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International Journal of Pediatric... Nov 2022This paper serves to review the historical progression of clinical, epidemiological and immunological evidence on the relationship between tonsillectomy and... (Review)
Review
OBJECTIVE
This paper serves to review the historical progression of clinical, epidemiological and immunological evidence on the relationship between tonsillectomy and poliomyelitis and its influence on clinical medicine.
METHODS
A literature review was conducted using terms relating to poliomyelitis, tonsillectomy, and immunology. Primary sources published between 1900 and 2000 were reviewed, analyzed and evaluated based on their historical, clinical, epidemiological, scientific and immunological pertinence towards the relationship between tonsillectomy, and poliomyelitis during epidemics.
RESULTS
The first study proposing a relationship between poliomyelitis and tonsillectomy was a case report published in 1910 by Phillip Sheppard. In response, other physicians began conducting clinical and epidemiological studies investigating the relationship between recent tonsillectomy and poliomyelitis in children. While the results of many of these studies demonstrated an increased morbidity and mortality rate associated with poliomyelitis in children who underwent recent tonsillectomy, other studies claimed there was no connection. Opposing study results and diverging physician views on this relationship left the medical community divided on whether to recommend against elective tonsillectomies during poliomyelitis outbreaks. The relationship between tonsillectomy and poliomyelitis was established after many years of clinical and epidemiological studies. Further scientific and immunological investigations revealed the causal nature of this relationship.
Topics: Adenoids; Child; Elective Surgical Procedures; Humans; Palatine Tonsil; Poliomyelitis; Tonsillectomy
PubMed: 36067711
DOI: 10.1016/j.ijporl.2022.111290 -
Rhinology Dec 2019To estimate the rate of revision surgery after previous adenoidectomy in children and to compare the rate of revision adenoidectomy in children with different conditions... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
To estimate the rate of revision surgery after previous adenoidectomy in children and to compare the rate of revision adenoidectomy in children with different conditions and by using different surgical techniques.
METHODOLOGY
The study protocol was registered on PROSPERO (CRD42018107877). Two authors independently searched databases, specifically PubMed, MEDLINE, EMBASE, and the Cochrane Review database. The keywords used were "adenoids","adenoidectomy","reoperation","revision"and "regrowth". The revision rate was pooled using a random-effect model. Subgroup analyses were conducted for children based on different settings, countries, risks of bias, and surgical techniques.
RESULTS
A total 16 studies with 95 727 children were analyzed (mean age: 4.69 (1.62) years; 60% boys; sample size: 5983 patients). Five studies had a low risk of bias, 10 studies had a moderate risk of bias, and one study had a high risk of bias. The rate of revision adenoidectomy was 1.9%. Ages at initial surgery and follow-up were not significantly associated with revision surgeries. The revision rate was not significantly different in children receiving surgeries in different settings (single center vs multicenter vs population-based, country (non-United States vs United States, and risk of bias. Moreover, surgical techniques, such as curettage, suction cautery, microdebridement, and coblation did not significantly affect revision rates in children who received adenoidectomy.
CONCLUSIONS
Revision surgery was undertaken with a frequency of 1.9% in children who underwent adenoidectomy. A lack of strong evidence exists to correlate surgical techniques with revision rate in pediatric adenoidectomy.
Topics: Adenoidectomy; Adenoids; Child; Child, Preschool; Female; Humans; Male; Pharyngeal Diseases; Reoperation
PubMed: 31403138
DOI: 10.4193/Rhin19.101 -
International Journal of Molecular... Sep 2023Adenoid cystic carcinoma (ACC) has a worldwide incidence of three to four cases per million population. Although more cases occur in the minor and major salivary glands,... (Review)
Review
Adenoid cystic carcinoma (ACC) has a worldwide incidence of three to four cases per million population. Although more cases occur in the minor and major salivary glands, it is the most common lacrimal gland malignancy. ACC has a low-grade, indolent histological appearance, but is relentlessly progressive over time and has a strong proclivity to recur and/or metastasise. Current treatment options are limited to complete surgical excision and adjuvant radiotherapy. Intra-arterial systemic therapy is a recent innovation. Recurrent/metastatic disease is common due to perineural invasion, and it is largely untreatable as it is refractory to conventional chemotherapeutic agents. Given the rarity of this tumour, the molecular mechanisms that govern disease pathogenesis are poorly understood. There is an unmet, critical need to develop effective, personalised targeted therapies for the treatment of ACC in order to reduce morbidity and mortality associated with the disease. This review details the evidence relating to the molecular underpinnings of ACC of the lacrimal gland, including the chromosomal translocations, -signalling pathway aberrations, DNA damage repair gene mutations and epigenetic modifications.
