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Scientific Reports Aug 2017When adenoids (Ad) and tonsils (Tn) become hypertrophied, craniofacial and general body growth is affected. However, there are no objective explicit criteria for...
When adenoids (Ad) and tonsils (Tn) become hypertrophied, craniofacial and general body growth is affected. However, there are no objective explicit criteria for evaluating the size of the Ad and Tn, and their respective growth patterns remain unclear. This study determined the average proportions of the Ad and Tn sizes to the upper airway area at various developmental stages in Japanese individuals. Lateral cephalometric radiographs were obtained from 300 Japanese children and teenagers (150 boys and 150 girls, aged 6-20 years), and the respective proportions of Ad to the nasopharynx (Ad/Np) and Tn to the oropharynx (Tn/Op) in the upper airway were determined. Average and standard deviation (SD) were calculated for each of the 5 age groups: lower primary school, upper primary school, junior high school, senior high school, and young adults. We investigated the correlation between age and growth patterns of Ad and Tn, and determined the average Ad/Np and Tn/Op. There was an age-related decrease in Ad and Tn size, and a significant positive correlation between Ad/Np and Tn/Op values in the upper primary school group. Both Ad/Np and Tn/Op decrease as individuals approach adulthood. However, the growth patterns of the Ad/Np and Tn/Op differ from each other.
Topics: Adenoids; Adolescent; Age Factors; Child; Cross-Sectional Studies; Female; Humans; Japan; Male; Nasopharynx; Organ Size; Oropharynx; Palatine Tonsil; Public Health Surveillance; Young Adult
PubMed: 28851993
DOI: 10.1038/s41598-017-09893-9 -
BMC Medicine May 2023Removal of tonsils and adenoids is among the most common surgical procedures worldwide. Evidence of increased risk of cancer following such surgery is, however,...
BACKGROUND
Removal of tonsils and adenoids is among the most common surgical procedures worldwide. Evidence of increased risk of cancer following such surgery is, however, inconclusive.
METHODS
We conducted a population-based, sibling-controlled cohort study of 4,953,583 individuals in Sweden with a follow-up during 1980-2016. History of tonsillectomy, adenotonsillectomy, and adenoidectomy was identified from the Swedish Patient Register whereas incident cases of cancer during follow-up were identified from the Swedish Cancer Register. We used Cox models to calculate hazard ratios (HR) with 95% confidence intervals (CI) of cancer in both a population and a sibling comparison. The sibling comparison was used to assess the potential impact of familial confounding, due to shared genetic or non-genetic factors within a family.
RESULTS
We found a modestly increased risk for any cancer following tonsillectomy, adenoidectomy, or adenotonsillectomy in both the population (HR 1.10; 95%CI 1.07-1.12) and sibling (HR 1.15; 95%CI 1.10-1.20) comparisons. The association did not differ greatly by type of surgery, age at surgery, or potential indication for surgery, and persisted more than two decades after surgery. An excess risk was consistently observed for cancer of the breast, prostate, thyroid, and for lymphoma in both population and sibling comparisons. A positive association was observed for pancreatic cancer, kidney cancer, and leukemia in the population comparison whereas a positive association was observed for esophageal cancer in the sibling comparison.
CONCLUSIONS
Surgical removal of tonsils and adenoids is associated with a modestly increased risk of cancer during the decades following the surgery. The association is unlikely attributed to confounding due to shared genetic or non-genetic factors with a family.
Topics: Male; Humans; Palatine Tonsil; Adenoids; Sweden; Cohort Studies; Siblings; Kidney Neoplasms
PubMed: 37226237
DOI: 10.1186/s12916-023-02902-x -
Journal of Medical Virology Jul 2019The role of human adenovirus (HAdV) infection in different acute diseases, such as febrile exudative tonsillitis, conjunctivitis, and pharyngoconjunctival fever is well...
