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International Journal of Pediatric... Dec 2021adenoidectomy is one of the most common surgical procedure in pediatric otolaryngology practice. Clinical guidelines (such as the Spanish or American) suggest... (Review)
Review
OBJECTIVE
adenoidectomy is one of the most common surgical procedure in pediatric otolaryngology practice. Clinical guidelines (such as the Spanish or American) suggest adenoidectomy when the enlargement of the adenoids is associated with nasal obstruction. Nasal endoscopy and cephalograms are adequate methods to estimate the size of the adenoids. However, they do not measure nasal patency. This systematic review is designed with the objective of exploring the relationship between adenoid size and nasal ventilation through rhinomanometry.
REVIEW METHODS
3 authors members of the YO-IFOS rhinology study group independently analyzed the data sources (Pubmed, the Cochrane Library, EMBASE, SciELO) for papers assessing both nasal resistance and/or nasal airflow in rhinomanometry and adenoid size by any method (endoscopy, cephalogram, direct examination).
RESULTS
A total of 10 studies with a total population of 969 participants met the inclusion criteria. 5 authors explored the size of the adenoids through endoscopy. 4 authors explored the adenoids through lateral cephalograms. Finally, a further 2 authors explored adenoid size studying the resected tissue. Five studies explored the correlation between adenoid size and nasal resistance in rhinomanometry, which ranged from 0.20 to 0.84. Finally, 5 studies used nasal decongestant. It was found higher sensitivity and specificity, a higher area under the curve for the receiver operating characteristic curve, and higher correlation with adenoid size for rhinomanometry under nasal decongestion.
CONCLUSION
Up to now, there is no ideal diagnostic method for adenoid hypertrophy. Therefore, it seems prudent to use a combination of all currently available tools, as they provide complementary, rather than supplementary information. Available evidence suggests that rhinomanometry combined with nasal decongestant could help to elucidate the existence of nasal obstruction in intermediate cases of adenoid hypertrophy, as well as throw light on other possible causes for nasal obstruction, mainly turbinate hypertrophy.
Topics: Adenoidectomy; Adenoids; Child; Endoscopy; Humans; Hypertrophy; Nasal Obstruction; Rhinomanometry
PubMed: 34537548
DOI: 10.1016/j.ijporl.2021.110895 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Apr 2019Adenoid tissue are the major constituent of Waldeyer's ring which are physiologically natural defense mechanism of the body against inhaled allergens and... (Review)
Review
Adenoid tissue are the major constituent of Waldeyer's ring which are physiologically natural defense mechanism of the body against inhaled allergens and microorganisms.In all children, the volume of the adenoid increases with age with a maximal volume in the age group of 5-6 years, followed by a gradual decrease in volume by the age of 8-9 years.Allergic rhinitis is a non-infectious chronic inflammatory disease of nasal mucosa mediated by immunoglobulin E and involved by a variety of immunocompetent cells (T, B lymphocytes, mast cells, etc.) after atopic individual contact with allergens.Adenoid hypertrophy and allergic rhinitis are common and frequently-occurring diseases in children. Both of them may exist simultaneously and may cause similar clinical symptoms. This paper reviews the relationship between adenoid hypertrophy and allergic rhinitis.
Topics: Adenoids; Allergens; Child; Child, Preschool; Humans; Hypertrophy; Immunoglobulin E; Rhinitis, Allergic
PubMed: 30970416
DOI: 10.13201/j.issn.1001-1781.2019.04.023 -
International Archives of Allergy and... 2023Adenoidectomy is a common procedure in children who have adenoid hypertrophy (AH), but anesthesia risks should be considered. We proposed a novel classification system...
INTRODUCTION
Adenoidectomy is a common procedure in children who have adenoid hypertrophy (AH), but anesthesia risks should be considered. We proposed a novel classification system for adenoids based on their appearance. Additionally, we explored whether the novel classification of adenoids correlates with the response to therapy and thus might be helpful for further treatment recommendations.
