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International Journal of Pediatric... Oct 2020To examine the potential risk factors for adenoid regrowth and the incidence of revision adenoidectomy. (Meta-Analysis)
Meta-Analysis
AIMS
To examine the potential risk factors for adenoid regrowth and the incidence of revision adenoidectomy.
METHODOLOGY
The English-language literature published from January 1995 to January 2020 regarding adenoid regrowth and revision adenoidectomy was reviewed. The keywords used were 'adenoids', 'adenoid regrowth' and 'revision adenoidectomy'. The inclusion criteria were English language, sample size greater than five and presentation of extractable data on risk factors for adenoid regrowth and rates of revision adenoidectomy. Random-effects modelling was used to estimate summary outcomes.
RESULTS
Twenty studies met the inclusion criteria. There was a total of 143369 cases of baseline adenoidectomies. The mean age at primary surgery was 4.62 years (SD = 1.47 years, range of 2.3-7.3 years) and the mean age at revision adenoidectomy was 5.43 years (SD = 1.80 years, range of 2.5-7.6 years). Six studies reported on adenoid regrowth and a total of 4950 baseline adenoidectomies were examined. The prevalence of adenoid regrowth was 8%. Fifteen studies examined the rate of revision adenoidectomy and a total of 119369 baseline adenoidectomies were analysed. The revision adenoidectomy rate was 2%. Of the patients with revision adenoidectomy, 14% had allergic rhinitis and 9% had asthma. With regards to indications for revision adenoidectomy, 26% had OSA, 86% were snorers, 63% had nasal obstruction, 32% had recurrent AOM and 73% had OME.
CONCLUSION
The combined revision adenoidectomy rate from this study is 2%. Young age at first surgery was prevalent as well as co-morbidities of allergic rhinitis and asthma and indications for primary adenoidectomy like upper airway obstructive symptoms and middle ear disease. However, given the heterogeneity of these studies, direct cause and effect could not be concluded.
Topics: Adenoidectomy; Adenoids; Adolescent; Child; Child, Preschool; Humans; Reoperation; Risk Factors
PubMed: 32896343
DOI: 10.1016/j.ijporl.2020.110220 -
Archivos Argentinos de Pediatria Jan 2015Adenotonsillectomy is the most common surgical procedure in otolaryngology.The main indication for this procedure is upper airway obstruction associated with... (Comparative Study)
Comparative Study
INTRODUCTION
Adenotonsillectomy is the most common surgical procedure in otolaryngology.The main indication for this procedure is upper airway obstruction associated with hypertrophic tonsils and/or adenoids.
OBJECTIVES
To describe the differences in quality of life before and after an adenoidectomy and/or tonsillectomy and compare it with that of healthy children.
POPULATION AND METHODS
All children aged 1 to 17 years old hospitalized for an elective surgery between July 2012 and April 2014 were enrolled.They were compared to a control group of children in the same age range. The survey used was validated in Spanish (OSA-18) and has been especially designed to establish a relationship between obstructive sleep apnea and quality of life in pediatrics.
RESULTS
Eighty-five surgery patients and 100 healthy control children were assessed. The impact on quality of life was mild in 37.6% of children, moderate in 32.9%, and severe in 29.4%,while it was mild for 96% of the control group.The average±SD of the total pre-surgery score was 67.5±20.3 (95% confidence interval [CI]:63.13-71.88). The average post-surgery scores were 37.9±21.4 (95% CI: 33.24-42.48) and 37.25±23.9 (95% CI: 32.19-42.33) at 3 and 6 months,respectively (p<0.001). The average score for the control group was 31.2±13.2 (95% CI: 28.6-33.8) and was significantly different from the post-surgery groups (p=0.03).
CONCLUSIONS
Quality of life was reduced in children with a surgical indication for symptomatic adenotonsillar hypertrophy, while it was significantly improved after the surgery.
Topics: Adenoidectomy; Adenoids; Adolescent; Child; Child, Preschool; Female; Humans; Hypertrophy; Infant; Male; Palatine Tonsil; Prospective Studies; Quality of Life; Sleep Apnea, Obstructive; Tonsillectomy
PubMed: 25622157
DOI: 10.5546/aap.2015.eng.21 -
Acta Otorhinolaryngologica Italica :... Aug 2018Expression profiles of CXC- and CC-chemokines in various forms of tonsillar disease were studied to evaluate whether certain chemokines play a predominant role in a...
