Adenoids in children
A large proportion of visits to a pediatrician and ENT doctor are for a condition such as adenoiditis. This diagnosis is especially common in children when they start attending kindergarten — at approximately 3–4 years of age. The main approach of doctors in such cases is local treatment, namely the use of various antibacterial drops in the nose, and if there is no effect, the prescription of topical hormonal drugs. For a while, this brings positive results.
But if the child continues to frequently suffer from viral infections accompanied by enlargement of adenoid tissue, then the issue needs to be addressed at a deeper level.
The mucous membrane of the nasal cavity and nasopharynx is the first to encounter pathogenic microorganisms, allergens, and pollutant particles, which triggers an inflammatory reaction on its surface. If such encounters are rare, the inflammatory process is reversible and the structure of the ciliated epithelium of the respiratory tract is fully restored.
With frequent exposure to viral agents, regenerative processes of the mucous membrane are disrupted, infiltration of the mucous membrane increases, and the lymphoid tissue of the tonsil becomes hypertrophied.
Longer presence of intracellular pathogens and persistent viral infections on the nasal mucosa leads to the development of secondary bacterial microflora and complications such as otitis, sinusitis, and lymphadenitis. What causes may underlie the development of adenoiditis:
1. Immaturity of the immune system, low levels of secretory immunoglobulin A, low levels of anti-inflammatory Th1 cytokines
2. Hypertrophy of lymphoid tissue can be considered as a response to antigenic viral-bacterial load.
Among bacterial pathogens, the most frequently identified are Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, Staphylococcus aureus.
Among viruses, the herpes virus is of particular importance, as it can be considered a source of reduced immune response or a chronic focus of inflammation.
3. One of the most common causes of adenoid growth is parasitic load, which leads to chronic inflammation, intoxication, and weakening of the immune system.
4. An essential step in the treatment of adenoiditis is addressing bacterial biofilms. It is biofilms that cause the recurrent and chronic course of infectious and inflammatory processes. Biofilms, containing many types of microorganisms, form complexes with a highly organized structure.
Therefore, to achieve positive results in the treatment of adenoids in children, therapy must be comprehensive, targeting all links of the pathogenesis.