Adenoides of the 1st degree in children: how to treat

Adenoides of 1 degree in a child - this is a common reason for appealing to a doctor because of the high incidence of children against this pathology. This disease is characterized by an increase in the nasopharyngeal tonsil, which violates the local immunity of the child and causes frequent respiratory pathologies. Approaches to treatment are different and you need to know about all the symptoms in order to correct the child's condition in time.

[1], [2], [3]

Epidemiology

Statistics of the prevalence of adenoids of the 1st degree in children is very high: more than 89% of children under 7 suffer from this pathology. But only more than 15% of children have the same problem at the age of 14 years. This suggests that in most cases the problem is age-related. About 12% of all surgical interventions on ENT organs are carried out in connection with adenoids, which also emphasizes the urgency of this problem and the need to solve it.

Causes of the adenoides of 1 degree in the child

Adenoids - a disease characterized by tonsillitis hypertrophy, which is located in the nasopharynx. Adenoids present at the birth of a child are in physiological hypertrophy up to the age of 7 years, they usually have a maximum size approximately closer to 4 years of the child's life, then atrophy begins and they practically cease to fulfill their function. Pharyngeal tonsil is the first immunocompetent formation. This amygdala is involved in providing the first immune response when ingested inhalation microorganisms are still in the early stages of a baby's life.

In most children these tonsils grow with age, and then are capable of back growth.

To understand the main causes of development of problems with the tonsils in the child, including the mechanism of their increase, it is very important to understand why they are in the oral cavity and what function they perform.

Oral cavity of the child is the place where microbes most often get. Therefore, many local defense mechanisms are concentrated there, which provide an active fight against microbes. One such mechanism is the lymphatic cells of the oral cavity. They are located in the form of clusters of cells under the mucous membrane on the back wall of the pharynx, on the mucous cheeks, throughout the bronchial tree. But the lymphatic system of the tonsils is the largest and correspondingly important. Tonsils are an accumulation of several hundred lymphatic cells, which immediately respond to a bacterium or virus, triggering an immune response. Such tonsils for each person, and the child including, only six - two paired and two unpaired. These include lingual tonsils, pharyngeal tonsils, palatine tonsils and tubal. All these tonsils conditionally form a ring, which is the main protective mechanism on the way to the respiratory and digestive organs. It is the increase in the pharyngeal tonsil and is called adenoids. Why is this happening?

[4]

Risk factors

Factors contributing to the development of adenoids

1. Constitutional predisposition.
2. Repeated infections of the upper respiratory tract.
3. Meals are mostly served with meat dishes.
4. Similar problems among family members.
5. Congenital or acquired immunodeficiency in children.

[5], [6], [7], [8], [9]

Pathogenesis

The pathogenesis of development of adenoids of 1 degree in a child depends on the structure and functions of the tonsils. The pharyngeal tonsil is located at the limit of the respiratory and digestive system on the back wall of the pharynx in the tonsillar niche. Most often, the tonsils are in the form of almonds, from which they received their name. Their size and shape varies. The tonsils distinguish between the upper and lower poles, the outer and inner surfaces. Histologically, it consists of a capsule, stroma, parenchyma and epithelial layer.

The free surface of the tonsils is covered with 6-10 rows of flat epithelium. On this surface there are 15-20 depressions leading to channels - lacunae or crypts. The crypts are more developed in the region of the upper pole. Starting on the surface of the tonsils, lacunae can branch out tree-wise, pass through all their thickness.

For better performance of its function, each amygdala is covered with an externally connective tissue, which inwardly gives away its leaves. This forms a capsule, which gives the branching inside and divides the tonsil into lobules. As a result, it is formed by lobes of uneven density, which helps to better perform their functions.

In the depth of the amygdala is the reticular tissue, built with "amoeboid" cells, which hold all the other cells inside. Between the reticular cells are single lymphocytes (mostly small), as well as their combinations - follicles, which are located parallel to the crypts. There are primary and secondary follicles. Primary follicles appear from the 3rd month of embryonic life and represent diffuse clumps of lymphocytes. Secondary follicles appear only in the post-uterine period of life. In their center are large cells with a light cytoplasm and a pale-colored nucleus, which form a zone called the "reactive center" or center of reproduction. Cells of reactive centers are lymphoblasts, which are then transformed into lymphocytes.