Expression profiles of CXC- and CC-chemokines in various forms of tonsillar disease were studied to evaluate whether certain chemokines play a predominant role in a specific subset of tonsillar disease. Total RNA was isolated from 89 biopsies (21 hyperplastic palatine tonsils, 25 adenoids, 16 chronic inflammatory palatine tonsils and 27 chronic inflammatory palatine tonsils with histological prove of acute inflammation), reverse transcribed and subjected to PCR amplifying IL-8, Gro-alpha, eotaxin-1, eotaxin-2, MCP-3, MCP-4 and RANTES. 2% agarose gel electrophoresis revealed a predominance of IL-8 in the chronic inflammatory palatine tonsil group compared to tonsillar hyperplasia. Furthermore, eotaxin-2 was strongly overexpressed in adenoid samples compared to chronic inflammatory specimens. Our data suggest that the majority of diseases related to adenoid formation are mediated via an eotaxin-2 expression, whereas chronic inflammatory tonsillitis is associated with IL-8 upregulation. These data imply that adenoids are related to a Th-2, and chronic inflammatory tonsillitis to a Th-1 based immune response.
Topics: Adenoids; Adult; Chemokines; Child; Child, Preschool; Gene Expression; Humans; Hyperplasia; Palatine Tonsil; Tonsillitis
PubMed: 30197422
DOI: 10.14639/0392-100X-1743 -
Journal of Breath Research Feb 2018This paper attempts to identify the sources and evaluate the prevalence of halitosis in children with adenoid hypertrophy. The study included pediatric patients admitted...
This paper attempts to identify the sources and evaluate the prevalence of halitosis in children with adenoid hypertrophy. The study included pediatric patients admitted for adenoidectomy due to obstructive symptoms. Patients with possibly other causes of halitosis, were excluded from the study. Halitosis was detected in 30 out of 136 children (22.1%). The effect of adenoid hypertrophy on halitosis was confirmed by the significant reduction in the organoleptic score rated according to the Rosenberg scale (on average by 2°) and the levels of volatile sulfur compounds (on average 84 ppb) post-adenoidectomy, as compared to pre-surgery results. In total, we reported a statistically significant decrease in the abovementioned values in 90% of patients with halitosis. It was found that in patients with halitosis, as compared to patients with no oral malodor, anaerobic bacteria and Staphylococcus aureus were more frequently observed in the adenoid tissue. Streptococcus oralis strains were more commonly reported in the material taken during adenoidectomy in children without oral malodor.
Topics: Adenoids; Adolescent; Bacteria, Anaerobic; Breath Tests; Child; Child, Preschool; Female; Halitosis; Humans; Hypertrophy; Male; Mouthwashes; Odorants; Sensation
PubMed: 29146888
DOI: 10.1088/1752-7163/aa9b3a -
Clinical Pediatrics Jul 2023We aimed to investigate the attention function, which is a parameter of cognitive functions, at different obstruction types (adenoid and tonsil hypertrophy, adenoid...
We aimed to investigate the attention function, which is a parameter of cognitive functions, at different obstruction types (adenoid and tonsil hypertrophy, adenoid hypertrophy only, tonsillar hypertrophy only, and normal) of oral cavity and nasopharynx, and the relationship between obstruction level, type, and attention (N = 80). To evaluate attention function, Stroop test has been performed. Eighteen-item Quality of Life (OSA-18) and Brouillette Symptom Score questionnaires have been completed with each child's parents. Significant and positive relation has been found between Brouillette Symptom Score, OSA-18 score, and each 5 sections of Stroop test's points. It has been shown that children with adenotonsillar hypertrophy (ATH) are negatively affected in terms of obstructive symptoms and quality of life. At the situation of obstructive pathology, the Stroop test durations are affected negatively. Results are supporting that quality of life and attention parameter are affected negatively at children with ATH.
Topics: Child; Humans; Adenoids; Palatine Tonsil; Sleep Apnea, Obstructive; Quality of Life; Hypertrophy
PubMed: 36475879
DOI: 10.1177/00099228221142952 -
Indian Journal of Pediatrics Nov 2020
Topics: Adenoids; Allergens; Child; Humans; Hypertrophy; Ultrasonography
PubMed: 32910335
DOI: 10.1007/s12098-020-03487-6 -
Zhonghua Bing Li Xue Za Zhi = Chinese... Jul 2022To investigate the clinicopathological characteristics, immunophenotype, molecular characteristics, differential diagnosis, clinical treatment and prognosis of mixed...
