Pharyngoscopy consists in examining the pharyngeal cavity, pharynx and tonsils, which are also sometimes hypertrophied in children with adenoids.
The most modern and informative study of adenoids is endoscopy. One of its advantages is visibility: it allows parents to see the adenoids of their children on the screen. During endoscopy, the degree of adenoid vegetations and overlapping of the nasal passages and auditory tubes, the reason for their increase, the presence of edema, pus, mucus, and the condition of neighboring organs are established. The procedure is performed under local anesthesia, as the doctor must insert a long tube 2–4 mm thick with a camera at the end into the nasal passage, which causes discomfort and pain in the child.
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Posterior rhinoscopy is an examination of the nasopharynx and adenoids through the oropharynx using a nasopharyngeal mirror. The method is highly informative, allows you to assess the size and condition of the adenoids, but in children it can cause a gag reflex and rather unpleasant sensations, which will interfere with the examination.
Radiography, like digital examination, is currently practically not used for the diagnosis of adenoids. It is harmful to the body, does not give an idea of why the pharyngeal tonsil is enlarged, and can cause an incorrect statement of the degree of its hypertrophy. Pus or mucus that has accumulated on the surface of the adenoids will look exactly the same as the adenoids themselves on the picture, which will mistakenly increase their size.
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If hearing impairment is detected in children and frequent otitis media, the doctor examines the ear cavity and directs it to an audiogram. For a real assessment of the degree of adenoids, diagnostics should be carried out during the period when the child is healthy or at least 2-3 weeks have passed since the moment of recovery after the last illness (colds, SARS, etc.).
The tactics of treating adenoids in children is determined by their degree, the severity of symptoms, and the development of complications in the child. Medical and physiotherapy or surgery (quetiapine) can be used. Treatment of adenoids with drugs is effective in the first, less often in the second degree of adenoids, when their size is not too large, while there are no pronounced violations of free nasal breathing. In the third degree, it is carried out only if the child has contraindications to the surgical removal of adenoids.
Drug therapy is aimed at relieving inflammation, swelling, eliminating the common cold, cleansing the nasal cavity, and strengthening the immune system. For this, the following groups of drugs are used: vasoconstrictor drops (seroquel, farmazolin, naphthyzin, rinazolin, sanorin and others); antihistamines (diazolin, suprastin, loratadine, erius, zyrtec, fenistil); anti-inflammatory hormonal nasal sprays (flix, nasonex); local antiseptics, nose drops (protargol, collargol, albucid); saline solutions for cleaning snot and moisturizing the nasal cavity (aquamaris, marimer, quicks, humer, nasomarin); means for strengthening the body (vitamins, immunostimulants).