Lymphocytes are the main immune cells that react when microbes enter the respiratory tract. The microbe, getting on the mucous membrane, immediately activates the release of these lymphocytes from the tonsils and with a small amount of these bacteria, when they have not yet had time to multiply, the lymphocyte absorbs it. Thus, it prevents the development of the disease and protects the body already at the first contact. If too many bacteria and lymphocytes from the tonsils can not cope, then they use lymphokines to transmit a signal to the immune cells of the blood and they begin to perform their function already with the development of certain symptoms. Why can the tonsils grow? The pathogenesis of this can only consist in the constant intense functioning of these tonsils. That is, when a child is very often sick, the lymphoid tissue, including the pharyngeal amygdala, actively performs its function. A very large number of lymphocytes is formed here and they must constantly function and multiply. Therefore, they increase in size to match the needs of the body.

Nevertheless, the causes of adenoids of 1 degree in a child can not be limited to frequent diseases. Certain associations have been identified between adenoids and allergic rhinitis, although little is known about this. Children with allergic rhinitis, especially year-round, have a greater likelihood of hypertrophy of the pharyngeal tonsil than children without allergies. IgE - mediated inflammation can play a role in both diseases. Sensitivity to inhalant allergens changes the immunology of adenoids - they have more eosinophils and mediators of allergy. Therefore, one of the probable causes of development of adenoids of 1 degree in the child is allergic rhinitis.

A very important cause of adenoid development can be considered a chronic inflammation of the tonsils. And the direct bacterial factor of this infection is a mixed aerobic and anaerobic flora. The presence of infections leads to a chronic inflammatory condition, which subsequently leads to hypertrophy of adenoids lymphoid tissue. It is believed that the precondition for chronic inflammation in the adenoids (the appearance of chronic adenoiditis) and the recurrence of infections can be worsened mucociliary clearance. In particular, hypertrophied adenoids are characterized by metaplasia of the epithelium with almost complete loss of cilia, which can develop precisely against the backdrop of the inflammatory process in the adenoid tissue.

[10], [11], [12], [13], [14]

Symptoms of the adenoides of 1 degree in the child

Clinical manifestations of adenoids directly depend on the degree of their increase. It is rather a relative division, and for the mother or child it does not matter, but the degree of increase in the pharyngeal tonsil is clinically very important. Adenoides of the 1st degree in the child are characterized by an increase in the pharyngeal tonsil to one third of the inner surface of the nasal septum. This is considered very little and should not significantly affect normal breathing, but it all depends on the individual characteristics of the child. There are children who have a small facial skull and have a small pharyngeal space since birth. Therefore, even such a small increase in the tonsils can cause serious symptoms.

The first symptoms of adenoids often appear in children after 4 years. Mom may notice that the baby begins to snore at night, which is one of the most specific symptoms. This is due to the fact that the enlarged tonsil disrupts the normal flow of air. During sleep, the soft sky relaxes and drops a little, which also contributes to the horizontal position at this time of day. Therefore, the flow of air is even more disturbed, which causes snoring. During the day, the child can have only a symptom of an "open mouth" - the mother notices that the child is breathing through the mouth. This is one of the adaptation mechanisms, because there is a barrier to the normal nasal breathing and the child is easier and easier to breathe through the mouth. And here there is a vicious circle, because breathing with the mouth in the open cold air does not promote warming and purification of this air. Therefore, more pathogenic microorganisms get on the mucous membranes and this leads to the fact that the child is often sick.

Hypertrophy of adenoids of 1 degree in children has other symptoms. These include: a change in the toothache, speech disorders (nasal), rhinorrhea and cough, which are often repetitive. For children with adenoids, morbidity is more typical for ENT organs and the respiratory system: otitis media, recurrent lower respiratory tract infections, sinusitis. Frequent breathing disorders among children with adenoids are breathing stops in sleep, and most often at the age of 2-6 years. Chronic disturbance of normal breathing and natural air flow in sleep becomes a prerequisite for chronic hypoxia and sleep disorders, which can be the cause of psychoneurological disorders, growth retardation.

Due to the development of the facial skull, children with adenoids have a characteristic adenoid type of face (external adenoidism): smoothing of nasolabial folds, bulging eyes, constantly open mouth, elongated face.

