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International Journal of Medical... 2020Interleukin-17 (IL-17) C is a cytokine expressed by epithelial cells in response to bacterial stimulation. In contrast to other members of the IL-17 family of... (Observational Study)
Observational Study
Interleukin-17 (IL-17) C is a cytokine expressed by epithelial cells in response to bacterial stimulation. In contrast to other members of the IL-17 family of cytokines, IL-17C is upregulated early during infection, maintains integrity of the epithelial layer barrier, and mediates the innate immune response. We investigated the expression profile of IL-17C in pediatric adenoids. Pediatric adenoid tissues and lavage fluids were collected from a total of 38 subjects. The amebocyte lysate test and real-time PCR using primers were performed to evaluate bacterial contents in adenoids. Expression of IL-17RE in adenoids was analyzed using real-time polymerase chain reaction and western blot. The expression of IL-17C was evaluated by western blot and immunohistochemistry and compared between allergic rhinitis (AR) and control subjects. The levels of Hsp27, Hsp70, and IL-17C in adenoid lavage fluids were evaluated by enzyme-linked immunosorbent assay, and the correlation between these molecules was statistically analyzed. The pediatric adenoids were found to be exposed to bacteria and had a normal flora comprising both gram-negative and -positive bacteria. IL-17RE, an IL-17C specific receptor, was highly expressed in the epithelium of adenoids. IL-17C was expressed in all evaluated adenoid tissue samples, irrespective of the allergic status of the patient. IL-17C secretion was detected in half of the adenoid lavage fluid samples and was associated with Hsp70 level. Our findings indicate the possible role of pediatric adenoids in innate immunity modulation via an innate immunity-associated cytokine.
Topics: Adenoids; Child; Child, Preschool; Epithelial Cells; Female; Humans; Immunity, Innate; Interleukin-17; Male; Receptors, Interleukin-17; Rhinitis, Allergic
PubMed: 33162788
DOI: 10.7150/ijms.49244 -
Otolaryngology--head and Neck Surgery :... May 2021The primary objective was to determine if obstructive sleep apnea (OSA) can improve after adenoidectomy.
OBJECTIVE
The primary objective was to determine if obstructive sleep apnea (OSA) can improve after adenoidectomy.
STUDY DESIGN
Case series with chart review.
SETTING
Tertiary children's hospital between 2016 and 2018.
METHODS
The study included children under 3.5 years with small (1+ or 2+) palatine tonsils, large (3+ or 4+) adenoids, and documented OSA on polysomnogram (PSG).
RESULTS
Seventy-one children were included. Age at adenoidectomy was 2.0 years (95% CI, 1.8-2.2) and 71.8% were male. Mean follow-up was 2.5 years (95% CI, 2.3-2.7). Twenty-six children (36.6%) obtained a repeat PSG at a mean of 9.7 months (95% CI, 6.3-13.2) after adenoidectomy. Among those with a postoperative PSG, apnea-hypopnea index decreased in 77.0% (mean, -3.2 events/h; 95% CI, -14.1 to 7.6), and the proportion with moderate to severe OSA decreased from 65.4% to 30.8% ( = .03). Six children (23.1%) had a normal PSG after adenoidectomy. Tonsillectomy was performed in 14.1% of children at 12.1 months (95% CI, 7.5-16.7) after adenoidectomy. Despite similar preoperative PSG variables, younger children (1.5 vs 2.1 years, = .02) were more likely to require tonsillectomy. Substantial adenoid regrowth was identified in 1 child at the time of tonsillectomy.
CONCLUSION
Adenoidectomy may improve OSA in young children with large adenoids and small tonsils. However, younger age predicted the need for subsequent tonsillectomy. Prospective studies with additional PSG data are necessary to corroborate these findings.
Topics: Adenoidectomy; Child, Preschool; Female; Humans; Infant; Male; Sleep Apnea, Obstructive; Tonsillectomy
PubMed: 32960140
DOI: 10.1177/0194599820955172 -
International Orthodontics Mar 2021To evaluate the correlation between craniofacial structures, anthropometric measurements, and bony and soft tissue nasopharyngeal dimensions in African Black adolescents.
OBJECTIVES
To evaluate the correlation between craniofacial structures, anthropometric measurements, and bony and soft tissue nasopharyngeal dimensions in African Black adolescents.
