Adenoids: cut or leave


  • Restless amygdala
  • Lzhediagnostika
  • Seven times measure
  • Then cut off
  • Naughty technique
  • "Gold standard
  • Do not go to kindergarten
  • Choosing a doctor

    Restless amygdala

    Adenoids: cut or leaveFor some it brings a lot of problems. Although originally intended to protect. Nasopharyngeal tonsil or adenoids, keeps the first line of defense against microbes - those which seek to penetrate into the body from the air inhaled through the nose. On their way just is a kind of filter in the form of the adenoids. There are developed special cells (lymphocytes) that neutralize microorganisms.

    This turbulent body reacts to anyinflammation. During his illness increased adenoids. When the inflammatory process is returned to its normal state. If the interval is too short between the diseases (a week or less), the adenoids do not have time to decrease, they are constantly inflamed.

    Such a mechanism ( "have no time at all times") leadsto what adenoids grow even more. Sometimes they "swell" to such an extent that almost completely cover the nasopharynx. The consequences are obvious - the difficulty of nasal breathing and hearing loss. If they are not stopped in time, the adenoids can cause changes in shape of the face, bite, blood composition, curvature of the spine, speech disorders, renal function, urinary incontinence.

    Nuisance adenoids delivered usuallychildren. During adolescence (13-14 years) adenoid tissue alone decreased to negligible size and life does not complicate. If from the beginning to react professionally the problem. Errors usually begin from the moment of diagnosis.


    The cause of misdiagnosis can be bothoverconfidence ENT doctor (child came into the office, he opened his mouth: "Ah, everything is clear, it's adenoids operation.!"), and lack of knowledge. The fact that the child is not breathing nose, adenoids are not always to blame. The reason may be allergic and vasomotor rhinitis, deviated septum, even a tumor. Of course, an experienced doctor can determine the extent of the disease in pronunciation, tone of voice, nasal speech. But it is impossible to rely on.

    Accurate picture of the disease can be obtainedonly after examination of the child. The oldest method of diagnosis, which, however, is most often used in children's clinics - a digital examination. Climb up into the nasopharynx and fingers to feel the amygdala. The procedure is very painful and subjective. One finger like this, and the other - a. One climbed: "Yeah, adenoids." The other did not felt: "What do you mean, there was no adenoids." The child sits in tears, and then another doctor, he will not open his mouth - it hurts.

    Rejection and rear rhinoscopy method -"Inserting" mirror deep in the mouth (children have the urge to vomit). Diagnosis is again placed mostly on the basis of X-ray of the nasopharynx, which allows you to find a degree of increase of the adenoids and does not provide information about the nature of the inflammation and the relationship with neighboring important structures in the nasopharynx, which in any case can not be damaged during surgery. So it was possible to do 30-40 years ago.

    Modern methods are painless and allow toaccurately determine the size of the adenoids and whether they are in need of surgical treatment. This can be computed tomography, or endoscopy. The nasal cavity is injected tube (endoscope) connected to the camera. As we move deeper into the tubes on the monitor displays all the "hidden" areas of the nose and nasopharynx.

    The misconception may introduce themselves and adenoids. A common situation. When my mother with a child comes to the doctor? Typically, a week after the disease: "Doctor, we do not get out of the" sick "! Every month we have the conjunctivitis, the otitis, tonsillitis is, the sinusitis. " The clinic take a picture: enlarged adenoids. (What is natural during the inflammatory process!) Write: operation. A 2-3 weeks after the disease, if the child does not pick up a new infection, the adenoids bounce back. Therefore, if the clinic you have been told that the child's adenoids, and it is necessary to remove, consider to consult with another doctor. The diagnosis can not be confirmed.

    Seven times measure

    There are 3 degrees of adenoids, andOnly 3rd considered undoubted pathology. In the early stages of the disease are effective conservative methods: homeopathy, laser therapy, cryotherapy (cold therapy) antibiotics. If therapy does not work, there is a question about the operation.

    often practiced in a domestic medicineapproach: "Let us cut and then we'll see." Treat pattern. Adenoids? So the operation. Of course, it can be treated conservatively. And if that does not help? All the same it is necessary to operate. So it is better at once. Adenoids ruthlessly deleted. Delete just like in any case can not be adenoids, or appendix, or other useful things.

    Another common mistake: if you remove the adenoids, the child will no longer get sick. It is not true. Indeed, inflammation of the tonsils is a serious source of infection. Therefore, adjacent organs and tissues are also in danger - there are easy to move microbes. But it is impossible to cut with a knife infection. It is still "come out" in another place in the sinuses, ear, nose.

    Infection can detect, identify,Make tests to determine the sensitivity to drugs and then prescribe treatment more likely that the disease will be defeated. Adenoids removed not because the child is sick. And only when it difficult nasal breathing, leading to complications such as sinusitis, sinusitis, otitis.

    Children with severe allergies,especially with asthma, the operation is often contraindicated. Removal of nasopharyngeal tonsils can lead to deterioration and exacerbation of disease. Therefore, they are treated conservatively.

