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European Archives of... Dec 2005Adenoid hyperplasia is a common cause of nasal obstruction in the pediatric age group. Recently, the adenoids were shown to harbor Helicobacter pylori (HP) based only on... (Review)
Review
Adenoid hyperplasia is a common cause of nasal obstruction in the pediatric age group. Recently, the adenoids were shown to harbor Helicobacter pylori (HP) based only on the rapid urease test (RUT). We conducted this pilot study to identify the presence of HP in the adenoids histologically and assess the reliability of both the RUT and histology in detecting HP in an extragastric location, using nested (two-steps) polymerase chain reaction (nPCR). Consecutive patients undergoing adenoidectomy for obstructive adenoid hyperplasia were enrolled. Adenoid specimens were subjected to the RUT. Histological sections stained with hematoxylin and eosin, Giemsa and Warthin-Starry were examined. We then used nPCR to detect the presence of HP in the studied specimens. Twenty-five patients (3-10 years; mean of 5.5 years) were enrolled. Twenty-one (84%) adenoids were positive by the RUT. Seventeen (68%) had bacteria on histological sections; four (16%) contained HP-like organisms. However, all specimens were negative by nPCR. No patient had a history of symptoms suggestive of laryngopharyngeal reflux within 6 months of the study. In conclusion, the children enrolled in this study did not have HP in their adenoids. High false positive results can occur with the RUT when used on adenoid tissues. It is not possible to rely solely on morphology to detect HP in an extragastric location. The nPCR remains the best way to identify HP accurately, but does not imply its presence in an active role.
Topics: Adenoidectomy; Adenoids; Child; Child, Preschool; Helicobacter Infections; Helicobacter pylori; Humans; Pilot Projects; Polymerase Chain Reaction; Urease
PubMed: 15924276
DOI: 10.1007/s00405-005-0926-1 -
L' Orthodontie Francaise Dec 2018Enlarged adenoids are often associated with oral breathing. The latter can impact the dental arches. The purpose of this study was to determine the relationships between...
INTRODUCTION
Enlarged adenoids are often associated with oral breathing. The latter can impact the dental arches. The purpose of this study was to determine the relationships between dental arch measurements and the size of adenoids.
MATERIALS AND METHODS
A cross-sectional study was carried out on 86 children. The dimensions of the adenoids were determined from nine radiographic evaluation methods and the dental arch measurements made on the casts. The association between the grade of adenoids and the dental arch measurements was sought by Spearman correlation. That between the quantitative variables assessing adenoids and dental arch measurements was sought by Pearson correlation. The strength of these associations was analyzed using Cohen's values in 1988. The significance was set at p = 0.05.
RESULTS
Palatal depth was significantly and positively correlated with adenoid grade according to the method of Holmberg and Linder-Aronson (rho = 0.55, p = 0.005) and with the adenoid measurements according to the methods of Kemaloglu, Fujioka, Johannesson, De Menezes and Maran with r respectively equal to 0.65, 0.59, 0.63, 0.47, 0.74; and p respectively equal to 0.001, 0.002, 0.001, 0.019, and < 0.001. It was also significantly but negatively correlated with the adenoids measurements according to Hibbert's method (r = -0.52, p = 0.008). Overbite was significantly and negatively correlated with adenoid dimension using the De Menezes method (r = -0.541, p = 0.006).
DISCUSSION
The strength of the associations shows that using respectively Maran and De Menezes methods can allow to better highlight the association between the dimensions of the adenoids and the palatal depth and the overbite.
Topics: Adenoids; Cephalometry; Child; Cross-Sectional Studies; Dental Arch; Female; Humans; Hypertrophy; Male; Nasopharynx; Odontometry; Organ Size; Overbite
PubMed: 30565559
DOI: 10.1051/orthodfr/2018037 -
Postgraduate Medical Journal Jul 2018Pathogenic bacteria associated with the adenoids and tonsils cause much morbidity in the paediatric population. Hyperplasia of the adenoids is associated with otitis... (Review)
Review
Pathogenic bacteria associated with the adenoids and tonsils cause much morbidity in the paediatric population. Hyperplasia of the adenoids is associated with otitis media with effusion and hyperplasia of the palatine tonsils is associated with both recurrent tonsillitis and obstructive sleep apnoea. Most current knowledge of the microbiology of the upper airways has been derived from culture-based studies, which usually reflect only a small fraction of the bacteria present on the mucosal surface. Culture-independent molecular surveys based on 16S ribosomal RNA sequencing are now being employed to determine the microbiota on the surface and within the tissue of adenoids and palatine tonsils. This review describes the new techniques applied in determining the microbiome and summarises the results of studies employing these techniques.