Topics: Humans; Carcinoma, Adenoid Cystic; Lacrimal Apparatus; Salivary Gland Neoplasms; Neoplasm Recurrence, Local; Salivary Glands
PubMed: 37762061
DOI: 10.3390/ijms241813755 -
Frontiers in Immunology 2023Adenoid hypertrophy is the main cause of obstructive sleep apnea in children. Previous studies have suggested that pathogenic infections and local immune system...
INTRODUCTION
Adenoid hypertrophy is the main cause of obstructive sleep apnea in children. Previous studies have suggested that pathogenic infections and local immune system disorders in the adenoids are associated with adenoid hypertrophy. The abnormalities in the number and function of various lymphocyte subsets in the adenoids may play a role in this association. However, changes in the proportion of lymphocyte subsets in hypertrophic adenoids remain unclear.
METHODS
To identify patterns of lymphocyte subsets in hypertrophic adenoids, we used multicolor flow cytometry to analyze the lymphocyte subset composition in two groups of children: the mild to moderate hypertrophy group (n = 10) and the severe hypertrophy group (n = 5).
RESULTS
A significant increase in naïve lymphocytes and a decrease in effector lymphocytes were found in severe hypertrophic adenoids.
DISCUSSION
This finding suggests that abnormal lymphocyte differentiation or migration may contribute to the development of adenoid hypertrophy. Our study provides valuable insights and clues into the immunological mechanism underlying adenoid hypertrophy.
Topics: Child; Humans; Adenoids; Sleep Apnea, Obstructive; Lymphocyte Subsets; Lymphocyte Count; Hypertrophy
PubMed: 37283767
DOI: 10.3389/fimmu.2023.1186258 -
HNO Jul 2020The number of operations for tonsillectomy have been significantly decreasing for many years in Germany. In children the number of adenotonsillectomies has decreased by...
The number of operations for tonsillectomy have been significantly decreasing for many years in Germany. In children the number of adenotonsillectomies has decreased by two thirds within a decade. This phenomenon is mirrored by a significant increase in the number of annually performed tonsillotomies, a surgical procedure which is preferably performed for volume reduction in cases of tonsillar hypertrophy. The aim of this article is to elucidate the different interventional procedures, their typical indications and risks.
Topics: Adenoids; Child; Germany; Humans; Palatine Tonsil; Tonsillectomy; Tonsillitis
PubMed: 32504114
DOI: 10.1007/s00106-020-00884-3 -
Modern Pathology : An Official Journal... Nov 2022Adenoid ameloblastoma is a very rare benign epithelial odontogenic tumor characterized microscopically by epithelium resembling conventional ameloblastoma, with...
Adenoid ameloblastoma is a very rare benign epithelial odontogenic tumor characterized microscopically by epithelium resembling conventional ameloblastoma, with additional duct-like structures, epithelial whorls, and cribriform architecture. Dentinoid deposits, clusters of clear cells, and ghost-cell keratinization may also be present. These tumors do not harbor BRAF or KRAS mutations and their molecular basis appears distinct from conventional ameloblastoma but remains unknown. We assessed CTNNB1 (beta-catenin) exon 3 mutations in a cohort of 11 samples of adenoid ameloblastomas from 9 patients. Two of the 9 patients were female and 7 male and in 7/9 patients the tumors occurred in the maxilla. Tumors of 4 of these 9 patients harbored CTNNB1 mutations, specifically p.Ser33Cys, p.Gly34Arg, and p.Ser37Phe. Notably, for one patient 3 samples were analyzed including the primary tumour and two consecutive recurrences, and results were positive for the mutation in all three tumors. Therefore, 6/11 samples tested positive for the mutation. In the 6 mutation-positive samples, ghost cells were present in only 2/6, indicating beta-catenin mutations are not always revealed by ghost cell formation. Dentinoid matrix deposition was observed in 5/6 mutation-positive samples and clear cells in all 6 cases. None of the cases harbored either BRAF or KRAS mutations. Beta-catenin immunoexpression was assessed in the samples of 8 patients. Except for one wild-type case, all cases showed focal nuclear expression irrespective of the mutational status. Together with the absence of BRAF mutation, the detection of beta-catenin mutation in adenoid ameloblastomas supports its classification as a separate entity, and not as a subtype of ameloblastoma. The presence of this mutation may help in the diagnosis of challenging cases.
