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American Journal of Orthodontics and... Nov 2012Although the scientific literature recognizes that lateral cephalometric radiographs might be clinically useful, there is no consensus in relation to the best parameter...
INTRODUCTION
Although the scientific literature recognizes that lateral cephalometric radiographs might be clinically useful, there is no consensus in relation to the best parameter available. Therefore, this research was aimed at evaluating current radiographic assessment methods designed to investigate adenoid hypertrophy and nasopharyngeal obstruction.
METHODS
Children from 4 to 14 years old with nasal obstruction or oral breathing complaints, suspected to be caused by adenoid hypertrophy, received cephalometric examinations. One hundred twenty radiographic records were evaluated according to several current methods, and data were compared with respective gold-standard videonasopharyngoscopic examinations, in relation to the percentage of choanal obstruction.
RESULTS
Groups derived from a grading system had significantly different percentages of choanal obstruction. However, this parameter showed low sensitivity. Significant but moderate correlations were observed between most of the quantitative radiographic parameters and the percentage of choanal obstruction. Alternatively, a regression model was introduced; it demonstrated satisfactory ability to predict choanal obstruction percentage. Despite limitations, this model could also distinguish patients who might benefit from referral to otolaryngologic care.
CONCLUSIONS
Current adenoid assessment methods have significant limitations. A novel assessment method introduced here might be clinically useful.
Topics: Adenoids; Adolescent; Airway Obstruction; Cephalometry; Child; Child, Preschool; Cross-Sectional Studies; Endoscopy; Female; Humans; Hypertrophy; Linear Models; Male; Radiography; Video Recording
PubMed: 23116508
DOI: 10.1016/j.ajodo.2012.07.008 -
The Laryngoscope Jul 2014
Review
Topics: Adenoids; Child; Endoscopy; Humans; Hypertrophy; Nose; Tomography, X-Ray Computed
PubMed: 24105739
DOI: 10.1002/lary.24366 -
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 -
International Journal of Pediatric... Apr 2016To propose a novel endoscopic adenoid grading system using a rigid nasal endoscope and to study its correlation with the clinical diagnosis.
OBJECTIVES
To propose a novel endoscopic adenoid grading system using a rigid nasal endoscope and to study its correlation with the clinical diagnosis.
METHODOLOGY
Prerecorded video clips of rigid nasal endoscopy taken during endoscopic adenoidectomy were retrieved. Otolaryngology consultants blinded to the clinical diagnosis of the child were presented these videos and asked to grade the adenoid hypertrophy as per the proposed endoscopic ACE (Airway/Choana/Eustachian tube) grading system. The clinical diagnosis was correlated with the different aspects of the descriptive endoscopic grading system.
RESULTS
152 video clips were presented to the otolaryngology consultants for grading. The average age was 8.6 years (SD-3.48), while the male female ratio was 3:2. The A subcomponent of the ACE grading showed significant correlation with the diagnosis of sleep disordered breathing and chronic adenotonsillitis, C subcomponent with sleep disordered breathing and the E subcomponent with the diagnosis of otitis media.
CONCLUSION
The proposed endoscopic grading is easily applicable and at the same time clearly describes the relation of the adenoids to the nasopharynx, choana and Eustachian tube. Different aspects of the grading system correlated differently with the clinical diagnosis emphasizing that a descriptive scoring rather than a comprehensive scoring is a more relevant clinical tool.