METHODS
We used fiberoptic nasal endoscopy to determine the degree and appearance of AH. Obstructive Sleep Apnea Questionnaire (OSA-18) was used to assess the quality of life of children with AH. The adenoids were divided into three types: edematous type, common type, and fibrous type. In adenoid tissues, the eosinophils were counted. Immunohistochemistry and Western blot were done to determine the expression of CysLTR1, CysLTR2, CGR-α, and CGR-β in different types of adenoids.
RESULTS
70.67% (106/150) of AH patients presented with allergic rhinitis (AR), and of them, 68% (72/106) of adenoids were the edematous type. The expressions of CGR-α, CGR-β, and eosinophil count were higher in the edematous compared with the common and fibrous types. The expression of the leukotriene receptor was similar in all types. Upon montelukast combined with nasal glucocorticoid therapy, improvement of OSA-18 scores and AH grade was significantly compared to montelukast monotherapy for edematous type. There was not any statistically significant difference between the scores upon montelukast combined with nasal glucocorticoid and montelukast monotherapy for common and fibrous type. We observed a positive correlation between eosinophil count in the blood and in the adenoid tissue.
CONCLUSION
AR was the risk factor for the development of edematous AH. All subtypes of AH responded to montelukast, while there was an additional effect of nasal glucocorticoid in the edematous type. A combination therapy of nasal glucocorticoid with leukotriene receptor antagonist can be recommended for AH patients with AR, patients with edematous adenoids, and/or patients with increased eosinophils in blood routine.
Topics: Child; Humans; Adenoids; Glucocorticoids; Quality of Life; Rhinitis, Allergic; Sleep Apnea, Obstructive
PubMed: 36996773
DOI: 10.1159/000528445 -
Head and Neck Pathology Jun 2022
Topics: Adenoids; Ameloblastoma; Humans
PubMed: 34491520
DOI: 10.1007/s12105-021-01372-y -
European Archives of... Oct 2023Adenoid hypertrophy is one of the main causes of nasal obstruction in 'children. Adenoid hypertrophy can be approached either with nasal corticosteroids, or surgically... (Review)
Review
INTRODUCTION
Adenoid hypertrophy is one of the main causes of nasal obstruction in 'children. Adenoid hypertrophy can be approached either with nasal corticosteroids, or surgically when medical treatment fails. Different adenoidectomy techniques have been proposed to reduce morbidity and surgical risks, with a consequent marked increase in the use of new surgical procedures in recent years, with a progressive increase in the use of coblation. This state-of-the-art review aims to systematically review the current literature on the role of coblation in adenoidectomy.
METHODS
The selection criteria included children submitted to adenoidectomy with coblator vs other techniques. 11 research questions were defined. 4 databases were explored by four authors: PubMed (Medline), the Cochrane Library, EMBASE and SciELO. The level of evidence and quality of the selected articles were assessed according to assessed according to the Quality Assessment Checklist of the National Institute for Health and Clinical Excellence.
RESULTS
20 studies met the inclusion criteria: 2 metanalysis, 12 randomized clinical trial, 2 non-randomized clinical trial, 1 prospective cohort study, and 3 retrospective cohort study. It encompassed a total population of 8375 participants. Regarding the different surgical techniques, 18 studies (excluding metanalysis) performed coblation (n = 1550), 6 microdebridement (n = 883), 15 curettage (n = 4016), and 1 suction coagulation (n = 1926).
CONCLUSION
Coblator adenoidectomy appears to offer better adenoid control compared to curettage, with a possible, although not confirmed lower rate of revision surgery. Similarly, this greater resection of adenoid tissue seems to be related to a greater reduction of nasal obstruction. The advantages of this technique are mainly less surgical bleeding-although it is not clear this is a clinically relevant difference, and less postoperative pain compared to cold curettage. The difference in pain is small, as adenoidectomy is not a painful surgery in general. There is little evidence on the control of OME and comparison with other techniques such as microdebrider adenoidectomy.
Topics: Child; Humans; Adenoidectomy; Adenoids; Hypertrophy; Nasal Obstruction; Pain, Postoperative; Prospective Studies; Retrospective Studies; Randomized Controlled Trials as Topic
PubMed: 37493842
DOI: 10.1007/s00405-023-08094-7 -
European Annals of Otorhinolaryngology,... Dec 2018This study compares the efficacy of adenoidectomy on otitis media with effusion (OME) in patients with different size of adenoids and the connection between differently...
