Adenoid hypertrophy j 35.2. Hypertrophy of the palatine tonsils and adenoids. Diagnosis and treatment
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Adenoiditis is a pathological process that is accompanied by inflammation of the pharyngeal tonsils. The main task of the tonsils is to provide proper protection against infections. Doctors call them adenoids. Most often, the disease is diagnosed in young patients aged 3-7 years. Adenoiditis can occur in two forms - acute and chronic.
Description of adenoiditis and ICD-10 code
Acute adenoiditis is a disease that mainly develops in young children, although it can also be diagnosed in adults. Acute inflammation occurs under the influence of pathogenic viruses or bacteria. ARI and streptococcal infection can affect the development of the disease.
Also, acute adenoiditis can affect the body of a child who has a weakened immune system, after hypothermia, by inhaling harmful substances that are in the atmosphere. The development of an acute form of adenoiditis occurs similarly to the development of tonsillitis.
In the photo - acute adenoiditis
According to ICD 10, adenoiditis has the following designation:
- J35.2 - adenoid hypertrophy.
- J35.3 - enlargement of the tonsils with hypertrophy of the adenoids.
- J35.8 - other chronic pathologies of the tonsils and adenoids.
Symptoms of acute adenoid hypertrophy
The clinical picture of the pathological process is divided into those symptoms that can be seen visually, and those that can only be detected by a doctor when using an instrument.
The visual symptoms of adenoiditis include:
- Difficulty breathing through the nose;
- Hearing impairment;
- Discharge of mucus from the nose, which contains pus and a thick consistency;
- Discharge from the nasopharynx flows down the back of the pharynx, as a result of which the child has a productive cough;
- Rise in temperature to 37.5 degrees;
- Nasal congestion;
- nasality head;
- Otitis;
- Headache;
- Due to the inability to breathe through the nose, the baby has a constantly parted mouth;
- Hyperemia of the skin under the nose;
- Persistent infections and colds with bacterial and viral etiology. This is due to the fact that the air flow enters the lungs through the mouth, therefore, it is not purified, dry and affected by bacteria and viruses;
- Snoring at night;
- Halitosis;
- Restless night sleep;
- During sleep, the baby opens his mouth.
On the video, acute adenoiditis:
Treatment
Adenotomy
This manipulation involves the surgical removal of the adenoids.
What are the symptoms and what can be the treatment of adenoiditis in children, is described in this article:
How is the treatment of adenoids in children without surgery, and how safe it is, will help to understand this
Non-traditional means
It is possible only in combination with conservative methods. This will ease the condition of the child and bring the recovery process closer.
The following recipes are considered effective:
- Take aloe leaves, squeeze juice out of them. Combine it in equal quantity with water. Use the mouthwash solution 2 times a day. It can also be dripped into the nose, 3 drops in each passage. But how the common cold is treated with aloe juice is described in great detail in this
In the photo - aloe leaves for the nose
- From pine buds taken in an amount of 20 g, inhalations can be performed. Pour raw materials with 200 ml of hot water, boil for 10 minutes and apply for inhalation of vapours. The duration of the manipulation will be 10 minutes.
In the photo - pine buds
- For inhalation, you can use 1 kg of sea salt. Heat it in a pan, put a couple of drops of an oil solution of sage and linden. Tilt your head over the pan and cover with a towel. Inhale the vapors for 15 minutes.
In the photo - sea salt for inhalation
- Take the leaves of Kalanchoe, squeeze out the juice and drip it into each nasal passage 3 drops 3 times a day.
In the photo, Kalanchoe leaves
- Combine St. John's wort and butter in an amount of 1:4. Add 5 drops of celandine herb juice. Apply for instillation of 2 drops in each nostril. The duration of treatment will be 10 days.
- Take 200 g of lard, honey, cocoa and butter. Put everything in a container. Set on fire. Place the finished product in a glass container, and then add 10 g to a glass of warm milk and consume at night.
- To create a compress, you need to take a soft dough, sprinkle it with the stems of the ragwort plant. Put the resulting mass on the neck. The duration of the manipulation is 30 minutes.
The point of view of Dr. Komarovsky
The well-known pediatrician Komarovsky believes that the treatment of acute adenoiditis can take place in the comfort of home. But only in this case it is necessary to fulfill all the prescriptions of the doctor. For treatment, various medicines can be used, as well as traditional medicine. At the direction of the otolaryngologist, an individual treatment regimen is prescribed. It is determined by the doctor, taking into account the symptoms, well-being and other characteristics of the body.
Dr. Komarovsky recommends that parents give their consent to the operation to remove the adenoids. But you need to perform it with apnea syndrome. Then breathing slows down for 5-10 seconds. With such a delay, the child's condition deteriorates sharply. Surgical intervention should be carried out with exudative otitis media. It can cause a large amount of mucus to accumulate in the middle ear. This leads to hearing loss. Pediatrician Komarovsky advises to treat adenoids in the formation of jaw deformities and in case of a malignant tumor.
On the video, acute adenoiditis in children is treated according to Komarovsky:
Acute adenoiditis is a disease that is infectious or bacterial in nature. In children, it manifests itself in the form of unpleasant symptoms, including headache, difficulty in nasal breathing, and apnea. You should not delay the treatment, otherwise there is a risk of complications and the transition of the pathology to a chronic form.
Often parents hear in the medical environment (children's otolaryngologists) a mysterious and incomprehensible expression - "Adenoids, ICD code 10 in children". What is the ICD, in general? What does the code and the personalized stroke (“J”), the numbers standing with it (35.2, 35.3, 35.8) mean, which the attending physician can record in the child’s medical history?
How to find in the ICD information about one of the varieties of adenoid proliferation - adenoid hypertrophy. And, about the characteristic feature of this etiopathogenesis - subfebrile body temperature? These are the questions, and the answers to which, are of interest to parents of children with adenoids.
Meet - ICD (codes, strokes): general information
ICD: An abbreviation that stands for International Classification of Diseases. This is a catalog (collection) where almost all diseases are included, their clinical descriptions, symptoms, types, types, degrees and stages of these pathologies.
The appearance of the ICD catalog looks like this:
Related Articles Adenoids and tonsils: what's the difference?