Topics: Adenoidectomy; Adenoids; Adolescent; Child; Child, Preschool; Endoscopy; Eustachian Tube; Female; Humans; Hypertrophy; Male; Microsurgery; Nasopharynx; Retrospective Studies; Sleep Apnea Syndromes
PubMed: 26968070
DOI: 10.1016/j.ijporl.2016.02.002 -
Archives of Otolaryngology--head & Neck... Aug 1993Adenoid physiology as reflected in the qualitative and quantitative bacteriology and immune cell distribution was correlated with clinical presentation in 69 children... (Comparative Study)
Comparative Study
Adenoid physiology as reflected in the qualitative and quantitative bacteriology and immune cell distribution was correlated with clinical presentation in 69 children (16 to 130 months of age) undergoing adenoidectomy for obstructive adenoid hyperplasia (n = 38) or chronic adenoid infection (n = 31) and in 16 adenoid core biopsy specimens from 16 nondiseased controls. In the control adenoids, few potentially pathogenic bacteria were found as the dominant bacteria in the adenoid core (25%), and significantly greater concentrations of nonpathogens (commensals) were isolated (P < .01). Potential pathogens as the dominant bacteria were found twice as often in obstructive adenoid hyperplasia (62%) and in chronic adenoid infection (55%) (P < .05). Haemophilus influenzae was most common in the diseased adenoids, 53% in obstructive adenoid hyperplasia and 48% in chronic adenoid infection, compared with only 19% in the controls (P < .05). No significant differences in lymphocyte density, B and T cells, as well as T-helper subsets, were found between clinical classifications. However, T-suppressor cells, monocytes-macrophages, and natural killer cells were significantly increased in chronic adenoid infection only (P < .05). The findings in this study support roles for both alterations in bacterial homeostasis and an altered immune profile in the etiology of chronic adenoid disease in children.
Topics: Adenoids; B-Lymphocytes; Bacteria; Biopsy; Child; Child, Preschool; Chronic Disease; Female; Humans; Hyperplasia; Leukocyte Count; Lymphatic Diseases; Male; Reference Values; T-Lymphocytes
PubMed: 8343242
DOI: 10.1001/archotol.1993.01880200021003 -
International Journal of Pediatric... Feb 2013To examine the expression of vascular endothelial growth factor (VEGF) in hypertrophied adenoids in children and investigate the possible regulatory mechanism.
OBJECTIVES
To examine the expression of vascular endothelial growth factor (VEGF) in hypertrophied adenoids in children and investigate the possible regulatory mechanism.
METHODS
Thirty-eight children with hypertrophied adenoids (moderate, 16; severe, 22) were enrolled to investigate the VEGF expression in the adenoid tissues using immunohistochemistry (IHC) and quantitative reverse transcription polymerase chain reaction (qRT-PCR). The IL-6 concentration in the nasopharyngeal secretions was measured using an enzyme-linked immunosorbent assay (ELISA). VEGF mRNA expression was further measured in isolated adenoidal cells in vitro after IL-6 stimulation, and the activation of the p38 signalling pathway was determined by Western blot analysis.
RESULTS
Our findings showed extensive immunoreactivity of VEGF in the hypertrophied adenoids in children. The levels of VEGF protein and mRNA were significantly higher in severely hypertrophied adenoids than in moderately hypertrophied adenoids (P<0.05). The expression of IL-6 was detectable in the nasopharyngeal secretions, which was significantly associated with the severity of the hypertrophied adenoid. VEGF mRNA expression was upregulated in isolated adenoidal cells in vitro after IL-6 stimulation, and the p38 signalling pathway was activated.
CONCLUSIONS
The increased expression of VEGF in adenoid tissues suggests a possible role of the IL-6/VEGF axis in the pathogenesis of hypertrophied adenoids in children.
Topics: Adenoids; Blotting, Western; Child; Child, Preschool; Enzyme-Linked Immunosorbent Assay; Female; Humans; Hypertrophy; Immunohistochemistry; Interleukin-6; Male; Real-Time Polymerase Chain Reaction; Signal Transduction; Vascular Endothelial Growth Factor A
PubMed: 23177780
DOI: 10.1016/j.ijporl.2012.09.040 -
Acta Oto-laryngologica Oct 2007Membrane-bound mucin MUC4 represents the predominant mucin expressed in the adenoid epithelium followed by MUC5AC (gel-forming mucin). This may suggest that... (Comparative Study)
Comparative Study
CONCLUSION
Membrane-bound mucin MUC4 represents the predominant mucin expressed in the adenoid epithelium followed by MUC5AC (gel-forming mucin). This may suggest that membrane-bound mucins could be involved in pathogen binding and immunological stimulation.