To investigate the clinicopathological characteristics, immunophenotype, molecular characteristics, differential diagnosis, clinical treatment and prognosis of mixed carcinoma of cervix with adenoid cystic pattern. Three cases of mixed cervical carcinoma with adenoid cystic pattern were collected at the Affiliated Hospital of Xuzhou University Medical School from 2018 to 2021.The clinicopathological characteristics were analyzed, immunohistochemistry (IHC) and in situ hybridization (ISH) were performed. The related literature was reviewed. The three patients were postmenopausal women with a median age of 74.7 years. The clinical symptom was vaginal bleeding without obvious causes. One case was an endophytic tumor, and the others were exophytic. The median diameter of the three cases was 3.3 cm. Two patients underwent hysterectomy, the tumors infiltrated the external 1/3 and middle 1/3 of the cervix respectively. All the lymph nodes were negative. One patient had a previous biopsy. Microscopically, all three tumors were characterized by a cribriform structure, which were filled with basophilic myxoid substance and surrounded by tubules lined by two layers of cells. The tumor cells had scanty cytoplasm and showed the characteristics of cervical basal-like cells. All three cases were accompanied by high-grade squamous intraepithelial lesions and squamous cell carcinoma, and one also showed a non-specific spindle cell sarcomatoid component. Within the double-layered epithelial structure, the outer epithelium was positive for p63, CD117, p16 (clone E6H4) and MYB protein and negative for S-100 by IHC. The combined positive score of PD-L1 (clone 22C3) was less than 1 in all three cases. Human papillomavirus (HPV) types 16 and 18 were detected in one patient preoperatively, while high-risk HPV were positive in the other two patients by RNAscope ISH postoperatively. None of the three cases showed MYB gene rearrangement by FISH. The mean follow-up time was 23.3 months (36, 28 and 6 months, respectively). Two patients underwent hysterectomy and radiotherapy survived without disease. One patient survived with tumor just by radiotherapy and drug therapy. Mixed cervical carcinoma with adenoid cystic pattern is extremely rare. It is a high-grade malignancy with poor prognosis. The tumor is associated with high-risk HPV infection, without MYB gene rearrangement, and with low PD-L1 immunoreactivity. Radical surgery combined with radiotherapy and chemotherapy is the mainstay of treatment at present.
Topics: Adenoids; B7-H1 Antigen; Carcinoma, Squamous Cell; Cervix Uteri; Female; Human papillomavirus 16; Humans; Mixed Tumor, Malignant; Papillomavirus Infections; Uterine Cervical Neoplasms
PubMed: 35785831
DOI: 10.3760/cma.j.cn112151-20220301-00137 -
Medicina (Kaunas, Lithuania) Jul 2022: the upper respiratory tract harbors the highest bacterial density in the whole respiratory system. Adenoids, which are located in the , are a major site of bacterial...
: the upper respiratory tract harbors the highest bacterial density in the whole respiratory system. Adenoids, which are located in the , are a major site of bacterial colonies in the upper airways. Our goal was to use culture-independent molecular techniques to identify the breadth of bacterial diversity in the adenoid vegetations of children suffering from chronic rhinosinusitis and obstructive sleep apnea. : in total, 21 adenoid samples were investigated using amplification and sequencing of the V3-V4 hypervariable region of the bacterial 16S rRNA gene. : among the most common bacterial species found were , , , and . and dominated the microbiome in all 21 samples, attributing to more than 60% of all detected genetic material. : since both and are, predominantly, oral cavity and dental microorganisms, our findings may suggest oral microbiome migration deeper into the oropharynx and nasopharynx where these bacteria colonize adenoid vegetations.
Topics: Adenoids; Bacteria; Child; Genes, rRNA; Humans; Microbiota; RNA, Ribosomal, 16S; Veillonella
PubMed: 35888639
DOI: 10.3390/medicina58070920 -
Progress in Orthodontics Sep 2023Identifying the prevalence of adenoid hypertrophy (AH) and craniofacial factors associated with this condition requires studies with random sampling from the general...