Topics: Adenoids; Child; Humans; Hypertrophy; Microbiota; Palatine Tonsil; Recurrence; Sequence Analysis, RNA; Tonsillitis
PubMed: 29884749
DOI: 10.1136/postgradmedj-2018-135602 -
Otolaryngology--head and Neck Surgery :... Nov 2000The goal was to determine the incidence of symptomatic adenoidal regrowth after adenoidectomy.
OBJECTIVE
The goal was to determine the incidence of symptomatic adenoidal regrowth after adenoidectomy.
STUDY DESIGN
A cross-sectional follow-up study was done in a randomly selected group of 175 children who had undergone adenoidectomy 2 to 5 years earlier. Nasopharyngoscopy was performed in those children who still had symptoms of nasal obstruction.
SETTING
All surgery was performed at an academic hospital-based practice in the northeastern United States by a single surgeon using a consistent operative technique.
RESULTS
Forty-six (26%) patients had nasal airway obstruction symptoms at follow-up. Of the 35 who agreed to undergo nasopharyngoscopy, not a single one had adenoids occupying more than 40% of the nasopharynx, and most (71%) were found to have either no or only trace amounts of adenoidal tissue (usually in the pharyngeal recess).
CONCLUSION
Adenoids rarely, if ever, regrow enough to cause symptoms of nasal obstruction after adenoidectomy that includes visualization and electrocautery of the adenoid bed.
Topics: Adenoidectomy; Adenoids; Child; Child, Preschool; Cross-Sectional Studies; Follow-Up Studies; Humans; Postoperative Period; Retrospective Studies
PubMed: 11077344
DOI: 10.1067/mhn.2000.110727 -
Recent Patents on Inflammation &... May 2012Adenotonsillar disease (adenoiditis and recurrent tonsillitis) is a prevalent otolaryngologic disorder aetiologically based on chronic inflammation triggered by a... (Review)
Review
Adenotonsillar disease (adenoiditis and recurrent tonsillitis) is a prevalent otolaryngologic disorder aetiologically based on chronic inflammation triggered by a persistent bacterial infection. These bacteria, mostly Staphylococcus aureus, Haemophilus sp., and Streptococcus sp., persist predominantly intracellular and within mucosal biofilms. The recurrent or chronic inflammation of the adenoids and faucial tonsils leads to chronic activation of the cell-mediated and humoral immune response, resulting in hypertrophy of the lymphoid tonsillar tissue. This hypertrophic tissue is the cause for the prominent clinical symptoms: obstruction of the upper airways, snoring, and sleep apnea for adenoiditis or sore throat, dysphagia and halitosis for recurrent tonsillitis. Treatment strategies should target the persisting bacteria within their biofilm or intracellular shelter. Macrolide antibiotics like clarithromycin are able to modulate the immune system and to interfere in bacterial signaling within biofilms. Clindamycin, quinupristin-dalfopristin, and oritavancin are intracellular high active compounds. Surgical removal of the hypertrophic tissue by modern procedures like laser tonsil ablation, eliminates not only a mechanical obstacle of the airways, it removes also the basis for the aetiologic cause, the "biofilm carrier". This review summarizes the role of bacterial persistence in mucosal biofilms for the aetiology, diagnosis and treatment of adenotonsillar disease and relevant patents.
Topics: Adenoids; Animals; Anti-Bacterial Agents; Bacteria; Bacterial Infections; Biofilms; Humans; Hypertrophy; Patents as Topic; Tonsillitis
PubMed: 22452646
DOI: 10.2174/187221312800166877 -
The Kaohsiung Journal of Medical... Jan 1999Magnetic resonance (MR) imaging, which is able to demonstrate the actual size of adenoids by differentiating them from other soft-tissue structures, can be effectively...
Magnetic resonance (MR) imaging, which is able to demonstrate the actual size of adenoids by differentiating them from other soft-tissue structures, can be effectively used to study the normal development of adenoids. To assess the normal development of adenoids and to understand their role in the nasopharyngeal airway compromise, the adenoids of 290 children who had MR examination for other reasons were measured by midsagittal T1-weighted spin-echo MR image. The maximal thickness of adenoids (A), anteroposterior depth of the nasopharynx (N) and the adenoid-nasopharynx (A/N) ratios were obtained using this method. The results showed that of the infants under the age of 3 months only 2 out of 11 adenoids (18%) could be identified. By 4 months of age, adenoids could be identified in 6 of 8 infants (75%). After 5 months of age, all adenoids were well demonstrated by MR imaging. The adenoids developed rapidly during infancy and reached a plateau between 2- and 14 years of age with a mean thickness ranging from 10.7 to 12.2 mm. Finally, the adenoids regressed rapidly after 15 years old. The A/N ratios, which could be used to assess the airway compromise, had a plateau between 2- and 7 years of age. After that, with the steady growth of the nasopharynx, the possible role of adenoid in airway compromise will become increasingly less significant in later childhood.