You can see that each position is assigned: a common code (serial number) and an identification stroke, which is indicated in Latin letters. For example, in the list of ICD number 10. This is the code of the disease, the disease-causing condition of a person related to the respiratory system. The letter "J", and next to the prescribed numerical numbers (from 00 to 99), in the 10th code denotes a personalized stroke of the varieties of ENT diseases of the respiratory system.
If necessary, when you need to find out exactly which respiratory diseases are included in this medical rubric, or find information about a specific disease in this section ( Adenoid hypertrophy, microbial code 10), then reveal the link of this code. In the list you can find:
- 2 – Hypertrophy of the adenoids
- 3 – Hypertrophy of the tonsils with hypertrophy of the adenoids
- 8 – Other chronic diseases of the tonsils and adenoids
Children's adenoid vegetation, most often manifests itself in the period from 3 to 10 years of age. Otolaryngologists classify adenoid pathogenesis as: hypertrophy of the nasopharyngeal tonsils (glands). This excessive, painful enlargement of the adenoids in the nasal cavity, which occurs on the basis of the inflammatory process (the causative agent is an adenovirus infection), will be discussed in the next section.
Hypertrophic adenoids, as described in the ICD
There are precisely established clinical parameters of nasal adenoids, adenoiditis, which are divided into categorical clinical manifestations:
- First category (according to ICD 10):– Normal (within the normal range) indicators of the parenchyma of the organ . In the International Classification of Disease, a healthy form of adenoids is written briefly and little. The main thing is that the nasal glands are practically not felt by children, they do not bring painful symptoms and signs (runny nose, nasal voice, nasal congestion). Adenoid layers in the region of the vomer merge with the nasal mucosa, do not stand out above the inner surface of the nasal epidermis. The protective functionality of the glandular lymphoid tissue is stable and stable.
- The second category (according to Mkb 10,J35.2 - adenoid hypertrophy): - Medium heavyyoblunt deviations in the nasal epidermal layer of the lymph glands. As a rule, such a condition is inherent and characteristic of stage 1, 2 adenoiditis. Clinicians of pediatric otolaryngology already describe adenoids as - adenoid proliferation, enlarged and, accordingly, hypertrophied glands. Their color changes dramatically (from the previous pink color to a dark purple, bluish tint). The smooth surface disappears, and the adenoid layers are covered with thickenings, tubercles. When treatment is delayed, without cardinal primary measures of drug exposure, these hypertrophic adenoids quickly “decompose”. Adenoids turn into pasty, purulent foci of dangerous strain-gene intoxication in the body of children.
- The third category (according to Mkb 10,JJJ – 35.2, 35.3, 35.4 – 35,8): – Tyazhyolye, extremely dangerous etiopathology chronic adenoiditis. Adenoids in this stage are unlikely to be cured by continuing medical measures of conservative therapy. The weakened immunity of the child can no longer cope with the onslaught of adenovirus invasion. The main culprits of adenoids in such a strong form of hypertrophy (pathogenic microflora - staphylococci, streptococci, Pseudomonas aeruginosa and Escherichia coli, meningococci) acquire the property of drug "mutation", nihilism to drugs. Powerful antibiotics and corticosteroids cease to exert their destructive effect, aimed at destroying the harmful viral, microbial, bacterial intervention. This is an unambiguous, according to the unanimous conclusion of pediatric ENT specialists, an operable category and stage of nasal adenoid disease in children.
Related Articles Hypertrophy of the adenoids in children: etiology, description of characteristic symptoms, the importance of early diagnosis
Important warning! From caring attention and attitude to the nasopharyngeal organs of children (nose, throat), it directly depends on whether the child will be diagnosed with category 1 (the initial degree and stage of adenoid pathology), or category 2 or category 3 (according to ICD 10).
Moreover, one of the obvious signals that cannot be missed in the general well-being of children, their health, is the subfebrile body temperature of children. What does it mean? This is a sluggish, slow increase in temperature in the human body.
If 36.6 is considered a normal starting point, then the temperature measured in the morning, afternoon, evening, which fluctuates in the range of 37.2 - 37.5, is the subfebrile temperature. And, precisely, it indicates that not everything in the child’s body is good, an inflammatory focus is “reproducing” somewhere. The situation is insidious in that the external and internal symptoms of the disease (for example, the onset of hypertrophy of the adenoids, tonsils) are invisible. Does not give children feelings of malaise, pain, discomfort.
Such an anamnesis (the course of the disease) indicates an extremely low, weak children's immunity to adenorespiration. Therefore, everyday control over the health and well-being of the child, even if he is completely healthy and cheerful, is of great importance. Adenoids, ICD code 10 in children: adenoid hypertrophy (ICD code 10), this, unfortunately, is a fact confirming once again the proof that the illnesses of our children are, to a greater extent, the fault of the parents. Their irresponsibility for the healthy life of their child!
Adenoiditis is a pathological process that is accompanied by inflammation of the pharyngeal tonsils. The main task of the tonsils is to provide proper protection against infections. Doctors call them adenoids. Most often, the disease is diagnosed in young patients aged 3-7 years. Adenoiditis can occur in two forms - acute and chronic.
Acute adenoiditis is a disease that mainly develops in young children, although it can also be diagnosed in adults. Acute inflammation occurs under the influence of pathogenic viruses or bacteria. ARI and streptococcal infection can affect the development of the disease.
Also, acute adenoiditis can affect the body of a child who has a weakened immune system, after hypothermia, by inhaling harmful substances that are in the atmosphere. The development of an acute form of adenoiditis occurs similarly to the development of tonsillitis.
In the photo - acute adenoiditis
According to ICD 10, adenoiditis has the following designation:
- J35.2 - hypertrophy of the adenoids.
- J35.3 - Enlargement of the tonsils with hypertrophy of the adenoids.
- J35.8 - Other chronic pathologies of the tonsils and adenoids.
The clinical picture of the pathological process is divided into those symptoms that can be seen visually, and those that can only be detected by a doctor when using an instrument.
