The adenoids are lymphatic organs that defend the organism from diverse infections. One is located behind the nasal cavity, in the highest part of the pharynx. Adenoids begin to grow after 9 months of life, growth that accentuates towards the third year.

Adenoiditis is an infection that is manifested by fever and abundant nasal purulent mucosa. During childhood, recurrent infections can lead to adenoids growth (hypertrophy).

Adenoidal Hypertrophy reduces the space where air, which enters through the nose, passes towards the larynx and trachea. This provokes children to breathe through the mouth, adopting a classic mouth breathing position.

It is important to know that the damage -that adenoid hypertrophy produces to health- can be considerable. A non-treated Adenoid Hypertrophy brings as a consequence complications, such as: ear infections, maxillary malformation, concentration disorders and academic level drop, among others. It is necessary to diagnose, not only the hypertrophy, but its magnitude (size measured in degrees I, II, III). From it will be developed the suitable treatment to avoid complications.

Degrees of hypertrophy

In order to measure the extent of adenoid vegetation, the rhino-pharynx x-ray is used. As it can be observed in the picture, in the first image (degree 0) there is adenoid tissue absence. This situation is the habitual one in adults. In the second image, corresponding to degree I a habitual situation in normal children is observed, that is to say, there are adenoids but no noticeable obstruction. It is normal for a child to have Degree I, since it allows him to have a level of defense without a significant obstruction of the respiratory tract.

The third image, degree II, corresponds to an obstruction of 66% of the air passage from the nose towards the inferior respiratory routes.

In the fourth image, degree III there is a complete obstruction to the air passage. Degrees II and III are surgical cases, because the degree of respiratory difficulty and associate complications is important.

Clinical History

Nasal Respiratory Insufficiency, noisy breathing, dribbling in the pillow while sleeping, mouth breathing. Snoring in children is more frequently associated with those with large tonsils. Speech disorder. Presence of nasal mucosa. Although average otitis is not a symptom, presence of otitis warrants the necessity to look for adenoid pathology.

Treatment

Conventional Medical Treatment: consists in antibiotics administration, anti-inflammatory, anti-allergic, vaccines, and improve general state in necessary cases. This type of treatment acts favorably avoiding the growth of the adenoids.

Surgical Treatment: when adenoids have a size equivalent to a degree II or III, the Otolaryngologist will consider the surgery, denominated adenoidectomy. In the same surgical procedure, in some cases, the extraction of tonsils is practiced which are also usually ill. If the adenoids are not totally extracted, recidivists can be seen associated to surgery leftovers.

The systemic treatment contemplates the use of immunemodulating adaptogens such as Astrágalus membranáceus and Ganoderma lucidum which offer important anti-inflammatory effect; natural antimicrobial such as Hydrastis canadensis, in combination with other plants that increase the Energy, obtaining the normalization in adenoid's size in a great number of children, this way avoiding an operation.