Topics: Adenoids; Adolescent; Adult; Age Factors; Child; Child, Preschool; Female; Humans; Infant; Magnetic Resonance Imaging; Male
PubMed: 10063790
DOI: No ID Found -
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 -
The Journal of Laryngology and Otology Apr 1992Methods of evaluating adenoidal size pre-operatively are controversial. Symptoms and clinical evaluation have been both advocated and condemned. Depending on the... (Comparative Study)
Comparative Study
Methods of evaluating adenoidal size pre-operatively are controversial. Symptoms and clinical evaluation have been both advocated and condemned. Depending on the methodology, measurement of the radiological adenoidal shadow has been difficult to correlate with the clinical patency of the nasopharyngeal airway and to the actual size of the removed adenoid. Four different methods were used to measure the adenoidal size on 74 radiographs. The methods were evaluated against the degree to which the adenoids obstructed the nasopharynx on flexible endoscopy of the postnasal space. Obstructive symptomatology was also evaluated against the degree of obstruction. The radiological method that best correlated to the endoscopic findings was that of Cohen and Konak (1985). However, obstructive symptomatology had the overall highest correlation to endoscopic findings.
Topics: Adenoids; Adolescent; Airway Obstruction; Child; Child, Preschool; Endoscopy; Humans; Infant; Lymphatic Diseases; Methods; Nasopharynx; Radiography
PubMed: 1613348
DOI: 10.1017/s0022215100119449 -
Acta Oto-rhino-laryngologica Belgica 2000Tonsillectomy and adenoidectomy procedures are among the oldest surgical procedures still performed today. Tonsils and adenoids are part of Waldeyer's ring, the basic...
Tonsillectomy and adenoidectomy procedures are among the oldest surgical procedures still performed today. Tonsils and adenoids are part of Waldeyer's ring, the basic function of which is antibody formation. Because of their location at the portal of entry of many airborne and alimentary antigens, the tonsils and adenoids often have been considered as the first line of defense against respiratory infections. Indications for adenoidectomy or tonsillectomy are to date still controversial. The two main indications for tonsillectomy are upper airway obstruction due to tonsillar hypertrophy and recurrent acute or chronic tonsillitis. Adenoid hypertrophy with upper airway or eustachian tube obstruction and recurrent acute or chronic adenoiditis or otitis media are main indications to perform an adenoidectomy. The possible immunological effects of tonsillectomy and adenoidectomy are still controversial. Some authors have found changes in immunoglobulin levels after tonsillectomy, while others failed to find significant changes. In a review of long-term follow-up studies, the authors showed that while tonsillectomy may lead to certain changes in the cellular and humoral immune system, these alterations are clinically insignificant and no increased frequency of immunomodulated diseases should be expected.
Topics: Acute Disease; Adenoidectomy; Adenoids; Child; Child, Preschool; Chronic Disease; Female; Humans; Hypertrophy; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Male; Nasal Obstruction; Palatine Tonsil; Postoperative Period; Recurrence; Tonsillectomy
PubMed: 11082777
DOI: No ID Found -
The Annals of Otology, Rhinology, and... 1979At adenoidectomy specimens for bacteriological, virological, and histological investigation were obtained from the adenoids of 144 children, 53 of whom suffered from...
At adenoidectomy specimens for bacteriological, virological, and histological investigation were obtained from the adenoids of 144 children, 53 of whom suffered from otitis media with effusion, or frequently recurring otitis media. Comparison of findings in children with ear diseases with those obtained in the rest of the material showed that Hemophilus influenza was cultured from 50% of the specimens from the children with ear diseases, while only 14% of the cultures from the other children yielded H. influenza. Virus isolates were made from 17 adenoids. In children with ear diseases a virus was isolated from 28% of the specimens, whereas positive isolates were obtained in only 3% of the rest of the speciemens. Both findings are statistically significant and support the view that the adenoid tissue may play an important role in the etiology of otitis media with effusion. The infected adenoid may be the direct source of the primary infections, or continuous microbial irritation in the nasopharynx may indirectly be the cause of otitis media with effusion, as persistent infection and edema maintain chronic dysfunction of the eustachian tube. Thus adenoidectomy may be beneficial in the treatment of frequently recurring otitis media, preventing otitis media with effusion from developing.
Topics: Adenoids; Adolescent; Bacterial Infections; Child; Child, Preschool; Haemophilus influenzae; Humans; Infant; Lymphangitis; Lymphatic Diseases; Otitis Media; Recurrence; Virus Diseases; Viruses
PubMed: 312617
DOI: 10.1177/000348947908800203