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The Laryngoscope Feb 1982Adenoidectomy in the presence of an inadequate palate may result in velopharyngeal insufficiency. When an adenoidectomy is indicated in a child whose palate is not fully...
Adenoidectomy in the presence of an inadequate palate may result in velopharyngeal insufficiency. When an adenoidectomy is indicated in a child whose palate is not fully adequate, a partial adenoidectomy may be considered. Partial adenoidectomy involves removing the upper part of the adenoid for relief of nasal obstruction while leaving the lower portion of the adenoid intact to ensure velopharyngeal competence. Fifty-eight children underwent partial adenoidectomy over a 4-year period; 55 of these children had preoperative nasal obstruction; 49 had a tonsillectomy done at the same time; and 2 had had a previous T&A. The rationale for retaining the lower portion of the adenoid includes a short soft palate, decreased palatal mobility, a mild submucous cleft palate, huge tonsils pushing the palate anteriorly, and a short hard palate. The relief of nasal obstruction was excellent. There were no primary postoperative hemorrhages, and none of the 58 children developed velopharyngeal insufficiency following partial adenoidectomy.
Topics: Adenoidectomy; Adenoids; Adolescent; Airway Obstruction; Child; Child, Preschool; Female; Fluoroscopy; Humans; Male; Palate; Velopharyngeal Insufficiency
PubMed: 7162308
DOI: 10.1002/lary.1982.92.2.135 -
Head and Neck Pathology Jun 2022
Topics: Adenoids; Ameloblastoma; Humans
PubMed: 34491520
DOI: 10.1007/s12105-021-01372-y -
International Journal of Pediatric... Nov 2008To evaluate adenoids' importance in pediatric rhinosinusitis as a cause of mechanical blockage or as a reservoir for pathogenic bacteria.
OBJECTIVE
To evaluate adenoids' importance in pediatric rhinosinusitis as a cause of mechanical blockage or as a reservoir for pathogenic bacteria.
METHODS
A retrospective chart review of prospectively collected data was performed, which included 410 children under the age of 14 who underwent adenoidectomy in the study. Adenoid bacteriology was evaluated with adenoid tissue culture, and sinusitis grade and adenoid size were determined using preoperative PNS X-ray. A potential correlation between these factors was then analyzed.
RESULTS
The overall adenoid bacteria isolation rate was 79.3%. The most common bacteria were Haemophilus influenza (28.5%), Streptococcus pneumonia (21.7%), Streptococcus pyogenes (21.0%), and Staphylococcus aureus (15.6%), and bacterial isolation rate increased significantly according to sinusitis grade (p=0.000). This was especially true of Haemophilus influenzae and Streptococcus pneumonia, whose isolation rates increased significantly (p=0.011, p=0.001 each). There was no statistically significant difference in sinusitis grade or bacterial isolation rate according to adenoid size.
CONCLUSIONS
Based on these results, adenoids contain many potentially pathogenic bacteria. We suggest that in pediatric rhinosinusitis, adenoids act as a reservoir for pathogenic bacteria rather than as a barrier causing mechanical obstruction.
Topics: Adenoidectomy; Adenoids; Child; Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Male; Prospective Studies; Retrospective Studies; Rhinitis; Sinusitis
PubMed: 18789545
DOI: 10.1016/j.ijporl.2008.07.016 -
Current Allergy and Asthma Reports Nov 2009Adenoids and/or tonsil inflammation with concomitant obstructive hypertrophy is one of the oldest and most common pediatric problems. Adenoids are a component of...
Adenoids and/or tonsil inflammation with concomitant obstructive hypertrophy is one of the oldest and most common pediatric problems. Adenoids are a component of Waldeyer's ring and because of their anatomic position can be relevant in the pathogenesis of otitis media when they are inflamed and/or enlarged. Adenoid pads can create mechanical eustachian tube obstruction. Therefore, in some cases, adenoidectomy may have a role in the clinical management of otitis media with effusion. However, eustachian tube dysfunction related to the adenoids may also have an allergy-related functional component. Allergic inflammation has been described for middle ear effusion, and some studies have reported that mast cells increase and allergic mediators release in adenoids as well. Nasal endoscopy has a key role in confirming a diagnosis of adenoid hypertrophy and/or adenoiditis and in detecting an association between adenoid inflammation/infection and otitis media with effusion, especially during infancy and early childhood.