The visual symptoms of adenoiditis include:
- Difficulty breathing through the nose;
- Hearing impairment;
- Discharge of mucus from the nose, which contains pus and a thick consistency;
- Discharge from the nasopharynx flows down the back of the pharynx, as a result of which the child has a productive cough;
- Rise in temperature to 37.5 degrees;
- Nasal congestion;
- nasality head;
- Otitis;
- Headache;
- Due to the inability to breathe through the nose, the baby has a constantly parted mouth;
- Hyperemia of the skin under the nose;
- Persistent infections and colds with bacterial and viral etiology. This is due to the fact that the air flow enters the lungs through the mouth, therefore, it is not purified, dry and affected by bacteria and viruses;
- Snoring at night;
- Halitosis;
- Restless night sleep;
- During sleep, the baby opens his mouth.
On the video, acute adenoiditis:
Adenoiditis can be treated in two ways - conservative and operational. The first option is prescribed in the case when the disease proceeds normally and there are no severe symptoms. But the surgical method of therapy is advisable to use when there is a risk of complications, and also if the disease is not amenable to conservative therapy.
This manipulation involves the surgical removal of the adenoids.
Adenotomy is undesirable for the following reasons:
- Adenoid tissue tends to grow, therefore, if there is a predisposition to the disease, then remission will occur periodically. You will have to take the child back to the doctor for a second operation.
In the photo - adenotomy
Antibacterial drugs
Antibiotics may be used to treat the disease. Among the most effective are:
- Klacid (is it possible to use Klacid for vasomotor rhinitis, this article will help to understand)
In the photo, the drug Klacid
It is advisable to use these antibiotics in the acute course of adenoiditis, which is accompanied by purulent discharge. Parents should not be afraid of such therapy, because today doctors use gentle antibiotics that do not threaten the health of your child.
The treatment regimen will necessarily include vasoconstrictor drops. Among the most effective are:
- Nasonex (what is the price of nasal allergy spray Nasonex, indicated in this article)
In the photo - Nasonex
Thanks to these drugs, it is possible to ease the baby's breathing, but only the same medication can not be used for 7 days. In addition, it is worth dripping drops after the procedure for washing the nasopharynx has been performed.
In this case, you can use a solution, for the preparation of which take 1 liter of water, 20 g of salt. Draw the solution with a syringe without a needle. Do all the steps 3 times a day.
A wet compress on the neck will help ease nasal breathing. It is necessary to moisten a terry towel in cold water, wring it out. Roll 4 times and wrap around the patient's neck. When the towel becomes warm, then remove it. Perform similar actions 4-5 times. But the number of procedures will be 2.
How to use and apply Tonsilotren for adenoids in children will help you understand the content of this article.
What to do when a child has adenoids and does not breathe his nose, and what medicines should be used, this article will help you understand.
What are the symptoms and what can be the treatment of adenoiditis in children, is described in this article:
How adenoids are treated in children without surgery, and how safe it is, this information will help to understand.
Alternative treatment can only be used in combination with conservative methods. This will ease the condition of the child and bring the healing process closer.
The following recipes are considered effective:
- Take aloe leaves, squeeze juice out of them. Combine it in equal quantity with water. Use the mouthwash solution 2 times a day. It can also be dripped into the nose, 3 drops in each passage. But how the common cold is treated with aloe juice is described in great detail in this article.
In the photo - aloe leaves for the nose
In the photo - pine buds
In the photo - sea salt for inhalation
In the photo, Kalanchoe leaves
The point of view of Dr. Komarovsky
The well-known pediatrician Komarovsky believes that the treatment of acute adenoiditis can take place in the comfort of home. But only in this case it is necessary to fulfill all the prescriptions of the doctor. For treatment, various medicines can be used, as well as traditional medicine. At the direction of the otolaryngologist, an individual treatment regimen is prescribed. It is determined by the doctor, taking into account the symptoms, well-being and other characteristics of the body.
Dr. Komarovsky recommends that parents give their consent to the operation to remove the adenoids. But you need to perform it with apnea syndrome. Then breathing slows down for 5-10 seconds. With such a delay, the child's condition deteriorates sharply. Surgical intervention should be carried out with exudative otitis media. It can cause a large amount of mucus to accumulate in the middle ear. This leads to hearing loss. Pediatrician Komarovsky advises to treat adenoids in the formation of jaw deformities and in case of a malignant tumor.
On the video, acute adenoiditis in children is treated according to Komarovsky:
Acute adenoiditis is a disease that is infectious or bacterial in nature. In children, it manifests itself in the form of unpleasant symptoms, including headache, difficulty in nasal breathing, and apnea. You should not delay the treatment, otherwise there is a risk of complications and the transition of the pathology to a chronic form.
Often parents hear in the medical environment (children's otolaryngologists) a mysterious and incomprehensible expression - "Adenoids, ICD code 10 in children". What is the ICD, in general? What does the code and the personalized stroke (“J”), the numbers standing with it (35.2, 35.3, 35.8) mean, which the attending physician can record in the child’s medical history?
How to find in the ICD information about one of the varieties of adenoid proliferation - adenoid hypertrophy. And, about the characteristic feature of this etiopathogenesis - subfebrile body temperature? These are the questions, and the answers to which, are of interest to parents of children with adenoids.
ICD: An abbreviation that stands for International Classification of Diseases. This is a catalog (collection) where almost all diseases are included, their clinical descriptions, symptoms, types, types, degrees and stages of these pathologies.
The appearance of the ICD catalog looks like this:
You can see that each position is assigned: a common code (serial number) and an identification stroke, which is indicated in Latin letters. For example, in the list of ICD number 10. This is the code of the disease, the disease-causing condition of a person related to the respiratory system. The letter "J", and next to the prescribed numerical numbers (from 00 to 99), in the 10th code denotes a personalized stroke of the varieties of ENT diseases of the respiratory system.
If necessary, when you need to find out exactly which respiratory diseases are included in this medical rubric, or find information about a specific disease in this section ( Adenoid hypertrophy, microbial code 10), then reveal the link of this code. In the list you can find:
- – Hypertrophy of the adenoids
- – Hypertrophy of the tonsils with hypertrophy of the adenoids
- – Other chronic diseases of the tonsils and adenoids
Children's adenoid vegetation, most often manifests itself in the period from 3 to 10 years of age. Otolaryngologists classify adenoid pathogenesis as: hypertrophy of the nasopharyngeal tonsils (glands). This excessive, painful enlargement of the adenoids in the nasal cavity, which occurs on the basis of the inflammatory process (the causative agent is an adenovirus infection), will be discussed in the next section.