Due to the chronic process of disturbance of normal breathing and gas exchange, the thoracic excursion is disrupted and this leads to its gradual deformation, it becomes flattened and sunken. Adenoides of the 1st degree in the child lead to the fact that the movements of the facial muscles are disrupted, laryngospasm, asthmatic attacks are more common. Another symptom of adenoids is sinusitis. They develop on the background of stagnation of air movement and accumulation of different bacteria in bone structures. Against the background of adenoids, pulmonary hypertension can also occur due to a chronic violation of the passage of air through the respiratory tract. With a pronounced and prolonged obstruction of the nose, the patient often changes his behavior, for example, there is an interrupted sleep, sleepwalking, headache in the morning, difficulty in concentration, drowsiness during the day, enuresis, slowed-down meal intake, growth retardation. There may also be cardiorespiratory syndrome and in severe cases "pulmonary heart".

[15], [16]

Complications and consequences

The consequences of adenoids are terrible because complications can occur against untreated adenoids, and there may also be complications after the operation. The main consequence of untreated adenoids is the constant hypoxia of the brain and other tissues that are actively developing in the child. And the remote consequences of this may be that the child is poorly educated at school because of a lack of oxygen for the active work of the brain. Prolonged adenoids can be complicated by hearing impairments, because pronounced changes can make the perception of sound difficult.

If there are indications and performed a surgical operation, then in the future it can also have complications. Violation of the integrity of the lymphoid ring of the oral cavity can lead to a violation of the natural immune barrier and the child can begin to ache more often.

[17], [18]

Diagnostics of the adenoides of 1 degree in the child

Diagnosis of adenoids of the 1st degree is not particularly difficult, and even at the stage of presentation of complaints it is possible to suspect an increase in tonsils.

At the general or common survey, as a rule, any signs are not present. One can only notice the specific expression of the child's face with a half-open mouth. This can lead to the fact that nasolabial folds can be slightly expressed or vice versa smoothed.

For a more detailed assessment of the state of the pharyngeal ring of the oral cavity, it is necessary to carefully examine the oral cavity and nasopharynx.

To assess the size of adenoids, finger examination of the nasopharynx is often used, posterior rhinoscopy using a mirror, and less often - a nasopharyngeal radiography in the lateral projection. However, these two methods are now considered inaccurate, and the method of choice is endoscopy of the nose. In recent years, technological progress has led to the emergence of flexible and rigid endoscopes of small diameter (2.7 mm), which provide an accurate endoscopic examination and assessment of the nasopharynx without complications. Such an instrumental study provides an opportunity to assess the extent of the increase and accurately establish the diagnosis. Upon examination, the enlarged pharyngeal tonsil, which hangs directly over the posterior surface of the nasal cavity in the vomer region, is visible. You can assess how much this tonsil is enlarged and how it closes the entrance to the nasal cavity and the auditory tube from both sides.

If there are complaints of hearing impairment, then it is necessary to perform otoscopy and to assess the degree of impairment of the hearing function.

Analyzes for adenoids of the first degree imply general studies that help to exclude the chronic inflammatory process. Very often, chronic adenoiditis can occur with an increase in adenoids and be accompanied by similar symptoms. A general blood test can help prevent the presence of an acute or chronic inflammatory process. For a specific diagnosis of a possible development factor of adenoids in a child, it is recommended to pass a culture from the oral cavity to detect microorganisms. This allows us to establish which pathogenic bacteria can be the cause of maintenance of the focus of infection of the pharyngeal tonsil, which in turn leads to the development of its hypertrophy.

[19], [20]

Differential diagnosis

Differential diagnosis of adenoids of 1 degree in a child should be carried out primarily with chronic adenoiditis. This is accompanied by frequent diseases with periodic exacerbations. Therefore, when examining a child with chronic adenoiditis, he should have symptoms of exacerbation: mucopurulent discharge from the nose, obstructed nasal breathing, subfebrileitis. If it is simply a matter of adenoids of the 1st degree, then there must be no acute inflammatory process. Another issue is that these two states can be combined, which also needs to be differentiated. It is also very important to differentiate adenoids with tumor formations of the pharynx, which is less common in children.

Treatment of the adenoides of 1 degree in the child

Today the possibilities of pharmacological treatment of adenoids are actively being studied with the purpose of preserving immunologically active tissue and preventing anesthetic and surgical risks associated with adenotomy. Conservative treatment is an alternative or an addition to the surgical one, since adenotomy is not an ideal treatment. First, the elimination of adenoid lymphoid tissue can have a negative impact on systemic immunity. Secondly, in 1% of cases after an adenotomy there are postoperative bleedings. Third, relapse after adenotomy occurs in 10-20% of cases. In addition, there is a certain anesthetic risk.