METHODS
This retrospective cross-sectional study was conducted on 483 healthy adolescents (250 females and 233 males), randomly selected from one dental clinic. The inclusion criteria were skeletal and dental Class I, Black ethnicity, pubertal growth period as determined by the Greulich and Pyle atlas criteria, and no history of orthodontic treatment. Anthropometric measurements (stature, upper body height, lower body height, and BMI) and radiographic records (hand-wrist radiographs, and lateral cephalograms) were obtained. One investigator traced and analysed all cephalograms to determine three skeletal craniofacial parameters (maxillary length [Ar- ANS], mandibular length [Ar-Gn], and lower anterior facial height [ANS-Me]), and 14 (8 skeletal and 6 soft tissue) nasopharyngeal parameters. Pearson correlation coefficients and stepwise multiple linear regression analyses were conducted.
RESULTS
The mean skeletal ages of females and males were 11.31±2.31y and 12.66±1.85y, respectively. Multiple linear regression analyses showed that stature, posterior height of nasal cavity (S-PNS), length of nasal floor (AA-PNS), and mean area of bony nasopharynx (Area 1) were significantly correlated with maxillary length, P<.001. Stature, BMI, S-PNS, vertical angle of nasopharynx (Ba-S-PNS), Area 1, adenoid height (AD), and linear hyoid bone measurements (H-AA, H-RGN, H-Ax) were all correlated with mandibular length, P<.05. Lower facial height showed sexual dimorphism and was significantly associated with vertical nasopharyngeal measurements, BMI and upper body height.
CONCLUSIONS
Craniofacial structures were significantly associated with stature and upper body height. Maxillary growth was associated with bony nasopharyngeal variables. Mandibular growth and lower facial height were associated with bony and soft tissue nasopharyngeal variables. The sexual dimorphism in lower facial height warrants future studies to fully understand and manage the craniofacial complex and nasopharyngeal airway in African Black adolescents.
Topics: Adenoids; Adolescent; Black or African American; Anatomic Landmarks; Anthropometry; Cephalometry; Cross-Sectional Studies; Facial Bones; Female; Humans; Male; Mandible; Maxilla; Maxillofacial Development; Nasopharynx; Puberty; Retrospective Studies
PubMed: 33516651
DOI: 10.1016/j.ortho.2021.01.002 -
Oral Surgery, Oral Medicine, Oral... Jul 2022Adenoid ameloblastoma with dentinoid is an uncommon benign odontogenic neoplasm, and its unicystic variant seems to be even rarer. A 34-year-old man was referred for...
Adenoid ameloblastoma with dentinoid is an uncommon benign odontogenic neoplasm, and its unicystic variant seems to be even rarer. A 34-year-old man was referred for evaluation of an asymptomatic swelling in the posterior maxilla. Intraoral examination showed an expansive lesion, soft to palpation, covered by a normal color mucosa. Cone beam computed tomography revealed a well-defined unilocular hypodense tumor involving the left maxillary sinus. Histopathological examination of the surgically excised specimen showed a cystic tumor lined by an ameloblastic-like epithelium containing columnar basal cells with hyperchromatic and polarized nuclei. In some areas of the capsule, the tumor showed mural infiltration by sheets of cells containing central whirling structures. Dentinoid material was also observed in association with ameloblastic-like cells. The tumor was BRAF and KRAS wild-type. Collectively, these findings were consistent with the diagnosis of a unicystic variant of adenoid ameloblastoma with dentinoid.
Topics: Adenoids; Adult; Ameloblastoma; Epithelium; Humans; Male; Maxilla; Odontogenic Tumors
PubMed: 35153188
DOI: 10.1016/j.oooo.2021.10.005 -
BMC Pediatrics Apr 2023When analyzing the relationship between adenotonsillar hypertrophy and craniofacial morphology, researchers generally regarded hypertrophied adenoids and tonsils as a...
BACKGROUND
When analyzing the relationship between adenotonsillar hypertrophy and craniofacial morphology, researchers generally regarded hypertrophied adenoids and tonsils as a whole. It remains unclear whether different enlarged sites of pharyngeal lymphoid tissue would correlate with multiple craniofacial subtypes. We hypothesized there would be craniofacial subtypes correlated with different locations of hypertrophied adenoid and tonsil.
METHODS
Lateral cephalometric radiographs were obtained from 466 children (171 boys and 295 girls, aged 12.27 ± 2.69 years). They were divided into four groups according to different sites of enlarged pharyngeal lymphoid tissue: adenoid hypertrophy group (AG, n = 126), tonsillar hypertrophy group (TG, n = 59), adenotonsillar hypertrophy group (ATG, n = 69) and control group (CG, n = 212). Five commonly used angles for cephalometric measurements were investigated: SNA (Sella-Nasion-Point A), SNB (Sella-Nasion-Point B), ANB (Point A-Nasion-Point B), mandibular plane angle (MP/SN) and Y-axis angle (SGn/FH).