There are precisely established clinical parameters of nasal adenoids, adenoiditis, which are divided into categorical clinical manifestations:
- The first category (according to ICD 10): - Normal (within the normal range) indicators of the parenchyma of the organ. In the International Classification of Disease, a healthy form of adenoids is written briefly and little. The main thing is that the nasal glands are practically not felt by children, they do not bring painful symptoms and signs (runny nose, nasal voice, nasal congestion). Adenoid layers in the region of the vomer merge with the nasal mucosa, do not stand out above the inner surface of the nasal epidermis. The protective functionality of the glandular lymphoid tissue is stable and stable.
- The second category (according to ICD 10, J35.2 - adenoid hypertrophy): - Medium heavyyoblunt deviations in the nasal epidermal layer of the lymph glands. As a rule, such a condition is inherent and characteristic of stage 1, 2 adenoiditis. Clinicians of pediatric otolaryngology already describe adenoids as - adenoid proliferation, enlarged and, accordingly, hypertrophied glands. Their color changes dramatically (from the previous pink color to a dark purple, bluish tint). The smooth surface disappears, and the adenoid layers are covered with thickenings, tubercles. When treatment is delayed, without cardinal primary measures of drug exposure, these hypertrophic adenoids quickly “decompose”. Adenoids turn into pasty, purulent foci of dangerous strain-gene intoxication in the body of children.
- The third category (according to ICD 10, JJJ - 35.2, 35.3, 35.4 - 35.8): - Tyazhyolye, extremely dangerous etiopathology chronic adenoiditis. Adenoids in this stage are unlikely to be cured by continuing medical measures of conservative therapy. The weakened immunity of the child can no longer cope with the onslaught of adenovirus invasion. The main culprits of adenoids in such a strong form of hypertrophy (pathogenic microflora - staphylococci, streptococci, Pseudomonas aeruginosa and Escherichia coli, meningococci) acquire the property of drug "mutation", nihilism to drugs. Powerful antibiotics and corticosteroids cease to exert their destructive effect, aimed at destroying the harmful viral, microbial, bacterial intervention. This is an unambiguous, according to the unanimous conclusion of pediatric ENT specialists, an operable category and stage of nasal adenoid disease in children.
Important warning! From caring attention and attitude to the nasopharyngeal organs of children (nose, throat), it directly depends on whether the child will be diagnosed with category 1 (the initial degree and stage of adenoid pathology), or category 2 or category 3 (according to ICD 10).
Moreover, one of the obvious signals that cannot be missed in the general well-being of children, their health, is the subfebrile body temperature of children. What does it mean? This is a sluggish, slow increase in temperature in the human body.
If 36.6 is considered a normal starting point, then the temperature measured in the morning, afternoon, evening, which fluctuates in the range of 37.2 - 37.5, is the subfebrile temperature. And, precisely, it indicates that not everything in the child’s body is good, an inflammatory focus is “reproducing” somewhere. The situation is insidious in that the external and internal symptoms of the disease (for example, the onset of hypertrophy of the adenoids, tonsils) are invisible. Does not give children feelings of malaise, pain, discomfort.
Such an anamnesis (the course of the disease) indicates an extremely low, weak children's immunity to adenorespiration. Therefore, everyday control over the health and well-being of the child, even if he is completely healthy and cheerful, is of great importance. Adenoids, ICD code 10 in children: adenoid hypertrophy (ICD code 10), this, unfortunately, is a fact confirming once again the proof that the illnesses of our children are, to a greater extent, the fault of the parents. Their irresponsibility for the healthy life of their child!
The goals of the treatment of adenoiditis: elimination of the bacterial focus in the parenchyma of the adenoid vegetation to prevent the recurrent course of the inflammatory process in the nasopharynx with spread to the nasal cavity, paranasal sinuses, middle ear, tracheal tree.
Urgent hospitalization for severe retronasal angina with severe intoxication and purulent complications (pharyngeal abscess, etc.). Scheduled hospitalization for the operation of adenotomy.
In acute adenoiditis, tube quartz and a helium-neon laser are used nasally and on the back of the pharynx, diathermy and electrophoresis of drugs on regional lymph nodes. Spa treatment is a combination of local treatment methods with general treatment by the natural physical factors of the spa. Endonasal mud solution electrophoresis, phototherapy (laser effect on the nasopharynx through a light guide or nasal cavity, NK laser on the submandibular zone).
In chronic adenoiditis, recreational activities are carried out (therapeutic breathing exercises, hardening, foot temperature-contrast baths), physiotherapy, helium-neon laser irradiation of adenoid tissue through the mouth and nasally, mud therapy, cryo-oxygen therapy, ozone ultrasonic treatment, lymphotropic therapy (ultraphonophoresis of 5% ampicillin ointment or other drugs on the region of the upper cervical lymph nodes - regional for the pharyngeal tonsil).
In acute adenoiditis, the same treatment is prescribed as in acute tonsillitis. At the beginning of the disease, they try to limit the development of inflammation and prevent the development of the suppurative process. In the presence of fluctuations, an abscess is opened. Antibacterial, hyposensitizing detoxification, irrigation therapy, aerosol inhalations of antiseptic agents are carried out. Additionally, vasoconstrictor nasal drops or nasal sprays, irrigation therapy, nasopharyngeal disinfectants (silver proteinate, collargol, iodinol, 0.1% oxyquinoline solution in 20% glucose solution) are prescribed.
Organ-preserving methods of treatment, taking into account participation in the regulation of humoral and cellular immunity at the local and systemic levels. Taking into account the significant role of the lymphoid tissue of the tonsils as an organ of immunity that forms the immune barrier of the mucous membrane of the upper respiratory tract, they adhere to the tactics of conservative organ-preserving therapy of chronic adenoiditis in the early stages of the disease. 3-4 times a year, cycles of complex therapy are carried out, including a direct effect on the inflammatory process in the nasopharynx and general therapy aimed at strengthening the child's condition, correcting immunity, and stopping allergic manifestations.