BACKGROUND
Identifying the prevalence of adenoid hypertrophy (AH) and craniofacial factors associated with this condition requires studies with random sampling from the general population, and multiple criteria can be used for assessing AH on lateral cephalometric radiograph (LCR). The present analysis represents the first report performed according to these requirements in a large cross-sectional sample of children.
METHODS
LCRs of 517 12-year-old children (286 males, 231 females) randomly selected from the general population were retrospectively retrieved. AH was defined using three criteria (At/Nd, Ad-Ba/PNS-Ba, 1-Npaa/Npa), and twelve craniofacial variables were measured (SNA, SNB, ANB, Wits, Cd-Gn, MnP^SN, MxP^MnP, TPFH/TAFH, OPT^SN, C2ps-C4pi^SN, H-CV, H-FH). Skeletal characteristics were compared between children with and without AH using Mann-Whitney U test. Binary logistic regression (adjusted for sex and skeletal growth) was used to independently quantify the association between craniofacial factors and AH.
RESULTS
The prevalence of children with AH was 17.6% (according to At/Nd), 19.0% (according to Ad-Ba/PNS-Ba), and 13.9% (according to 1-Npaa/Npa). Children with AH presented greater antero-posterior jaw discrepancy (larger ANB, smaller SNB), greater mandibular divergence (larger MnP^SN), forward head posture (larger OPT^SN and C2ps-C4pi^SN), and anteriorly positioned hyoid bone (larger H-CV). Larger SNA (OR = 1.39-1.48), while smaller SNB (OR = 0.77-0.88) and Wits (OR = 0.85-0.87), were associated with greater likelihood of having AH, independently from the assessment method used.
CONCLUSIONS
The prevalence of children with AH ranged from 13.9 to 19.0% based on LCR. Greater antero-posterior maxillo-mandibular discrepancy and mandibular retrusion were independently associated with higher likelihood of having AH.
Topics: Female; Male; Humans; Child; Cross-Sectional Studies; Prevalence; Adenoids; Retrospective Studies; Cephalometry
PubMed: 37691059
DOI: 10.1186/s40510-023-00481-4 -
International Immunopharmacology Jan 2024To identify adenoid inflammatory endotypes based on inflammatory markers, match endotypes to phenotypes, and predict endotypes.
OBJECTIVE
To identify adenoid inflammatory endotypes based on inflammatory markers, match endotypes to phenotypes, and predict endotypes.
METHODS
This cross-sectional study included 72 children with adenoid hypertrophy. Thirteen inflammatory markers and total immunoglobulin E (TIgE) in adenoid tissue were analyzed using Luminex and enzyme-linked immunosorbent assay (ELISA) for performing cluster analysis. Correlation analysis was used to examine the characteristics of each cluster. Receiver operating characteristic (ROC) curve analysis was performed to screen for preoperative characteristic data with predictive value for adenoid inflammation endotype.
RESULTS
The patients were divided into four clusters. Cluster 1 exhibited non-type 2 signatures with low inflammatory marker concentrations, except for the highest expression of Th1-related cytokines. Cluster 2 showed a non-type 2 endotype with the highest concentration of interleukin (IL)-17A and IL-22. Cluster 3 exhibited moderate type 2 inflammation, with the highest concentration of neutrophil factors. Cluster 4 demonstrated significant type 2 inflammation and moderate neutrophil levels. The proportions of AR and serum TIgE levels increased from clusters 1 to 4, and there was a gradual increase in the prevalence of chronic sinusitis from low to high neutrophilic inflammation. The area under the ROC curve for serum TIgE was higher than those for combined or other separate preoperative characteristics for predicting non-type 2 and type 2 inflammation in the adenoid tissue.
CONCLUSIONS
The evaluation of cytokines in adenoid tissue revealed four endotypes. Serum TIgE level was an important indicator of the endotype of adenoid inflammation. Identification of adenoid inflammatory endotypes can facilitate targeted treatment decisions.
Topics: Child; Humans; Rhinitis; Adenoids; Cross-Sectional Studies; Inflammation; Biomarkers; Cytokines; Immunoglobulin E; Cluster Analysis; Chronic Disease; Hypertrophy
PubMed: 38086270
DOI: 10.1016/j.intimp.2023.111318