AIMS
This study compares the efficacy of adenoidectomy on otitis media with effusion (OME) in patients with different size of adenoids and the connection between differently sized adenoids and middle ear effusion.
MATERIAL AND METHODS
Children with a history of at least 3 months' OME underwent adenoidectomy and myringotomy without the insertion of a tympanostomy tube. Treatment assignment was stratified by adenoids' size causing choanal obstruction (grade I-III) and according to Eustachian tube ostium obstruction (grade A-C). The subjects were followed for 12 months.
RESULTS
Adenoidectomy was significantly more effective in children with adenoids in contact with torus tubarius (grade B, C) compared to those with small adenoids without contact (P<0.001). The volume of the adenoids was irrelevant (P=0.146). The size of adenoids did not affect the viscosity of the middle ear secretion. The distribution of mucous and serous secretion was not dependent on the size of adenoids; the efficacy of adenoidectomy was 82% in mucous as well as serous secretion.
CONCLUSION
The relation between adenoids and torus tubarius is more important than the volume of the adenoids. The viscosity of middle ear fluids (serous or mucous) did not influence the rate of treatment efficacy.
Topics: Adenoidectomy; Adenoids; Adolescent; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Hypertrophy; Male; Otitis Media with Effusion
PubMed: 30290997
DOI: 10.1016/j.anorl.2017.11.011 -
Clinics (Sao Paulo, Brazil) Nov 2016Obstructive sleep apnoea syndrome is a type of sleep-disordered breathing that affects 1 to 5% of all children. Pharyngeal and palatine tonsil hypertrophy is the main... (Review)
Review
Obstructive sleep apnoea syndrome is a type of sleep-disordered breathing that affects 1 to 5% of all children. Pharyngeal and palatine tonsil hypertrophy is the main predisposing factor. Various abnormalities are predisposing factors for obstructive sleep apnoea, such as decreased mandibular and maxillary lengths, skeletal retrusion, increased lower facial height and, consequently, increased total anterior facial height, a larger cranio-cervical angle, small posterior airway space and an inferiorly positioned hyoid bone. The diagnosis is based on the clinical history, a physical examination and tests confirming the presence and severity of upper airway obstruction. The gold standard test for diagnosis is overnight polysomnography. Attention must be paid to identify the craniofacial characteristics. When necessary, children should be referred to orthodontists and/or sleep medicine specialists for adequate treatment in addition to undergoing an adenotonsillectomy.
Topics: Adenoids; Child; Child, Preschool; Craniofacial Abnormalities; Humans; Hypertrophy; Palatine Tonsil; Polysomnography; Sleep Apnea, Obstructive
PubMed: 27982168
DOI: 10.6061/clinics/2016(11)08 -
Journal of Medical Virology Jun 2017Epstein-Barr virus (EBV) is associated with the pathogenesis of several diseases in both adults and children. However, there have been no reports on the prevalence and...
Epstein-Barr virus (EBV) is associated with the pathogenesis of several diseases in both adults and children. However, there have been no reports on the prevalence and amount of EBV in the adenoids of adults; thus, it is important to investigate these in the adenoids and tonsils of adults and children. In this study, 67 patients who underwent tonsillectomy or adenotonsillectomy were included and divided into two groups: adults aged ≥ 16 years (n = 35) and children aged <16 years (n = 32). Patients' adenoid and tonsil tissues were analyzed using quantitative polymerase chain reaction for EBV DNA. EBV was detected in 26 (74%) adenoids and 25 (71%) tonsils among the adult group and was detected 21 (66%) adenoids and 20 (63%) tonsils in the child group. There was no significant difference in EBV DNA prevalence between the adenoids and tonsils for each group. However, there was a significant correlation between EBV DNA load in the adenoids and tonsils of the same individual in both groups (r = 0.579, P < 0.01, adult group; r = 0.919, P < 0.01, child group). In conclusion, EBV infection is prevalent in the adenoids and tonsils in adults and children. These results indicate that EBV continuously reside in the nasopharyngeal region after primal infection and may develop several diseases.