General therapy includes detoxifying measures, immunomodulatory treatment, relief of allergic manifestations. Local treatment excludes irrigation therapy, the so-called nasal douche for the elimination of antigens from the mucous membrane of the nasal cavity and nasopharynx using herbal and biological products, mineral water, antiseptics. Of the means of local therapy, therapeutic solutions and emulsions are used at a temperature of 37 C; washing the nasal cavity and nasopharynx with solutions of St. John's wort, calendula and propolis; instances in the nasal cavity of antiseptic drugs: aerosol-vacuum therapy and aerosol inhalations of homeopathic preparations; irrigation with emulsions of Kalanchoe, propolis, eucalyptus; instillation into the nose of medicinal solutions and oils, immunomodulators; infusion into the nose of drops based on starch-agar gel. Widely used tonic intranasal glucocorticoids fluticasone, sofradex in the form of nasal sprays. Immunotherapy is carried out using leukocyte interferon, lactoglobulin, thymus extract, levamisole. Inside, etiotropic homeopathic preparations are prescribed: umkalor, lymphomyosot, tonsilgon, tonsilotren, new baby in an age dosage according to various schemes. A good therapeutic effect was noted when using a 15% solution of dimephosphon, instillations into the nasal cavity of a freshly prepared superlymph solution (local cytokine therapy preparation).
Be sure to take measures to restore nasal breathing (suction of discharge from the nose in infants and young children, instillation of vasoconstrictor solutions, collargol or silver proteinate, soda-tannin drops. If complications are suspected, antibiotics are prescribed.
Do not use nasal sprays of vasoconstrictors in infants, as they can cause reflex laryngospasm or bronchospasm.
An obligatory component of complex conservative treatment is hyposensitizing therapy, vitamin therapy and immunorehabilitation, taking into account the state of the immune status. Sanitation of other inflammatory foci is shown.
With persistent hyperplasia of adenoid vegetation with corresponding clinical symptoms, complications from the nasal cavity, paranasal sinuses, middle ear, tracheobronchial tree, with the development of secondary autoimmune diseases, frequent exacerbations of adenoiditis, and the failure of conservative treatment, adenotomy is performed followed by anti-relapse treatment.
Hardening, prevention of respiratory viral diseases, timely sanitation of the oral cavity, gargling with antiseptics.
The presence of associated diseases of internal organs and body systems, endocrine disorders, allergic manifestations, a thorough examination by a therapist before surgery.
- Take aloe leaves, squeeze juice out of them. Combine it in equal quantity with water. Use the mouthwash solution 2 times a day. It can also be dripped into the nose, 3 drops in each passage. But how the common cold is treated with aloe juice is described in great detail in this article.
- Nasonex (what is the price of nasal allergy spray Nasonex, indicated in this article)
- Klacid (is it possible to use Klacid for vasomotor rhinitis, this article will help to understand)
Hypertrophy of the palatine tonsils, as a rule, occurs in childhood. Often found in babies with adenoids.
Surgical diseases of the tonsils and adenoids.
- J31.1 Hypertrophy of the tonsils (enlarged tonsils).
- J35.3 Hypertrophy of the tonsils with hypertrophy of the adenoids.
- J35.8 Other chronic diseases of tonsils and adenoids
Types of palatine tonsil hypertrophy
Allocate only 3 degrees of the disease
- Grade 1 - no specific treatment is required. It is necessary to make sure that the child does not get cold, breathes through the nose, does not eat too cold or hot drinks and foods.
- 2 degree. If the baby has, he is prescribed preventive treatment and physiotherapy, irrigation of the pharynx with various antiseptic preparations, rinsing the mouth and throat before going to bed and after eating.
- Level 3 is the hardest. It is necessary to monitor the condition of the child.
The size of the tonsils is determined by the ENT doctor during the examination. If the tonsils are close to each other and touching, breathing or swallowing is difficult, then the varch may prescribe a surgical operation to remove the tonsils - a tonsillectomy. This is done in rare cases, because as they grow older, the palatine tonsils atrophy, the growth of lymphoid tissue, which causes hypertrophy, stops, it decreases by adolescence.
Causes of the development of the disease and symptoms
Hypertrophy of the palatine tonsils in children appears under the influence of harmful factors from the environment. It can also be a consequence of infections transferred by the mother during pregnancy. According to doctors, the main reason lies in frequent SARS, hypothermia, and malnutrition. The mass of bacteria, viruses, inorganic substances that are inhaled with air lead to an increase in lymphatic tissue. Hypertrophy of the palatine tonsils at an early age is a kind of adaptation of the body. In each case, the causes of hypertrophy of the palatine tonsils are individual.
This disease has the following symptoms:
- The palatine tonsils are enlarged, but this does not bother the child.
- As the disease develops, the voice changes, the baby speaks as if his nose is constantly stuffy. Speech becomes slurred. Breathing through the nose is disturbed, the baby is forced to breathe through the mouth from time to time. Problems with breathing through the nose reduce the saturation of blood with oxygen, the partial pressure of carbon dioxide increases - all this can lead to malnutrition of tissues, the development of anemia, and a slowdown in the development of all systems and organs.
- The disease is accompanied by poor sleep, mood deterioration, increased irritability. You should carefully monitor the sleep of the child if he snores in his sleep, which can cause periodic breath holding.
- The appearance of the child is changing. He has a pale face, drooping lower jaw, constantly half-open mouth.
- The work of the nervous system is disrupted, psychological development suffers, memory deteriorates.
Hypertrophy of palatine tonsils in children: treatment
With a slight process of development of the disease, hypertrophy of the palatine tonsils is treated with gargling with a solution of furacilin. Apply UHF therapy, oxygen cocktails, gargles with decoctions of sage, blueberries and chamomile, mineral water, water with honey, saline solution. In addition, mud therapy is recommended (mud applications are applied to the neck area), which also gives excellent results. Cauterizing agents are used to reduce swelling of the tonsils.
Lymphotropic drugs:
- tonsilgon;
- lymphomyosot;
- umkalor;
- tonsilotren.
If the disease has developed to 2-3 degrees, then surgical treatment is prescribed - an operation to extract the tonsils or partial removal under local anesthesia. Before the operation, they take urine tests, a general blood test. After the operation, it is recommended to gargle with various solutions of antiseptics. Surgical intervention is contraindicated in acute and severe diseases, blood diseases.
Version: Clinical Protocols of the Ministry of Health of the Republic of Kazakhstan - 2013
general information
Short description
Hypertrophy of the palatine tonsils- this is their physiological increase in the tonsils in the absence of inflammation. Often this disease is combined with adenoids. It occurs mainly in children aged 3-10 years.
