Lobanovsky, 5-A

(044) 353 20 06

* Prices listed above are presented as introductory information. For more detailed information consult one of the clinics.