RESULTS
Children with isolated tonsillar hypertrophy correlated with increased SNA (unstandardized regression coefficient B = 1.38, p = 0.009) and SNB (B = 1.99, p = 0.001) compared with controls. However, children with isolated adenoid hypertrophy correlated with decreased SNB (B=-0.94, p = 0.036), increased ANB (B = 0.74, p = 0.014) and increased MP/SN (B = 2.22, p < 0.001). Similarly, children with adenotonsillar hypertrophy correlated with decreased SNB (B=-1.36, p = 0.015), increased ANB (B = 1.35, p < 0.001) and increased MP/SN (B = 2.64, p = 0.001).
CONCLUSIONS
Isolated adenoid hypertrophy correlated with a retrognathic mandible, an increased maxillo-mandibular sagittal discrepancy, and an increased mandibular plane angle. Isolated tonsillar hypertrophy correlated with maxillary and mandibular protrusion. Adenotonsillar hypertrophy did not show a superimposed craniofacial pattern of the above two but showed the same craniofacial pattern as isolated adenoid hypertrophy.
Topics: Male; Child; Female; Humans; Palatine Tonsil; Adenoids; Mandible; Hypertrophy; Cephalometry
PubMed: 37024864
DOI: 10.1186/s12887-023-03979-2 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Jan 2021To investigate the effects of postoperative surgical treatment of infantile adenoidal hypertrophy on children, the recurrence rate, and the changes in immune levels...
To investigate the effects of postoperative surgical treatment of infantile adenoidal hypertrophy on children, the recurrence rate, and the changes in immune levels before and after surgery. Low temperature plasma ablation was performed in 11 infants with adenoidal hypertrophy to evaluate the risk of postoperative anesthesia and the effect of surgery on recurrence rate and immunity. During the follow-up period of 3 to 6 months, 2 patients had recurrence(18.18%), including 1 case with round pillow hyperplasia and 1 case with tonsil reactive hyperplasia. Three months after surgery, the immune level did not decrease significantly compared with that before surgery. No serious complications occurred in all children. Infants with adenoidal hypertrophy fall asleep, snoring, open mouth breathing, and belching seriously affect the quality of sleep and growth. Children who have been ineffective for more than 2 months undergo low-temperature plasma ablation. General anesthesia is safer. After that, the sleep quality of the children was significantly improved, and the immunity did not decrease significantly. Low temperature plasma ablation in infants with adenoidal hypertrophy is safe and effective, but it is not a routine treatment. Clinical symptoms are easy to repeat. The indications for surgery should be appropriately weighed.
Topics: Adenoids; Child; Humans; Hypertrophy; Infant; Mouth Breathing; Palatine Tonsil; Snoring
PubMed: 33540971
DOI: 10.13201/j.issn.2096-7993.2021.01.010 -
Journal of Computer Assisted TomographyThis study aimed to quantify the adenoidal-nasopharyngeal ratio (ANR) in a cohort of healthy adults on cone beam computed tomography (CT) using the Fujioka method, which...
OBJECTIVE
This study aimed to quantify the adenoidal-nasopharyngeal ratio (ANR) in a cohort of healthy adults on cone beam computed tomography (CT) using the Fujioka method, which is a reproducible measure of adenoid size and nasopharyngeal patency.
METHODS
Electronic health records and maxillofacial cone beam CT in 202 consecutive patients aged 16 years and older were retrospectively reviewed. Patients with a history of adenoidectomy, sinonasal disease, lymphoproliferative disorders, and cleft palate were excluded from the study. The midsagittal reconstructed cone beam CT image was used to determine the ANR. Statistical analysis was conducted using 1-way analysis of variance.
RESULTS
Of the 202 subjects, 131 were female and 71 were male. The mean ± SD subject age was 45.43 ± 20.79 years (range, 16-91 years). The mean ± SD ANR in all subjects was 0.22 ± 0.13 (range, 0.03-0.75) and in each decade of adult life was as follows: younger than 21 years, 0.39 ± 0.12; 21 to 30 years, 0.29 ± 0.11; 31 to 40 years, 0.21 ± 0.09; 41 to 50 years, 0.20 ± 0.07; 51 to 60 years, 0.16 ± 0.10; 61 to 70 years, 0.13 ± 0.05; 71 to 80 years, 0.12 ± 0.05; 81 to 90 years, 0.11 ± 0.04; and 91 years or older, 0.10 ± 0. The differences in mean ANR among the age subgroups were statistically significant ( P < 0.001).
CONCLUSIONS
The mean ANR gradually decreased from 0.39 in the second decade of life to 0.16 in the sixth decade of life and plateaued at approximately 0.10 thereafter.