Protocol name:"Hypertrophy of palatine tonsils and adenoids"
Protocol code:
ICD-10 code(s):
J35.1 Hypertrophy of tonsils
J35.2 Hypertrophy of adenoids
J35.3 Hypertrophy of tonsils with hypertrophy of adenoids
Protocol development date: April 2013
Protocol Users: otorhinolaryngologists, general practitioners
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Clinical classification
The degree of hypertrophy of the palatine tonsil:
I degree - up to 1/3 of the distance from the edge of the anterior palatine arch to the tongue
II degree - up to 2/3 of this distance
III degree - the tonsil reaches the uvula of the soft palate
Degree of adenoids:
I degree - close 1/3 opener
II degree - close 2/3 of the coulter
III degree - close the coulter completely
List of basic and additional diagnostic measures
Main:
- collection of complaints and anamnesis
- palpation
- posterior rhinoscopy
– examination of the function of the nose
– complete blood count + blood platelet count test, blood clotting time test
- general urine analysis
- scraping on the eggs of the worm
- bacteriological examination of nasal discharge for flora and sensitivity to antibiotics
Additional: if necessary, blood biochemistry
Diagnostic criteria
Complaints and anamnesis:
- difficulty in nasal breathing, breathing with an open mouth, coughing at night (with hypertrophy of the pharyngeal tonsil);
- slurred speech, possibly difficulty in swallowing food, possibly difficulty in oral breathing (with hypertrophy of the palatine tonsils);
- restless sleep, snoring;
- frequent runny nose;
- hearing loss;
- weakening of memory.
Physical examination
Pay attention to the configuration of the face, palpation of regional submandibular and deep cervical lymph nodes, digital examination of the nasopharynx. Observed:
- soft, smooth texture of the tonsils against the background of their hypertrophy;
- the absence of pathological contents in the gaps;
- abnormal development of the dentoalveolar system;
- closed nasality;
- external signs of adenoidism.
Laboratory research:
- complete blood count + study of the level of platelets in the blood, study of the time of blood clotting;
- general urine analysis;
– study of microflora;
- cytological examination.
- pharyngoscopy;
- posterior rhinoscopy;
- endoscopy of the nasopharynx;
- X-ray diagnostics.
Expert advice: consultation of a pediatrician, dentist and other specialists as needed.
How to recognize and treat acute adenoiditis
Adenoiditis is a pathological process that is accompanied by inflammation of the pharyngeal tonsils. The main task of the tonsils is to provide proper protection against infections. Doctors call them adenoids. Most often, the disease is diagnosed in young patients aged 3-7 years. Adenoiditis can occur in two forms - acute and chronic.
Description and code for microbial 10
Acute adenoiditis is a disease that mainly develops in young children, although it can also be diagnosed in adults. Acute inflammation occurs under the influence of pathogenic viruses or bacteria. ARI and streptococcal infection can affect the development of the disease.
Also, acute adenoiditis can affect the body of a child who has a weakened immune system, after hypothermia, by inhaling harmful substances that are in the atmosphere. The development of an acute form of adenoiditis occurs similarly to the development of tonsillitis.
In the photo - acute adenoiditis
According to ICD 10, adenoiditis has the following designation:
- J35.2 - hypertrophy of the adenoids.
- J35.3 - Enlargement of the tonsils with hypertrophy of the adenoids.
- J35.8 - Other chronic pathologies of the tonsils and adenoids.
The clinical picture of the pathological process is divided into those symptoms that can be seen visually, and those that can only be detected by a doctor when using an instrument.
The visual symptoms of adenoiditis include:
On the video, acute adenoiditis:
Adenoids in a child: symptoms and treatment. It can be treated in two ways - conservative and operative. The first option is prescribed in the case when the disease proceeds normally and there are no severe symptoms. But the surgical method of therapy is advisable to use when there is a risk of complications, and also if the disease is not amenable to conservative therapy.
Adenotomy
This manipulation involves the surgical removal of the adenoids.
Adenotomy is undesirable for the following reasons:
Adenoid tissue tends to grow, therefore, if there is a predisposition to the disease, then remission will occur periodically. You will have to take the child back to the doctor for a second operation.
In the photo - adenotomy
Antibacterial drugs
Antibiotics may be used to treat the disease. Among the most effective are:
Klacid (is it possible to use Klacid for vasomotor rhinitis, this article will help to understand)
In the photo, the drug Klacid
It is advisable to use these antibiotics in the acute course of adenoiditis, which is accompanied by purulent discharge. Parents should not be afraid of such therapy, because today doctors use gentle antibiotics that do not threaten the health of your child.
Drops and solutions for washing
The treatment regimen will necessarily include vasoconstrictor drops. Among the most effective are:
Nasonex (what is the price of nasal allergy spray Nasonex, indicated in this article)
In the photo - Nasonex
Thanks to these drugs, it is possible to ease the baby's breathing, but only the same medication can not be used for 7 days. In addition, it is worth dripping drops after the procedure for washing the nasopharynx has been performed.
In this case, you can use a solution, for the preparation of which take 1 liter of water, 20 g of salt. Draw the solution with a syringe without a needle. Do all the steps 3 times a day.
A wet compress on the neck will help ease nasal breathing. It is necessary to moisten a terry towel in cold water, wring it out. Roll 4 times and wrap around the patient's neck. When the towel becomes warm, then remove it. Perform similar actions 4-5 times. But the number of procedures will be 2.
How to use and apply Tonsilotren for adenoids in children will help you understand the content of this article.
What to do when a child has adenoids and does not breathe his nose, and what medicines should be used, this article will help you understand.
What are the symptoms and what can be the treatment of adenoiditis in children is described in this article: http://prolor.ru/n/bolezni-n/adenoidit/u-detej-simptomy.html
How adenoids are treated in children without surgery, and how safe it is, this information will help to understand.
Non-traditional means
Alternative treatment can only be used in combination with conservative methods. This will ease the condition of the child and bring the healing process closer.
The following recipes are considered effective:
Take aloe leaves, squeeze juice out of them. Combine it in equal quantity with water. Use the mouthwash solution 2 times a day. It can also be dripped into the nose, 3 drops in each passage. But how the common cold is treated with aloe juice is described in great detail in this article.