Topics: Adenoids; Child; Eustachian Tube; Humans; Hypersensitivity; Immunity, Cellular; Otitis Media with Effusion; Risk Factors; Tonsillitis
PubMed: 19814919
DOI: 10.1007/s11882-009-0068-4 -
The Laryngoscope Jun 2000To determine the qualitative and quantitative microbiology of core adenoid tissue obtained from four groups of 15 children each, with recurrent otitis media (ROM),... (Comparative Study)
Comparative Study
OBJECTIVE
To determine the qualitative and quantitative microbiology of core adenoid tissue obtained from four groups of 15 children each, with recurrent otitis media (ROM), recurrent adenotonsillitis (RAT), obstructive adenoid hypertrophy (OAH), and occlusion or speech abnormalities (controls).
METHODS
Core cultures of surgically removed diseased adenoids and of healthy controls were cultured for aerobic and anaerobic bacteria.
RESULTS
Polymicrobial aerobic-anaerobic flora were present in all instances. Ninety-four organisms were isolated from control specimens, and 148 from ROM, 142 from RAT, and 149 from OAH specimens. The predominant aerobes in all groups were alpha-hemolytic and gamma-hemolytic streptococci, Haemophilus influenzae, Staphylococcus aureus, group A beta-hemolytic streptococci, and Moraxella catarrhalis. The prominent anaerobes were Peptostreptococcus, Prevotella, and Fusobacterium species. The number, concentration and distribution of types of most organisms did not vary among the three groups of diseased adenoids. However, the number of those that are potential pathogens and those that produced beta-lactamase was lower in the control than the diseased adenoids (P < .001).
CONCLUSION
The study highlights the importance of the bacterial load in the adenoids in contributing to the etiology of ROM, RAT, and OAH.
Topics: Adenoidectomy; Adenoids; Bacteria, Aerobic; Bacteria, Anaerobic; Bacterial Infections; Case-Control Studies; Child; Child, Preschool; Female; Humans; Hypertrophy; Male; Otitis Media; Tonsillitis
PubMed: 10852520
DOI: 10.1097/00005537-200006000-00021 -
European Archives of... Sep 2019Heat shock protein (HSP)27 and 70 are molecular chaperones that may have immunomodulatory functions. We determined if and at what levels each are expressed in the...
PURPOSE
Heat shock protein (HSP)27 and 70 are molecular chaperones that may have immunomodulatory functions. We determined if and at what levels each are expressed in the adenoids of pediatric subjects. We also examined tissue distributions, associated clinical characteristics, and antibacterial effects.
METHODS
Western blot, enzyme-linked immunosorbent assay (ELISA), and immunohistochemistry were applied to adenoidal tissues and lavage fluids obtained from children (N = 40) undergoing adenotonsillectomy.
RESULTS
Via western blot and ELISA, both HSP27 and 70 were regularly detected in adenoidal tissue and in lavage fluid samples. HSP27 was highly expressed in epithelium, whereas HSP70 showed strong subepithelial positivity and bore a significant relation to adenoidal size. Assayed levels of HSP27 and 70 correlated inversely, and their addition to culture media independently increased bacterial numbers (Staphylococcus aureus). Upon the precipitation of each from adenoidal lavage fluids, bacterial counts declined.
CONCLUSIONS
HSP27 and 70 are readily expressed in the adenoids of children and may be implicated in immunologic responses.
Topics: Adenoids; Child; Child, Preschool; Female; HSP27 Heat-Shock Proteins; HSP70 Heat-Shock Proteins; Heat-Shock Proteins; Humans; Immunoassay; Immunohistochemistry; Male; Molecular Chaperones; Nasal Lavage Fluid
PubMed: 31240454
DOI: 10.1007/s00405-019-05528-z -
The Journal of Laryngology and Otology May 2017This review examined the efficacy of intranasal corticosteroids for improving adenotonsillar hypertrophy. (Review)
Review
OBJECTIVES
This review examined the efficacy of intranasal corticosteroids for improving adenotonsillar hypertrophy.
METHOD
The related literature was searched using PubMed and Proquest Central databases.
RESULTS
Adenotonsillar hypertrophy causes mouth breathing, nasal congestion, hyponasal speech, snoring, obstructive sleep apnoea, chronic sinusitis and recurrent otitis media. Adenoidal hypertrophy results in the obstruction of nasal passages and Eustachian tubes, and blocks the clearance of nasal mucus. Adenotonsillar hypertrophy and obstructive sleep apnoea are associated with increased expression of various mediators of inflammatory responses in the tonsils, and respond to anti-inflammatory agents such as corticosteroids. Topical nasal steroids most likely affect the anatomical component by decreasing inspiratory upper airway resistance at the nasal, adenoidal or tonsillar levels. Corticosteroids, by their lympholytic or anti-inflammatory effects, might reduce adenotonsillar hypertrophy. Intranasal corticosteroids reduce cellular proliferation and the production of pro-inflammatory cytokines in a tonsil and adenoid mixed-cell culture system.
