Rus Articles Journal

Adenoides at the child: to treat or delete?

Adenoides. If the doctor from a threshold makes you such diagnosis when the child suddenly begins to snore at night and does not breathe a nose - it is not absolutely correct. On that simple basis that - it is more reasons for snore and the complicated breath through a nose, than one.

Let`s try to check words of the regional ENT SPECIALIST that at your kid adenoides are increased. Having just glanced in a nose and a throat to the kid, you will not see adenoides. It means that for establishment of the diagnosis of adenoides the doctor is simply obliged to take some special steps, to appoint or conduct some examinations that already on their basis to render the verdict.

Here we will also look at

what inspections and what information they can give the doctor are.

Survey of adenoides by means of a mirror

As looks

After survey of a throat the doctor takes small (diameter of 5 - 15 mm) a round mirror on the long handle and again for some reason watches to the kid a throat though, apparently, just looked at it. So in the American fighters police officers look under the bottom of the car or for a corner, expecting in a small mirror to see something big and bad. Actually the doctor looks for a soft palate to the kid and considers his adenoides.

That is seen by the doctor

what at usual survey it is impossible to see - the child`s nasopharynx, the size of his adenoides, their state. If the doctor is able to use this method well, he can see also Joana (an opening in a nose, opposite to nostrils) and mouths evstakhiyevy (sometimes speak - acoustical) pipes.

That the child

feels

If the doctor skilled and nothing is able to use this method, then. Or almost anything - only an easy spasm in a drink.

of Advantage of a method

Besides, at the known experience of the doctor it is possible to estimate not only a condition of adenoides, but also extent of their increase and even to assume at the expense of what they increased - it is very important for the choice of a method of treatment. If adenoides are increased at the expense of an inflammation, then they do not need to be deleted - it is necessary to treat. If adenoides just big, you, most likely, are waited by operation. Such inspection is good the fact that it can be carried out in any the ENT SPECIALIST - an office even if all equipment consists of a desk lamp, a reflector and a tool kit. Nearly forgot - in the out-patient card this method will be called a back rinoskopiya.

Shortcomings

Nevertheless should be able to watch a nasopharynx by means of a mirror. And yet the picture which was seen by the doctor cannot be documented in any way - it is necessary to take the doctor the word.

How to treat the diagnosis

If the doctor just tells to

“adenoides 3 - y degrees, it is necessary to delete“, then for such informative method it is not enough. Therefore to agree or to agree with recommendations, ask the doctor several leading questions. You remember - it is only necessary to delete hypertrophied, that is expanded, adenoides. If adenoides are increased at the expense of an inflammation - that is simply swelled, operation is not justified.

these Questions look quite innocent so any doctor willingly will answer them. So, what questions are? whether

  1. on a surface of adenoides slime or pus Is? If is, then there is nothing and to think of operation - it is necessary to get rid at first of slime and pus, and then to watch how it is breathed to the child. And if breath through a nose completely is restored, so the alarm concerning adenoides from the very beginning was false.
  2. What
  3. of color mucous membranes of adenoides? The question, of course, will guard the doctor, but it is always necessary to talk to the advanced parents longer than usual; besides, as the inflamed mucous membrane at the child looks, each mother knows as it is. Pale, cyanotic or it is bright - red mucous are signs of an inflammation. Means, besides, adenoides should at least try to be cured without operation. And only if a mucous membrane pink, on removal of adenoides it is necessary to agree with the direction.
  4. At adenoides a plain surface? The surface of healthy adenoides - “in a fold“ if it smooth, so is available hypostasis which is a consequence of an inflammation. And we already know that so far there is an inflammation on adenoides, they need to be treated, without resorting to operation.

Research of adenoides a finger

As looks

the Doctor suddenly gets up, presses the child`s cheek to himself to a hip and thrusts to it a finger into a mouth. The child, naturally, shouts and resists.

That is felt by the doctor

Adenoides it is possible to feel

if for any reasons they did not manage to be seen (for example if the doctor is not able to watch the kid by means of a mirror). At palpation the doctor can assume extent of increase in adenoides, and also understand, whether soft they (it is a symptom of inflammatory hypostasis) or dense (and this already a sign of a hypertrophy which is eliminated only with a surgical way).

That the child

feels

to It oppositely and sick. Very in a disgusting way.

of Advantage of a method

Everything that is necessary for carrying out similar research, is rubber gloves (at best) or clean hands of the doctor (it in the worst). And still the doctor can estimate extent of increase in adenoides and understand at the expense of what all of them - increased.

with

Shortcomings

In - the first, to the child it is painful. In - the second, at such research injuries - both the child, and doctor`s fingers are possible. And to parents to observe a similar picture extremely unpleasantly.

How to treat the diagnosis

If the doctor puts, say, the 3rd degree of adenoides and about anything, except operation does not speak any more, overcome yourself and ask it what were to the touch adenoides - soft or dense.

I Will repeat - soft adenoides are hypostasis, so, prospect of conservative treatment; dense mean inevitable operation. Forgive, but if you did not manage to prevent such cruel survey, try to take at least from it information maximum - it will help the child much better, than your complaints.