Topics: Adenoids; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; DNA, Viral; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; Male; Middle Aged; Palatine Tonsil; Prevalence; Real-Time Polymerase Chain Reaction; Viral Load; Young Adult
PubMed: 27864888
DOI: 10.1002/jmv.24737 -
Scientific Reports Jan 2018Activation-induced cytidine deaminase (AID) and apolipoprotein B mRNA-editing catalytic polypeptide 3 (A3) family are cytidine deaminases that play critical roles in...
Activation-induced cytidine deaminase (AID) and apolipoprotein B mRNA-editing catalytic polypeptide 3 (A3) family are cytidine deaminases that play critical roles in B-cell maturation, antiviral immunity and carcinogenesis. Adenoids and palatine tonsils are secondary lymphoid immune organs, in which AID and A3s are thought to have several physiological or pathological roles. However, the expression of AID or A3s in these organs has not been investigated. Therefore, we investigated the expression profiles of AID and A3s, using 67 samples of adenoids and palatine tonsils from patients, with reverse transcription quantitative polymerase chain reaction (RT-qPCR) and immunohistochemical analyses. AID and A3s expression levels in the adenoids and the palatine tonsils of the same individual significantly correlated with each other. Of note, AID expression level in the adenoids negatively correlated with the age (r = -0.373, P = 0.003). The younger group with adenoid vegetation and tonsillar hypertrophy showed more abundant AID expression than the older group with recurrent tonsillitis and peritonsillar abscesses (P = 0.026). Moreover, immunohistochemical analysis revealed the distribution of AID and A3s in the epithelial cells as well as germinal centres. The localisation of AID expression and its relation to age may contribute to adenoid vegetation and inflammation.
Topics: APOBEC Deaminases; Adenoids; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Cytidine Deaminase; Cytosine Deaminase; Female; Humans; Hypertrophy; Male; Middle Aged; Palatine Tonsil; Young Adult
PubMed: 29343743
DOI: 10.1038/s41598-017-18732-w -
BMC Medicine May 2023Removal of tonsils and adenoids is among the most common surgical procedures worldwide. Evidence of increased risk of cancer following such surgery is, however,...
BACKGROUND
Removal of tonsils and adenoids is among the most common surgical procedures worldwide. Evidence of increased risk of cancer following such surgery is, however, inconclusive.
METHODS
We conducted a population-based, sibling-controlled cohort study of 4,953,583 individuals in Sweden with a follow-up during 1980-2016. History of tonsillectomy, adenotonsillectomy, and adenoidectomy was identified from the Swedish Patient Register whereas incident cases of cancer during follow-up were identified from the Swedish Cancer Register. We used Cox models to calculate hazard ratios (HR) with 95% confidence intervals (CI) of cancer in both a population and a sibling comparison. The sibling comparison was used to assess the potential impact of familial confounding, due to shared genetic or non-genetic factors within a family.
RESULTS
We found a modestly increased risk for any cancer following tonsillectomy, adenoidectomy, or adenotonsillectomy in both the population (HR 1.10; 95%CI 1.07-1.12) and sibling (HR 1.15; 95%CI 1.10-1.20) comparisons. The association did not differ greatly by type of surgery, age at surgery, or potential indication for surgery, and persisted more than two decades after surgery. An excess risk was consistently observed for cancer of the breast, prostate, thyroid, and for lymphoma in both population and sibling comparisons. A positive association was observed for pancreatic cancer, kidney cancer, and leukemia in the population comparison whereas a positive association was observed for esophageal cancer in the sibling comparison.
CONCLUSIONS
Surgical removal of tonsils and adenoids is associated with a modestly increased risk of cancer during the decades following the surgery. The association is unlikely attributed to confounding due to shared genetic or non-genetic factors with a family.
Topics: Male; Humans; Palatine Tonsil; Adenoids; Sweden; Cohort Studies; Siblings; Kidney Neoplasms
PubMed: 37226237
DOI: 10.1186/s12916-023-02902-x