Topics: Humans; Male; Female; Ameloblastoma; beta Catenin; Proto-Oncogene Proteins B-raf; Adenoids; Proto-Oncogene Proteins p21(ras); Odontogenic Tumors; Mutation
PubMed: 35840721
DOI: 10.1038/s41379-022-01125-4 -
Journal of Medical Virology Sep 2022Adenoids and tonsils have gained interest as a new in vivo model to study local immune functions and virus reservoirs. Especially herpesviruses are interesting because...
Adenoids and tonsils have gained interest as a new in vivo model to study local immune functions and virus reservoirs. Especially herpesviruses are interesting because their prevalence and persistence in local lymphoid tissue are incompletely known. Our aim was to study herpesvirus and common respiratory virus infections in nonacutely ill adenotonsillar surgery patients. Adenoid and/or palatine tonsil tissue and nasopharyngeal aspirate (NPA) samples were collected from elective adenoidectomy (n = 45) and adenotonsillectomy (n = 44) patients (median age: 5, range: 1-20). Real-time polymerase chain reaction was used to detect 22 distinct viruses from collected samples. The overall prevalence of herpesviruses was 89% and respiratory viruses 94%. Human herpesviruses 6 (HHV6), 7 (HHV7), and Epstein-Barr virus (EBV) were found, respectively, in adenoids (33%, 26%, 25%), tonsils (45%, 52%, 23%), and NPA (46%, 38%, 25%). Copy numbers of the HHV6 and HHV7 genome were significantly higher in tonsils than in adenoids. Patients with intra-adenoid HHV6 were younger than those without. Detection rates of EBV and HHV7 showed agreement between corresponding sample types. This study shows that adenoid and tonsil tissues commonly harbor human herpes- and respiratory viruses, and it shows the differences in virus findings between sample types.
Topics: Adenoids; Child, Preschool; Epstein-Barr Virus Infections; Herpesviridae; Herpesviridae Infections; Herpesvirus 4, Human; Humans; Palatine Tonsil; Simplexvirus
PubMed: 35488185
DOI: 10.1002/jmv.27818 -
Otolaryngologic Clinics of North America Oct 2019Evidence-based recommendations are constantly being updated for various pediatric surgical procedures, including the role for tympanostomy tubes, as well as indications... (Review)
Review
Evidence-based recommendations are constantly being updated for various pediatric surgical procedures, including the role for tympanostomy tubes, as well as indications for adenoidectomy and tonsillectomy. With a growing body of research available on some of the most prevalent pediatric conditions, an update on the current concepts surrounding management is warranted.
Topics: Adenoidectomy; Adenoids; Child; Humans; Middle Ear Ventilation; Otitis Media; Otitis Media with Effusion; Otolaryngology; Palatine Tonsil; Practice Guidelines as Topic; Recurrence; Tonsillectomy; Tonsillitis
PubMed: 31353143
DOI: 10.1016/j.otc.2019.05.002 -
Vestnik Otorinolaringologii 2021To describe the technique and determine the indications for sleep endoscopy in children.
OBJECTIVE
To describe the technique and determine the indications for sleep endoscopy in children.
MATERIAL AND METHODS
This study included 35 children, the average age of 5 years 1 month ± 3 years 4 months (from 1 year 6 months to 14 years 5 months). All children underwent standard polysomnography and sleep endoscopy.
RESULTS
According to polysomnography, severe obstructive sleep apnea (OSA) was diagnosed in 21 children, moderate - in 8 children and mild - in 6 children. Sleep endoscopy revealed that in most cases in unoperated children (about 70%), adenoids and palatine tonsils were the cause of obstruction. In the group of children, who previously underwent surgery for OSA, the causes of residual apnea more often were soft palate and palatine tonsils. In 5 of 8 children, tonsils pharyngoscopy size did not exceed the 1st degree. In 1 child after adenotonsillectomy, the hypertrophic tori tubarii were the cause of obstruction. Another rare cause of upper airway obstruction, lingual tonsil hypertrophy, was found in 2 primary patients.
CONCLUSION
Sleep endoscopy is a safe and useful method that makes it possible to determine the level of obstruction in children and to plan the optimal amount of surgical treatment.
Topics: Adenoidectomy; Adenoids; Child; Child, Preschool; Humans; Palatine Tonsil; Polysomnography; Tonsillectomy
PubMed: 34783475
DOI: 10.17116/otorino20218605158