Topics: Adenoids; Adult; Cleft Palate; Cone-Beam Computed Tomography; Female; Humans; Male; Nasopharynx; Retrospective Studies
PubMed: 35819911
DOI: 10.1097/RCT.0000000000001346 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Aug 2021Obstructive sleep apnea(OSA) is a common disease in otolaryngology in children, and its incidence rate is increasing gradually, which seriously endangers children's... (Review)
Review
Obstructive sleep apnea(OSA) is a common disease in otolaryngology in children, and its incidence rate is increasing gradually, which seriously endangers children's growth and development, behavior cognition and so on. There are many etiologies of OSA in children. Besides tonsil hypertrophy and/or adenoid hypertrophy, the most common one, there are many different levels of airway obstruction caused by inflammation, dysplasia, obesity and other reasons. Different individualized treatment plan should be taken according to different etiology. This paper summarizes the different treatment methods of children OSA.
Topics: Adenoidectomy; Adenoids; Child; Humans; Palatine Tonsil; Sleep Apnea, Obstructive; Tonsillectomy
PubMed: 34304541
DOI: 10.13201/j.issn.2096-7993.2021.08.018 -
Research Square Mar 2022SARS-CoV-2 infection triggers adaptive immune responses from both T and B cells. However, most studies focus on peripheral blood, which may not fully reflect immune...
SARS-CoV-2 infection triggers adaptive immune responses from both T and B cells. However, most studies focus on peripheral blood, which may not fully reflect immune responses in lymphoid tissues at the site of infection. To evaluate both local and systemic adaptive immune responses to SARS-CoV-2, we collected peripheral blood, tonsils, and adenoids from 110 children undergoing tonsillectomy/adenoidectomy during the COVID-19 pandemic and found 24 with evidence of prior SARS-CoV-2 infection, including detectable neutralizing antibodies against multiple viral variants. We identified SARS-CoV-2-specific germinal center (GC) and memory B cells; single cell BCR sequencing showed that these virus-specific B cells were class-switched and somatically hypermutated, with overlapping clones in the adenoids and tonsils. Oropharyngeal tissues from COVID-19-convalescent children showed persistent expansion of GC and anti-viral lymphocyte populations associated with an IFN-γ-type response, with particularly prominent changes in the adenoids, as well as evidence of persistent viral RNA in both tonsil and adenoid tissues of many participants. Our results show robust, tissue-specific adaptive immune responses to SARS-CoV-2 in the upper respiratory tract of children weeks to months after acute infection, providing evidence of persistent localized immunity to this respiratory virus.
PubMed: 35350206
DOI: 10.21203/rs.3.rs-1276578/v1 -
Indian Journal of Otolaryngology and... Oct 2022Globally adenoidectomy is increasingly being performed in isolation for children who have middle ear effusion or chronic otitis media, chronic rhinosinusitis and...
Globally adenoidectomy is increasingly being performed in isolation for children who have middle ear effusion or chronic otitis media, chronic rhinosinusitis and nasopharyngeal obstruction causing sleep apnoea and mouth breathing. Several techniques have been described lately including endoscopic powered adenoidectomy with debrider. The present study was undertaken to compare the effectiveness of endoscopic powered adenoidectomy (EA) with respect to conventional adenoidectomy (CA). It is a prospective study of 60 patients requiring adenoidectomy consisting of 33 males and 27 females randomized into group A with 30 patients undergoing conventional adenoidectomy with curette and 30 patients undergoing endoscopic powered adenoidectomy with micro-debrider. The demographic data (age, sex, adenoid hypertrophy grade assessed by Clemens and Mcmurray scale) in both groups were not statistically significant ( > 0.05). However, significant differences were observed in mean operative time of both groups (CA-29.12 ± 6.70, EA-37.80 ± 6.90 min, < 0.05). The intra-operative blood volume loss was 21.30 ± 5.80 ml, 28.24 ± 6.93 ml in CA and EA respectively. No significant difference was seen in post-operative pain assessed by Visual Analogue Scale (VAS) (-0.39). Complete removal of adenoids was seen in 83.3% cases with EA versus 53.3% with CA (< 0.05). The residual adenoids noted after the CA and EA in Grade I was 23.3% and 13.3% respectively while in CA, grade II with 16.7% and grade III with 6.7% cases had residual adenoids. Injury to surrounding structure was seen in 16.7% and 10% of CA and EA respectively. However, no difference in complication rate was observed between the study groups (> 0.05). We conclude that endoscopic powered adenoidectomy is more complete, accurate, with less post-operative pain and lower incidence of recurrence in comparison with conventional adenoidectomy.
PubMed: 36452556
DOI: 10.1007/s12070-020-02122-2