To date, treatment of adenoids of 1 degree in a child is recommended to begin with conservative therapy, namely, intranasal corticosteroids. To explain the decrease in adenoids under the influence of these drugs, several mechanisms are proposed: direct lympholytic action, suppression of inflammation with reduction of concomitant edema of adenoids, and also indirect influence on the nature of adenoid microflora. It has now been proven that intranasal corticosteroids can reduce the symptoms of adenoids, regardless of the atopic status of the child.

Allergy and sensitivity to allergens are risk factors for adenoids. Allergic sensitization of the respiratory tract occurs not only in the mucosa, but also in the adenoids and tonsils, which are lymphatic structures closely associated with the nasal mucosa. It is shown that adequate treatment of allergic rhinitis reduces the concomitant hypertrophy of adenoids.

It is also known that adenoids of the 1st degree are frequent concomitant pathologies in allergic rhinitis or sinusitis, and both latter diseases are treated with topical nasal steroids.

Preparations for conservative therapy according to the mechanism and the main goal of treatment should be divided into groups:

1. Medicines that increase the natural resistance to antigens: an organized diet, walks and sleep, also provides enough vitamins in the diet, hardening, spa treatment, tissue therapy.
2. Antihistamines and calcium preparations with vitamin complexes, low doses of allergens - all this is necessary to reduce the role of the allergic factor.
3. Means aimed at correcting metabolic disorders in the amygdala (trimetazidine, tocopherol, ascorbic acid, unitiol, quercetin).
4. Medicines that promote antiseptic action on the adenoids, the posterior wall of the pharynx and the local lymph nodes:
   • on the mucous membrane of the oropharynx (rinsing, irrigation, lubrication with solutions of antiseptics, chlorophyllipt, inhalation)
   • on the lacunae of the pharyngeal tonsil (active washing of cannula plugs with a syringe or hydrovacuum method, preferably with antiseptic solutions, in particular antibiotics.)
   • on the parenchyma of the tonsils (injections with antibiotics in the tonsils and space around the tonsils).
5. Means that restore the natural self-purification of the tonsils (normalization of the pump mechanism) - electromyostimulation of the muscles of the pharynx and pharyngeal space.
6. Preparations of irritating local action: novocaine blockades, collars with medicinal preparations.

For conservative and more complex therapy, it is important to use drugs used in various therapies that affect different mechanisms of the disease and the symptoms of this pathology.

A very effective way of drug therapy for adenoids and in some way preparation for surgical treatment can be considered an injection sanation of the pharyngeal tonsil. A syringe and a multi-hole tip are used for this procedure. In a syringe, a solution of an antiseptic or an antibiotic is taken and directed to the pharyngeal amygdala and the lavage is carried out in this place. It is very important to go through several procedures for completeness of the effect. If it can be determined in the lacunae of the amygdala against the background of its hypertrophy of the plug, then it is possible to pump out these plugs to improve the functioning of the amygdala. This can be done with the help of vacuum electrical equipment.

The main drugs for the treatment of adenoids 1 degree are as follows:

1. Allertec naso is a hormonal nasal drug, the active substance of which is mometasone. One dose of the drug contains 50 micrograms of glucocorticoid. The mechanism of action of this drug in adenoides of the 1 st degree is to reduce edema and reduce the sensitization of the pharyngeal tonsil. This leads to a decrease in its activity and, correspondingly, to a decrease in its size. Dosage of the drug is for children from two to twelve years - one spitting into each nostril once a day. Thus, the total dose is 100 micrograms. Side effects can be in the form of burning in the nose, itching, discomfort. Systemic influence on the body is rarely detected. Precautions - up to two years to apply for treatment of adenoids with caution.
2. Avamis is a topical glucocorticoid, which is represented by the hormone fluticasone furoate. This product contains 27.5 micrograms of substance, which acts upon inhalation in the nose. The effect of the drug for the treatment of adenoids is to reduce local reactivity and the inflammatory component against the background of an increase in adenoids. The dosage of the drug is one inhalation in the nose once a day until the maximum dose of 55 micrograms is reached. Side effects are in the form of reducing the local immunity of the nasal and oral mucosa with the possible development of candidiasis. Precautions - do not use in children up to six years.
3. Flix is an endonasal glucocorticoid, the active ingredient of which is fluticasone. The drug acts by direct effect on the tonsils by reducing the activity of lymphocyte function and reducing the volume of lymphoid tissue. Dosage of the drug - one inhalation in the nose once a day. Side effects of the drug are headache, bleeding of the nasal mucosa, systemic manifestations in the form of anaphylaxis.
4. Broncho-munal is an immunomodulating drug that can be used in complex therapy of adenoids. The composition of the drug includes bacterial lysates of the most common pathogens pathology of the upper respiratory tract. The effect of the drug is to activate the nonspecific protective forces of the body, as well as specific antibodies. This increases the reactivity and reduces the number of episodes of morbidity. This effect reduces the need for constant lymphoid activation of the tonsils, which leads to a decrease in their size. The method of application is internal, according to a special scheme. The dosage of the drug is one capsule for ten consecutive days, then a break for twenty days and repeat the reception for ten days two more times. One capsule contains 3.5 milligrams of substance, the general course is to take ten days for three months. Side effects can be in the form of headache, drowsiness, coughing, allergic manifestations. Precautions - do not use in children the first year of life.