X-ray

the Most widespread way of statement of the diagnosis of increase in adenoides. And the worst. Except that the X-ray is always radiation (so, within half a year after that doctors should reflect strong whether to appoint to your kid a X-ray if they suspect, God forbid, of course, a fracture or pneumonia), it also godlessly lies - the truth, is exclusive in cases when business concerns adenoides.

Focus consists that the X-ray, in - the first, does not give idea of at the expense of what all - adenoides are increased; in - the second if on a surface of adenoides pus or slime accumulated, the X-ray will see it as well as adenoides - and will add to your kid degree - another.

Business is complicated also by the fact that the x-ray picture is a document. And it means that in any disputes not you will be right any more, and your doctor. Here supposedly you look - operation was justified: in a picture adenoides of most real 3 - y degrees.

Therefore if suddenly recommend you a X-ray of adenoides, will be better to refuse and insist on carrying out some other research. We know now that such ways are.

of Extent of increase in adenoides

of Extent of increase in adenoides were thought up just by radiologists - because in a x-ray picture it is the simplest to see extent of increase in these adenoides. Ask the doctor (if all of you made a picture) to show you where the kid has a nasopharynx gleam and where “the shadow of adenoides“ (it quite so is located and is called). And then also estimate as far as adenoides at the kid are increased.

I degree. Adenoides occupy up to 1/3 gleam of a nasopharynx. Even if the kid nevertheless snores at night and badly breathes a nose, to delete adenoides to you to anything. Business, most likely, in prolonged cold which is treated by drops and physical therapy, but not a surgical way.

II degree. Adenoides occupy exactly a half of a gleam. On them it is possible “to dump“ difficulty of breath in a dream, snore and decrease in legibility of the speech. Just you remember that extent of increase in adenoides has with indications to operation nothing in common. It just the description of a condition of a nasopharynx - and all.

of I-II degree. Adenoides somewhere between 1/3 and a half of a gleam of a nasopharynx. Externally they are shown not as the second and as the first degree therefore it is not necessary to agree to operation at all.

III degree. Adenoides occupy all gleam of a nasopharynx. The child does not breathe a nose neither in the afternoon, nor at night. And if breathes, then it is not the third degree - it is a slime congestion in a nasopharynx, let and occupying it entirely. The hearing decreases - sometimes to what the kid not only does not understand, but also does not hear the words turned to it.

IV degree - in its nature does not exist. Adenoides can be only I, II or III degrees. If the doctor makes the diagnosis “the IV degree of adenoides“, it is simply illiterate.

Endoscopy of a nasopharynx

the Most progressive, the most informative, and in combination both most rare and expensive method of diagnosis of adenoides. If the clinic bought the endoscope in an office the ENT SPECIALIST - the doctor - be pokoyna, she will try “to beat off“ it as soon as possible. And for a small particle of the very expensive endoscope will make out a bill and to you too. Let`s understand at first: what we pay for?

As it looks

the Endoscope - the long thin tube in fact representing a lens of a video camera which is carried out through a nose to the child`s nasopharynx (i.e. on depth of 3 - 4 cm). the Doctor can see what occurs in a nose and a nasopharynx or on the monitor screen, or through “peephole“ on other end of the endoscope.

of Advantage of a method

Endoscopy allows to examine most in detail a cavity of a nose and a nasopharynx, and the turned-out picture can be recorded on video or just to print in the form of a color photo so endoscopy of a nasopharynx is the best replacement to a x-ray picture.

by

Shortcomings

Thickness of modern endoscopes of 2 - 4 mm, therefore to carry out such endoscope through the child`s nose, to the doctor it is necessary to make anesthesia of a mucous membrane of a nose. Most often doctors apply lidocaine in the form of spray which in itself is capable to irritate a mucous membrane, and still is rather strong allergen. So if you do not know whether the kid has an allergy to lidocaine, or such allergic reactions already happened, it is better to refuse endoscopic research. Endoscopy of a nose and nasopharynx without anesthesia - it is too sick.

How to treat the diagnosis

If to your child carried out by

endoscopy of a nasopharynx - it is your chance to see what happens to adenoides of the child. Pay first of all attention to whether there is hypostasis of adenoides (mucous membranes pale, and the surface of adenoides is maleficiated) and whether there is on a surface of adenoides a slime or pus (it is possible to mix them unless among themselves). If on the monitor screen nothing is visible at all, except pus, certainly, immediately it is impossible to agree to removal of adenoides - the course of local anti-inflammatory therapy, washings of a nose and nasopharynx and physiotherapeutic treatment, and at all not operation are necessary.

you Remember
:
your task - not to get rid of adenoides at the child, and just to restore free breath through a nose. It is surgically possible to help only if adenoides are hypertrophied without any inflammation. Inflammatory changes demand treatment conservative, and only after elimination of hypostasis and pus from a nasopharynx it is possible to resolve an issue of that, it is required to delete adenoides to your kid or not.
When carrying out any research (first of all it is about survey of a nasopharynx a mirror or by means of the endoscope) demand from the doctor of the detailed description of all that he saw; be not limited to what the doctor will write down in the out-patient card “adenoides such-that degrees“. For definition of tactics of treatment it is necessary to know not so much extent of increase in adenoides how many at the expense of what they are increased. Then you will be able adequately to help your kid.