In the photo - aloe leaves for the nose
In the photo - pine buds
In the photo - sea salt for inhalation
In the photo, Kalanchoe leaves
The point of view of Dr. Komarovsky
The well-known pediatrician Komarovsky believes that the treatment of acute adenoiditis can take place in the comfort of home. But only in this case it is necessary to fulfill all the prescriptions of the doctor. For treatment, various medicines can be used, as well as traditional medicine. At the direction of the otolaryngologist, an individual treatment regimen is prescribed. It is determined by the doctor, taking into account the symptoms, well-being and other characteristics of the body.
Dr. Komarovsky recommends that parents give their consent to the operation to remove the adenoids. But you need to perform it with apnea syndrome. Then breathing slows down for 5-10 seconds. With such a delay, the child's condition deteriorates sharply. Surgical intervention should be carried out with exudative otitis media. It can cause a large amount of mucus to accumulate in the middle ear. This leads to hearing loss. Pediatrician Komarovsky advises to treat adenoids in the formation of jaw deformities and in case of a malignant tumor.
On the video, acute adenoiditis in children is treated according to Komarovsky:
Acute adenoiditis is a disease that is infectious or bacterial in nature. In children, it manifests itself in the form of unpleasant symptoms, including headache, difficulty in nasal breathing, and apnea. You should not delay the treatment, otherwise there is a risk of complications and the transition of the pathology to a chronic form.
Adenoids - classification according to ICD 10
Dear readers, I greet you and am very glad to see you again! Katya Ivanova is with you again. We continue the topic of adenoids with you, and today I want to talk about what adenoids are ICD 10.
I am sure that many do not know the designation of this encoding. So, in modern medicine, this is how adenoid disease is classified.
I propose to consider in detail this pathology with all its signs, symptoms and degrees of development, so that in the future you can navigate how to proceed further and what to do if this problem affects you.
Clinical Description
Adenoids are a vital organ that creates a protective barrier against the penetration of all kinds of viruses and infections into the nasopharynx through the nose. The development of hypertrophy of the unpaired tonsil is the result of frequent inflammatory processes in the nasopharynx.
This process is also called "adenoid vegetations". Adenoids affected by infection or viruses tend to grow and take on the appearance of a "cock's comb".
There are three stages of inflamed adenoids:
I - overgrown adenoid tissue covers 30% of the lumen of the nasopharynx;
II - filling of the nasopharyngeal space by 60%;
III - atrophied tissue completely covers the lumen of the nasopharynx.
Let's look at what pathological disorders of adenoid formations include microbial 10:
Hypertrophic adenoid vegetations (J35.2);
Hypertrophy of adenoids and adjacent tonsils (J35.3);
Concomitant chronic pathologies of the tonsils and adenoids (J35.8).
Adenoid hypertrophy
An increase in lymphoid tissue is called adenoiditis or adenoid hypertrophy.
Adenoiditis is a fairly common occurrence that is diagnosed by pediatricians and pediatric specialists in the field of otolaryngology in children aged three to seven years.
Inflamed adenoids lose their protective function, and are no longer able to protect the body from the penetration of pathogenic microflora through the nasal passages.
As a result of this, an inflammatory process begins: there is a change and violation of the system of full oxygen supply to the blood vessels, changes in the functioning of internal systems and aggravation of the general condition of a person.
The root causes of the development of pathology
The most common factors in the development of this disease are:
Frequent rhinitis, SARS, influenza, etc.;
Unfavorable ecological situation;
Untimely treatment of pathologies of the dental system and in the nose area;
Features of the course of pregnancy in women;
Increased tendency to catch colds;
The symptomatic picture largely depends on the stage of adenoid hypertrophy, which we discussed earlier. At the initial stage of adenoids, there are no significant changes in the child's condition.
According to microbial 10 adenoids of stages 2 and 3, complex diagnostics and systemic treatment are carried out. If your child regularly suffers from colds, you should think about it, because this is one of the signals for the future development of adenoid hypertrophy.
Determine children's pathology on their own without special medical instruments
impossible, but there are some symptoms that in most cases indicate that the child has an inflammatory process in the adenoids:
Runny nose that does not go away;
Discharge of pus from the nose;
Only mouth breathing;
Snoring or snoring while sleeping;
Complaints of frequent headaches and dizziness;
Lethargy and drowsiness;
At the initial stage of the course of the disease, this symptomatology, as you noticed, is local in nature.
Turning into a chronic and neglected form, all of the above symptoms entail other complications: the formation of an adenoid type of face, changes in bite and curvature of the nasal septum, disruption of the internal organs, memory impairment, mental and physical underdevelopment.
In addition, adenoid hypertrophy can provoke hypertrophy of adjacent tonsils - lingual, tubal, pharyngeal, paired tonsils (tonsils).
The inflammatory process of the nasopharyngeal tonsil can spread to other organs and cause chronic diseases - otitis, tonsillitis, laryngitis, sinusitis, sinusitis and pneumonia.
Diagnostics
The definition of adenoid hypertrophy according to microbial 10 in children is carried out by a pediatric otolaryngologist using special medical instruments and equipment. Let's look at what modern methods are used in this case:
The method of digital examination of the nasopharyngeal tonsil involves the definition of pathology to the touch with your fingers. This method of diagnosis is used by most doctors.
Radiography. This is a method of extensive research, which allows not only to determine the presence of pathology, but also the degree of its development. True, it is forbidden to use this method for young children. Therefore, radiography is more often used to determine adenoid hypertrophy by microbial 10 in children over the age of five.
Posterior rhinoscopic examination allows you to examine the condition and location of adenoid formations through the oropharynx using a special mirror.
Endoscopic examination involves the examination of the patient in two ways: through the nose and through the mouth using different equipment.
CT is the most optimal option for examining the unpaired nasopharyngeal tonsil, which makes it possible to obtain the most accurate results. The only drawback of this procedure is its high cost.
After making a diagnosis according to the microbial code 10, the doctor draws up a therapeutic regimen for the treatment of adenoids in a child.
The scheme and method of treatment is determined taking into account the degree of adenoiditis, with additional comorbidities and the general health of the child.
Often, at the initial stage, treatment is carried out by medication without surgery. The child is prescribed a saline solution, vasoconstrictor drops and medications to eliminate the inflammatory process, possibly antibiotics.