OBJECTIVES
The aim of this study was to investigate mucin expression in hypertrophic adenoids.
MATERIALS AND METHODS
Adenoidal samples were obtained from 12 children. The expression of eight mucin genes, MUC1-4, MUC5AC, 5B, 6 and 7 was studied by in situ hybridization utilizing digoxigenin-labelled oligonucleotide probes.
RESULTS
The dominant mucin genes were MUC4, 3 and 5AC, while MUC1, 2, 5B and 7 were sparsely expressed and MUC6 was not expressed. Expression patterns were very different from those in the upper airways. Most samples expressed two membrane-bound mucins (MUC4 and 3) and one secretory mucin (MUC5AC).
Topics: Adenoids; Biomarkers; Child; Child, Preschool; DNA; Disease Progression; Female; Gene Expression; Humans; Hypertrophy; In Situ Hybridization; Male; Mucins; Oligonucleotide Probes; Prognosis
PubMed: 17851936
DOI: 10.1080/00016480701200236 -
Pediatric Radiology 1995A number of diverse head and neck manifestations of HIV infection have been described, including adenoidal hypertrophy. We report a series of HIV-infected children in...
A number of diverse head and neck manifestations of HIV infection have been described, including adenoidal hypertrophy. We report a series of HIV-infected children in which 9 of 18 had abnormally small or radiographically absent adenoidal tissue. This finding did not, however, seem to correlate with several parameters for the severity or stage of illness.
Topics: Adenoids; Adolescent; Child; Child, Preschool; Female; HIV Infections; Humans; Hypertrophy; Infant; Male
PubMed: 7761177
DOI: 10.1007/BF02020859 -
International Journal of Pediatric... Mar 2013The main aim of this study was to evaluate TIMP-1 expression in germinal centers of hypertrophied adenoids in children on the assumption that it can be treated as a...
OBJECTIVES
The main aim of this study was to evaluate TIMP-1 expression in germinal centers of hypertrophied adenoids in children on the assumption that it can be treated as a marker of adenoidal tissue function.
PATIENTS AND METHODS
The study involved 54 children undergoing adenoidectomy; divided into three age groups: aged up to 5 years (8 children), 5-10 years (31 children) and over 10 years (15 children). The analyzed material was adenoids removed on the ground of hypertrophy, which caused obstructive symptoms and/or otitis media with effusion onset. Immunohistochemical analyses were carried out using monoclonal mouse antibody (Ab) (Novocastra) directed against human TIMP-1 protein. The presence of TIMP-1 positive lymphocytes within germinal centers and TIMP-1 immunostaining were scored.
RESULTS
The immunohistochemical staining showed the TIMP-1 positive lymphocytes mainly within the mantle zone. There was no statistically significant difference between the mean age of children for TIMP-1 immunoreaction levels. We have not found statistical correlation between the TIMP-1 staining and the clinical status of patients.
CONCLUSION
It is difficult to interpret our results. Our findings did not demonstrate changes in TIMP-1 expression according to age. This may indicate that the processes of hyperplasia, hypertrophy and atrophy of adenoid are not influenced by age and support our thesis that adenoid involution is rather the effect of changes in the number of lymphoid follicles that changes in them. However there is a need for further observational studies of TIMPs and MMPs in adenoid tissue.
Topics: Adenoidectomy; Adenoids; Adolescent; Child; Child, Preschool; Germinal Center; Humans; Hypertrophy; Immunohistochemistry; Tissue Inhibitor of Metalloproteinase-1
PubMed: 23318123
DOI: 10.1016/j.ijporl.2012.11.032 -
Meditsinskaia Sestra Aug 1979
Topics: Adenoids; Child; Child, Preschool; Humans; Inflammation
PubMed: 259855
DOI: No ID Found