    Then cut off

    Adenoids: cut or leaveOf course, adenoids - is not a fatal disease,from this no one has died. But there are situations where surgery is necessary. In the case of adenoids 3rd degree, when in fact the entire nasopharynx is closed amygdala, the child is not breathing nose, it is unlikely to help homeopathy. For the duration of adenotomy - one of the shortest operation. It lasts only 15-20 minutes, and the process of "cutting" - 2-3 minutes. The nasopharynx is put the knife in the shape of a ring (adenotome Beckman), they captured adenoid tissue and cut in one motion.

    After the operation, the children can lead a normal imagelife, except that in the first day or two, it is desirable not to ride. Most importantly - do not overheat the baby, do not feed solid and hot food, so as not to provoke bleeding. usually prescribed vitamin K for its prevention

    Naughty technique

    Operation is simple technically, and many ENT doctorsThey consider it a simple and trivial procedure. However, relapse (re-growth of the adenoids) occur frequently. According to various sources, is from 17 to 72% of cases. The reason most often a surgeon is not fully removed the adenoid tissue, left pieces. Not because the "hand trembled" (although these operations often rely on inexperienced young doctors, residents), a doctor does not see what he was doing.

    The knife is put over the velum, and then everythingmanipulations performed on the touch. About the same as if a surgeon sewing up a wound or cut appendicitis with eyes closed. Even the most experienced doctor can not guarantee a perfect result. There are cases when the child has to endure an operation more than once. Flawed methodology itself.

    Abroad, as we do in the clinics - boarded, tied, pulled, with lidocaine, with tears of blood, with the experience of a lifetime - do not have the mid 80-ies of the last century!

    "Gold standard

    Among modern methods includeendoscopic surgery. The operation is performed with the help of tiny cameras. Everything that happens in the nasopharynx, the doctor sees on the monitor. This allows you to completely remove the adenoid tissue, and prevent bleeding complications during surgery. The first in our country (1995), such operations have become children perform prof. GZ Piskunov in CDB MC RF President Administration and prof. VS Kozlov in the Center of Otorhinolaryngology microendoscopic Yaroslavl.

    In the West, the "gold" standard - it endoscopy,CT plus surgery under general anesthesia. We have the words "general anesthesia" just cause "square" eyes. Of course, it would be wrong to say that anesthesia - it is absolutely safe. But if you compare what is more dangerous - surgery with general anesthesia or without anesthesia - outweigh the latter. Local anesthetics act only on the mucosa.

    During the operation, the child is still in pain. He shouts, jerking, however it may be tied. And his instrument the surgeon can seriously harm. Frequent complications such as scalping the posterior pharyngeal wall, when cut off a small tongue, soft palate injury, damage to the auditory tube. Type blood, the pain, the horror that is experiencing a baby affect the psyche. In children who had surgery without anesthesia, often had nocturnal enuresis, tics, stuttering. In general, they continued to be treated further, only to have other doctors.

    Analgesia effect on the quality of the operation. Under anesthesia, the child is not sick, he does not resist, and the surgeon can carefully remove the adenoid tissue. So, whatever you do during any surgical manipulation of consciousness must be switched off. The child should not attend their surgery - a taboo. Properly executed anesthesia does not cause complications. A local anesthesia is possible only when there is an experienced anesthetist and good equipment.

    Do not go to kindergarten

    Adenoids: cut or leaveThe surest way of prevention - not to meetinfection. And the main source of her children - a kindergarten. a simple mechanism. Comes the first child to kindergarten. Until now, never sick and talked with two children in the nearest sandbox. A large company of peers in the garden: toys and pencils licks, spoons, dishes, linens - everything in common. And there will always be one or two children, whose snot hanging from the waist up, where parents in the garden "stuffed" is not because the child needs to develop contact with the children, but because they need to work.

    Less than two weeks as a beginner was sick,wheezing, coughing, feverish (up to 39). A doctor from the clinic looked throat, wrote "SARS (ARI)" prescribe antibiotics, which he likes. The fact that he will work on it this infection, it is still grandmother two told - now resistant microbes. And in a situation where the child has respiratory diseases, not necessarily immediately "sculpt" his antibiotic.

    It is possible that the immune system,first met with the infection, cope with her own. However, the child is given antibiotic. My mother has stayed seven days with the child - and the doctor: "Temperatures are not? So healthy! ". Mom - to work, baby - in the garden. Just do not recover children for a week! This requires at least 10-14 days. And the child returned to the team, brought nedolechennaya infection and given to anyone who could. And he picked up a new one. Against the backdrop of a weakened immune system antibiotic disease and it happens very often. There is chronic inflammation.

    Choosing a doctor

    We have many doctors, so many opinions. One says: Take away the adenoids, and all will be well. Another advises treated conservatively, in any case not removed, because they will grow back. How to understand? Do not hesitate to ask your doctor and do not worry that you will offend him with questions. Something did not understand - ask for clarification.

    If your doctor recommends that you remove the adenoids,ask the arguments in favor of this decision. A true professional will not be difficult to explain, based on what the diagnosis, why one or another preferred method of treatment, what are the alternatives, the possible risks. And you will go out of his office in full confidence that the operation a child is really necessary. Or do not need at all.

    You must be convinced that doing the right thing. Doubt in the diagnosis, a doctor - please consult with another specialist. Listen to two, three opinions. However, if endlessly run on doctors, no good there will not be. Choose a doctor who you feel most competent, persuasive, experienced, you can trust, and follow its recommendations.

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