Stages 2 and 3 of adenoid vegetations, when most of the lumen of the nasopharynx is blocked, require complex treatment with the use of therapeutic drugs and physiotherapy.
If such treatment becomes ineffective, the child is prescribed an operation that is performed under local or general anesthetics.
As you can see, this disease is very serious, and it develops quite rapidly, if you do not respond in a timely manner and take action, the consequences can be disastrous.
Therefore, dear parents, take care of your children so as not to bring them to such a state. I hope this information was very useful for you! See you soon!
Chronic diseases of the tonsils and adenoids in children
RCHD (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan)
Version: Clinical Protocols of the Ministry of Health of the Republic of Kazakhstan - 2016
Chronic tonsillitis is an infectious-allergic disease with local manifestations in the form of a persistent inflammatory reaction of the palatine tonsils, morphologically expressed by alteration, exudation and proliferation, which is formed as a result of the constant interaction of pathogenic microflora with the macroorganism.
Hypertrophy of the tonsils- physiological or pathological enlargement of the palatine tonsils.
Hypertrophy of the adenoids- physiological or pathological enlargement of the nasopharyngeal tonsil.
Correlation between ICD-10 and ICD-9 codes:
Protocol Users: pediatric otorhinolaryngologists, general practitioners, infectious disease specialists, hematologists, oncologists, pediatricians.
Level of evidence scale:
Correlation between strength of evidence and type of research
The purpose of the survey: to find out the level of satisfaction of medical personnel in public and private medical organizations. The timing of the survey: August 25 - September 25, 2018.
Classification
Clinical classification .
1. Nonspecific chronic tonsillitis:
a) compensated form;
b) decompensated form;
2. Hypertrophy of the tonsils:
a) I degree - the tonsils occupy one third of the distance from the palatoglossal arch to the midline of the pharynx;
b) II degree - tonsils occupy two thirds of this distance;
c) III degree - the tonsils are in contact with each other;
3. Hypertrophy of the adenoids:
a) I degree - adenoids cover only the upper third of the vomer;
b) II degree - adenoids cover the upper two-thirds of the vomer;
c) III degree - completely or almost completely cover the opener.
Diagnostics (outpatient clinic)
DIAGNOSTICS AT OUTPATIENT LEVEL
Diagnostic criteria:
Complaints and anamnesis
Chronic tonsillitis:
frequent sore throats;
· colds;
· a sore throat;
Discomfort in the throat
pain in muscles, joints;
Weakness, lethargy, fatigue;
subfebrile temperature.
Hypertrophy of the palatine tonsils:
difficulty breathing, swallowing;
Difficulty in speech
snoring at night
reflex cough.
Adenoid hypertrophy:
· nasal congestion;
Difficulty in nasal breathing, swallowing;
· constant rhinitis;
· nasality;
snoring at night
obstructive cessation of breathing during sleep;
frequent colds;
· fast fatiguability;
frequent otitis;
Hearing loss
enuresis.
Physical examination:
Chronic tonsillitis
Local status: liquid pus or caseous-purulent plugs in the lacunae, loosened surface of the tonsils, Giese's sign - congestive hyperemia of the edges of the palatine-lingual arches, Zach's sign - swelling of the upper edges of the anterior palatine arches, Preobrazhensky's sign - roller-like thickening of the edges of the palatoglossal arches, adhesions and adhesions of the tonsils with arches and a triangular fold.
General signs: subfebrile temperature (periodic), tonsillogenic intoxication, recurrent pain in the joints, cervical lymphadenitis, functional disorders of the acute and chronic nature of the kidneys, heart, vascular system, joints, liver and other organs and systems.
Hypertrophy of the palatine tonsils
Local status: increase in palatine tonsils of varying degrees.
General signs: sleep disturbance, speech disorder, headache, sleep disturbance, fatigue.
Hypertrophy of the adenoids
Local status: increase in adenoid vegetations of varying degrees.
General signs: violation of nasal breathing, nasal, dysplasia of the facial skull, hearing and speech disorders, headache, sleep disturbance, absent-mindedness, forgetfulness, bedwetting.
Laboratory studies: not specific.
Instrumental research:
Pharyngoscopy;
· Anterior rhinoscopy;
Posterior rhinoscopy;
Probing of the nasopharynx;
· Finger examination of the nasopharynx;
Diagnostic algorithm
Diagnostics (ambulance)
DIAGNOSTICS AT THE STAGE OF EMERGENCY AID
Diagnostic measures:
measurement of blood pressure;
measurement of BH;
measurement of heart rate;
pharyngoscopy;
palpation of the submandibular regions;
thermometry.
Diagnostics (hospital)
DIAGNOSTICS AT THE STATIONARY LEVEL
Diagnostic criteria: see ambulatory level.
Diagnostic algorithm: see ambulatory level.
List of main diagnostic measures:
Pharyngoscopy;
Posterior rhinoscopy;
· Histological examination of the surgical material.
List of additional diagnostic measures:
CT scan of the nose and nasopharynx;
MRI of the nasopharynx with contrast;
Endoscopy of the nasopharynx.
Differential Diagnosis
Table 1. Differential diagnosis of chronic tonsillitis with acute tonsillitis and pharyngomycosis
Treatment of palatine tonsil hypertrophy in children; ICD-10 code
Hypertrophy of the palatine tonsils, as a rule, occurs in childhood. Often found in babies with adenoids.
Hypertrophy of the palatine tonsils: ICD-10 code J35.2
Surgical diseases of the tonsils and adenoids.
Types of palatine tonsil hypertrophy
Allocate only 3 degrees of the disease
Hypertrophy of palatine tonsils in children: treatment
With a slight process of development of the disease, hypertrophy of the palatine tonsils is treated with gargling with a solution of furacilin. Apply UHF therapy, oxygen cocktails, gargles with decoctions of sage, blueberries and chamomile, mineral water, water with honey, saline solution. In addition, mud therapy is recommended (mud applications are applied to the neck area), which also gives excellent results. Cauterizing agents are used to reduce swelling of the tonsils.
If the disease has developed to 2-3 degrees, then surgical treatment is prescribed - an operation to extract the tonsils or partial removal under local anesthesia. Before the operation, they take urine tests, a general blood test. After the operation, it is recommended to gargle with various solutions of antiseptics. Surgical intervention is contraindicated in acute and severe diseases, blood diseases.