CONCLUSION
Intranasal corticosteroids have been used in adenoidal hypertrophy and adenotonsillar hypertrophy patients, decreasing rates of surgery for adenotonsillar hypertrophy.
Topics: Adenoids; Administration, Intranasal; Adolescent; Adrenal Cortex Hormones; Anti-Inflammatory Agents; Cell Proliferation; Child; Female; Humans; Hypertrophy; Inflammation Mediators; Male; Palatine Tonsil
PubMed: 28238295
DOI: 10.1017/S0022215117000408 -
European Archives of... Oct 2011The aim of this prospective work was to study the radiological and surgical correlation of adenoid size in children symptomatic with obstructive adenoid hypertrophy, and... (Comparative Study)
Comparative Study
The aim of this prospective work was to study the radiological and surgical correlation of adenoid size in children symptomatic with obstructive adenoid hypertrophy, and carried out at Tertiary care referral teaching hospital. Data of 25 randomly selected patients were used for analysis. Post nasal space images (lateral soft tissue neck X-ray) were analyzed using Fujioka's method. Surgical findings based on endoscopic picture of choanal view using 0-2.7 mm endoscope were analyzed. The comparison between the two results was subjected for statistical analysis. A total of 25 cases were included in the study. The mean age was 7 ± 0.45 years. The findings showed good correlation between adenoid sizes on X-ray films compared to the size seen intraoperatively using the methods mentioned above. The current study showed positive correlation between adenoid size on lateral view X-ray films and surgical findings. X-rays can be used as a helpful diagnostic tool when post nasal endoscopy is not available or not possible.
Topics: Adenoidectomy; Adenoids; Child; Child, Preschool; Endoscopy; Female; Follow-Up Studies; Humans; Hypertrophy; Male; Nasal Obstruction; Prospective Studies; Radiography; Radiosurgery; Treatment Outcome
PubMed: 21604073
DOI: 10.1007/s00405-011-1630-y -
Kulak Burun Bogaz Ihtisas Dergisi : KBB... 2008This study evaluated endoscopic adenoidectomy operations performed in children for hypertrophic adenoid tissue in the nasopharynx.
OBJECTIVES
This study evaluated endoscopic adenoidectomy operations performed in children for hypertrophic adenoid tissue in the nasopharynx.
PATIENTS AND METHODS
A total of 125 patients (67 boys, 58 girls; mean age 4.8+/-2.4 years; range 2 to 15 years) underwent endoscopic adenoidectomy under general anesthesia for one or more of the following complaints: nasal obstruction, mouth breathing, snoring, loss of appetite, slower development than peers, and decreased hearing. Preoperatively, 48 patients were eligible for endoscopic rhinoscopy, which showed an adenoid mass causing total or almost total obstruction of the nasal passage. In the remaining patients, lateral cranial radiographs showed a mass narrowing the air passage in the nasopharynx. Postoperative controls were carried out at one and four weeks by physical examination and an inquiry into the patients' satisfaction. In addition, endoscopic rhinoscopy was performed in the fourth week in eligible patients. Final controls were carried out at the end of the second year.
RESULTS
At the end four weeks, none of the patients had nasal obstruction or related complaints. Postoperative endoscopic rhinoscopy performed in 39 patients showed almost complete removal of adenoid tissues. None of the patients exhibited recurrent adenoid hypertrophy at the end of two years.
CONCLUSION
Hypertrophic adenoid tissue in the nasopharynx, especially those encroaching on the nasal cavity, can be removed completely under direct endoscopic visualization. Endoscopic adenoidectomy is a more satisfactory method than conventional adenoidectomy, because it allows control of how much adenoid tissue is removed.
Topics: Adenoidectomy; Adenoids; Adolescent; Child; Child, Preschool; Endoscopy; Female; Humans; Hypertrophy; Male; Nasal Obstruction; Treatment Outcome
PubMed: 18628638
DOI: No ID Found -
Vestnik Otorinolaringologii 2018The objective of the present review article was the analysis of the potential risks and negative consequences associated with the surgical treatment of adenoids and the... (Review)
Review
The objective of the present review article was the analysis of the potential risks and negative consequences associated with the surgical treatment of adenoids and the comparison of the potential harm to health and effectiveness of adenoidectomy for the children. It is concluded, based on the currently available information, that adenoidectomy provides an efficient surgical method for the management of the problems associated with adenoid pathology. The application of this technique based on the proper medical indications has no adverse effects on the children's health conditions and the mechanisms of immune protection. Moreover, it contributes to the improvement of the quality of life of the patients, fosters their physical and mental development.
Topics: Adenoidectomy; Adenoids; Child; Humans; Immunity; Postoperative Period; Quality of Life; Risk Assessment; Treatment Outcome
PubMed: 29697661
DOI: 10.17116/otorino201883273-76