An enlarged nasopharynx is called an adenoid and occurs in children between the ages of 2 and 15 years. It can sometimes be seen in adults.
As the adenoid grows, it can fill the nasopharyngeal dome and extend down the side walls, from the ear canal to the mouth of the larynx.
CAUSES OF APPEARANCE. Pathological proliferation of nasopharyngeal tissue usually occurs in preschool and school-age children after exposure to infectious diseases. For example, diseases such as scarlet fever, diphtheria, measles, angina, and influenza are associated with this process.
Sometimes hereditary causes, as well as frequent colds, and parents' neglect of their children's exercise, sports, and timely medical examinations, can also lead to adenoids.
SYMPTOMS. First, nasal breathing is disturbed, and the child begins to breathe through the mouth. The patient becomes relaxed and carefree.
Adenoids cause a lack of oxygen in the body, and the following conditions occur:
headache;
general malaise;
insomnia;
frequent fatigue;
malice;
hearing loss;
malformation of the upper jaw.
TYPES. There are three levels of adenoids: In grade I, the adenoids cover up to 1/3 of the temporal bone, in grade II to 1/2, and in grade III to 2/3, or almost completely.
Grade I adenoids do not significantly make it difficult for a child to breathe through the nose when awake, but the veins become more or less dilated due to the filling of the veins with blood during sleep. Therefore, if the child's medical history shows that the child's mouth is open during sleep, this may indicate the presence of an adenoid.
DEVELOPMENT. The enlargement of the nostrils reaches such a level that in some cases it can completely occupy the nasopharynx, larynx, auditory canal, and nasal cavity. In such cases, the patient often has a chronic inflammation of the ear, a sharp decrease in hearing, changes in the tone of voice, whitening of the eardrum, skin and soft tissues.
When nasal breathing is disturbed, serous fluid constantly flows from the nose, and the nasal cavity often becomes inflamed and sinusitis develops.
COMPLICATIONS. In children, long-term illness can lead to abnormalities in the development of the facial skeleton. The lower jaw, which is constantly hanging, becomes narrow and elongated, while the upper jaw develops a hard palate. It is high and narrow, and the pricus is damaged due to the incorrect placement of the teeth.
Adenoids negatively affect respiratory function and some mechanisms of cerebral circulation. Memory impairment leads to various neuropsychological changes.
In children with nasopharyngeal hypertrophy, over time, there may be a violation of the formation of the thorax (goose breast), anemia, an increase in the size of the spot at the base of the eye.
TREATMENT. Conservative treatment is used in acute colds, in other cases the adenoid is removed only surgically.
The conservative method is used when the ankles are slightly enlarged or cannot be operated on. The patient is prescribed antihistamines and calcium gluconate.
Surgery is necessary when enlarged nostrils make it difficult to breathe through the nose, and is usually performed at the age of 5-7 years. However, adenotomy is also performed in breastfed children when nasal breathing is more difficult, hearing is impaired, and other abnormalities due to adenoids occur.
AFTER SURGERY. After the operation, the child is placed on the side of the bed for 25-30 minutes, at the same time he is allowed to swallow a piece of ice or lick ice cream (this helps to reduce body temperature and stop bleeding faster).
2 hours after surgery, the patient is given liquid, cold foods. Spicy, hot fried foods, salty foods with pepper and vinegar should not be given, as this can cause nosebleeds. Such a diet should be followed by the patient for 4-5 days.
HEALTH EXERCISES. After the adenoid is removed, the child cannot breathe completely through the nose. Because he has been used to breathing through his mouth for a long time. With the help of a doctor and parents, a special "nasal breathing gymnastics" is performed for a month, and the child learns to breathe completely through the nose.
The following method of nasal gymnastics is recommended:
Exercise 1: The patient stands upright with his chest slightly out (without straining) and his abdomen slightly inward; (heels are joined at a 90-degree angle). The patient rests his hands on the lower part of the chest and begins to breathe slowly through the nose, while the abdomen should not protrude.
During breathing, the ribs under the arms are clearly felt. Exhale slowly through the nose.
Exercise 2: The patient is in the same position. He had only his hands behind his back and his palms together; the abdomen should be weighed as deeply as possible. Slow breathing through the nose; the chest expands and the lungs fill with air. After that, of course, exhale slowly through the nose.
Exercise 3: The patient is in the same position, but with his palms on his neck. The tips of the fingers are tied to the midline; at the same time as taking a deep breath through the nose, the elbows, previously extended forward, slowly spread to both sides. When you exhale slowly, the elbows slowly return to their original position.
Exercise 4: Same situation, but the arms are lowered freely on both sides. As you breathe in, move your arms back slowly until you make a 12-15 degree angle with your body; At the same time, without haste, the patient rises slightly at the tip of his legs, pulls his abdomen as far as possible, and immediately swells his chest. When exhaled, it is slowly returned to its original position.
Rajabboy MASHARIPOV,
doctor of medical sciences, professor.