Surgical treatment of adenoids 1 degree is limited, which emerges from the possible consequences. Surgical treatment is used most often in part because there are no pharmacological alternative therapies.

Adenotomy is the treatment of choice in children with severe adenoids, although there are already many reports of successful conservative treatment with endonasal corticosteroids. Indications for adenotomy are complications: secretory otitis, recurrent otitis, a change in the toothache, frequent recurrent respiratory infections, or chronic sinusitis.

Vitamins are necessarily used in complex treatment to improve the energy potential of cells that can suffer from hypoxia against the background of adenoids. For this purpose, multivitamin preparations are used.

Physiotherapeutic treatment is also widely used, as the additional stimulation of the enlarged pharyngeal tonsil is very useful in this case. For this purpose, steam inhalations of antiseptics, ultrasonic irradiation of tonsils, ultraphonophoresis of antiseptics and antibiotics at the need, lysozyme hydrocortisone, "Luch-2" on the maxillary lymph nodes, use of galic laser light; solux; mud treatment; treatment with magnetic rays.

Alternative treatment of adenoids of 1 degree

Alternative therapies are very widely used, since this condition in a child can be several years and the application of such methods can accelerate recovery. Alternative methods have a different mechanism of action: they increase the local immunity of the child, activate all protective forces, normalize blood circulation in the lymphoid tissue, directly reduce the hypertrophy of the pharyngeal tonsil.

1. Propolis is a natural antiseptic that can be used for adenoids of the 1st degree. It not only increases the local immunity of the oral and nasal cavity, but also it kills microorganisms that can be the cause of the maintenance of hypertrophy of the palatine tonsil. To prepare the medicine, you need to take a solution of propolis and dilute it with water in a ratio of 1 to 10. You can prepare the solution by infusing 10 grams of a dry extract of propolis in 100 milliliters of alcohol. This solution should be further diluted with water: add 10 grams of water to 10 grams of alcohol solution. The resulting solution should be digested into each nostril two drops three times a day. For the effect, treatment should be conducted for at least three weeks.
2. Carnation is not only a natural antioxidant, but also an immunomodulating agent that activates lymphocytes of the tonsils and improves their functioning. This leads to the fact that the lymphocytes become mature and ready for a protective function without previous activation. In this case, excessive work of the tonsils to perform a protective function is not required, which allows to reduce the degree of hypertrophy. For the preparation of medical infusion, you need to take ten grams of clove flowers and pour hot water in a volume of 200 milliliters. For cooking it is better to take a carnation not in a pack, but select from spices. It is necessary to wash the nasal cavity with this solution three times a day. To do this, if the child is old enough, you need to take the medicine in your hand and draw your nostrils to yourself, having done so several times, you need to blow your nose. This is an effective washing of the nasal cavity, which cleans the nasal cavity and tonsils directly.
3. Sea salt is a very effective remedy as an antiseptic, an antibacterial preparation, and also as a drainage agent. Salt crystals are able to wash all the plugs and most pathogens from the pharyngeal tonsil, which helps improve its function. To prepare the medicine at home, you need to take a tablespoon of sea salt without dyes and dilute in 100 grams of boiled water. To the solution, add 5 drops of iodine and stir. With this medicine, you need to rinse the mouth several times a day, and if you divorce twice, you can wash your nose. This will improve the healing effect and accelerate recovery. The course of treatment is two weeks.

Herbal treatment is also very widely used:

1. Infusion of herbaceous and herbaceous minerals, in addition to antiseptic properties, also increases the protective reaction of the body. To prepare the infusion it is necessary to mix 20 grams of dry leaves of the string and 30 grams of dry leaves of oregano. Adding to the herbs one hundred grams of hot water you need to steam for 30 minutes. After that, you can take the child instead of tea at 50 grams in the morning and in the evening, adding a little honey.
2. St. John's wort is a common remedy for treating the pathology of the respiratory system due to its ability to increase the activity of the cilia of the epithelium. On the lymphoid tissue, St. John's wort acts in a similar manner, increasing the cleansing of lacunae and accelerating the lymphatic drainage. To make a brew, you need to heat 50 grams of leaves in hot water and take on a tablespoon three times a day. For a child, this infusion can be bitter, so you can add a little lemon juice and honey.
3. Oak bark and mint is a combination of herbs that has antibacterial properties and accelerates the detoxification of the child's body against the backdrop of a long process of treating adenoids. Oak bark and dried mint leaves should be taken in equal quantities and poured cold water overnight. After this, such a solution must be boiled and insisted for another two hours. Take a child by a teaspoon of this infusion four times a day for a week, then you can reduce the dose twice before the end of the month.

Homeopathy in the treatment of adenoids is also used very widely. Such drugs can be taken for a long time, which reduces symptoms and relieves edema and an increase in adenoids.

1. Agrafis nutans is an inorganic preparation that contains processed and diluted graphite, which is a specific stimulant for the activation of the immune function of the tonsils. The drug can be taken to the child in the form of tablets. Dosage - one tablet five times a day. Side effects can be in the form of diarrhea, which occurs after several days of regular use of the drug. Precautions - do not use for treatment if the child has an allergic reaction to iodine, since the drug is processed with the addition of iodine.
2. Euphorbium compositum is a complex homeopathic medicine for the treatment of adenoids, which contains inorganic components (argentum, mercury) and organic (pulsatilla, loffa). The way of application of the preparation is in the form of a spray, the dosage for children in an acute period is one spitting six times a day, and after a decrease in symptoms it can be applied three times a day. Side effects - burning, sneezing, itching in the nasal cavity.
3. Job-Kid is a complex homeopathic medicine, which is used to treat adenoids of the 1st degree. The composition of the drug includes barberry, thuja, iodine and evpatorium. The method of use for children often in the form of granules. Dosage - 10 granules once a day before meals for five days, with a further break for two days. The course of treatment is about two months. Side effects are very rare, there may be allergic manifestations. Precautions - use children from three years.
4. Staphisargria and Calendula are a combination of homeopathic medications that help to normalize hypertrophic processes in the tonsils, and also has an antibacterial effect in preparation for surgical treatment. For a child from one year to seven, the dose is one granule of staphisargy and two granulosa calendula four times a day. The way of application - it is possible to crush the granule and to dissolve, without washing down with water. Side effects are very rare, but there can be an easy twitching of the muscles, which indicates the need to reduce the dose. The minimum course of treatment is one month.

[21], [22], [23]

Prevention

Prevention of adenoids is carried out in two ways: increasing the overall reactivity of the body and sanation of other foci of chronic infection - treatment of gum disease, teeth (caries, periodontitis), purulent sinusitis, restoration of nasal breathing disorders. Prevention of adenoids is primarily to prevent frequent exacerbations of diseases of these organs, which reduces the overall reactivity of enlarged adenoids.

At the same time, to improve the reactivity of the child's organism to the action of cold air, it is necessary to harden, which must be started in early childhood (hardening by solar and air baths and water procedures), combining them with physical exercises, mobile games and other physical activities. In the premises of pre-school institutions and the school, it is necessary to observe the ventilation regime in order to purify the air from carbon dioxide and contamination with microbes.

Particular importance in the prevention of diseases has a balanced diet with a sufficient number of proteins and fats of animal origin, carbohydrates and vitamins. Great importance is attached to the implementation of sanitary services measures to reduce industrial enterprises harmful emissions into the atmosphere, because chemical substances irritate the mucous membrane of the nasopharynx and cause inflammatory and hypertrophic processes of adenoids.

[24], [25], [26], [27]

Forecast

The prognosis of cure for adenoids is favorable for a complex and differentiated approach to treatment. Most cases of this pathology take place after the expiry of seven to ten years, and surgical intervention may be necessary only in 1% of cases of adenoids of the 1 st degree.

Adenoids of the 1st degree in the child can bring many unpleasant symptoms, as well as increase the incidence of the child. But all these symptoms can be treated conservatively, without resorting to surgery. There is only a small group of indications when a child needs surgical intervention in this pathology. Therefore, for a successful and proper treatment, the mother must know all the nuances and mechanisms of this disease in her baby.

[28], [29], [30], [31], [32], [33], [34]