The role of human adenovirus (HAdV) infection in different acute diseases, such as febrile exudative tonsillitis, conjunctivitis, and pharyngoconjunctival fever is well established. However, the relationships, if any, of HAdV persistence and reactivation in the development of the chronic adenotonsillar disease is not fully understood. The present paper reports a 3-year cross-sectional hospital-based study aimed at detecting and quantifying HAdV DNA and mRNA of the HAdV hexon gene in adenoid and palatine tonsil tissues and nasopharyngeal secretions (NPS) from patients with adenotonsillar hypertrophy or recurrent adenotonsillitis. HAdV C, B, and E were detectable in nearly 50% of the patients, with no association with the severity of airway obstruction, nor with the presence of recurrent tonsillitis, sleep apnea or otitis media with effusion (OME). Despite the higher rates of respiratory viral coinfections in patients with HAdV, the presence of other viruses, including DNA and RNA viruses, had no association with HAdV replication or shedding in secretions. Higher HAdV loads in adenoids showed a significant positive correlation with the presence of sleep apnea and the absence of OME. Although this study indicates that a significant proportion (~85%) of individuals with chronic adenotonsillar diseases have persistent nonproductive HAdV infection, including those by HAdV C, B, and E, epithelial and subepithelial cells in tonsils seem to be critical for HAdV C production and shedding in NPS in some patients, since viral antigen was detected in these regions by immunohistochemistry in four patients, all of which were also positive for HAdV mRNA detection.
Topics: Adenoids; Adenovirus Infections, Human; Adenoviruses, Human; Adolescent; Child; Child, Preschool; Cross-Sectional Studies; DNA, Viral; Female; Humans; Hypertrophy; Infant; Male; Palatine Tonsil; Tonsillitis; Virus Replication
PubMed: 30815882
DOI: 10.1002/jmv.25441 -
Head and Neck Pathology Jun 2022
Topics: Adenoids; Ameloblastoma; Humans
PubMed: 34491520
DOI: 10.1007/s12105-021-01372-y -
European Archives of... Oct 2023Adenoid hypertrophy is one of the main causes of nasal obstruction in 'children. Adenoid hypertrophy can be approached either with nasal corticosteroids, or surgically... (Review)
Review
INTRODUCTION
Adenoid hypertrophy is one of the main causes of nasal obstruction in 'children. Adenoid hypertrophy can be approached either with nasal corticosteroids, or surgically when medical treatment fails. Different adenoidectomy techniques have been proposed to reduce morbidity and surgical risks, with a consequent marked increase in the use of new surgical procedures in recent years, with a progressive increase in the use of coblation. This state-of-the-art review aims to systematically review the current literature on the role of coblation in adenoidectomy.
METHODS
The selection criteria included children submitted to adenoidectomy with coblator vs other techniques. 11 research questions were defined. 4 databases were explored by four authors: PubMed (Medline), the Cochrane Library, EMBASE and SciELO. The level of evidence and quality of the selected articles were assessed according to assessed according to the Quality Assessment Checklist of the National Institute for Health and Clinical Excellence.
RESULTS
20 studies met the inclusion criteria: 2 metanalysis, 12 randomized clinical trial, 2 non-randomized clinical trial, 1 prospective cohort study, and 3 retrospective cohort study. It encompassed a total population of 8375 participants. Regarding the different surgical techniques, 18 studies (excluding metanalysis) performed coblation (n = 1550), 6 microdebridement (n = 883), 15 curettage (n = 4016), and 1 suction coagulation (n = 1926).
CONCLUSION
Coblator adenoidectomy appears to offer better adenoid control compared to curettage, with a possible, although not confirmed lower rate of revision surgery. Similarly, this greater resection of adenoid tissue seems to be related to a greater reduction of nasal obstruction. The advantages of this technique are mainly less surgical bleeding-although it is not clear this is a clinically relevant difference, and less postoperative pain compared to cold curettage. The difference in pain is small, as adenoidectomy is not a painful surgery in general. There is little evidence on the control of OME and comparison with other techniques such as microdebrider adenoidectomy.
Topics: Child; Humans; Adenoidectomy; Adenoids; Hypertrophy; Nasal Obstruction; Pain, Postoperative; Prospective Studies; Retrospective Studies; Randomized Controlled Trials as Topic
PubMed: 37493842
DOI: 10.1007/s00405-023-08094-7 -
European Annals of Otorhinolaryngology,... Dec 2018This study compares the efficacy of adenoidectomy on otitis media with effusion (OME) in patients with different size of adenoids and the connection between differently...
AIMS
This study compares the efficacy of adenoidectomy on otitis media with effusion (OME) in patients with different size of adenoids and the connection between differently sized adenoids and middle ear effusion.
MATERIAL AND METHODS
Children with a history of at least 3 months' OME underwent adenoidectomy and myringotomy without the insertion of a tympanostomy tube. Treatment assignment was stratified by adenoids' size causing choanal obstruction (grade I-III) and according to Eustachian tube ostium obstruction (grade A-C). The subjects were followed for 12 months.
RESULTS
Adenoidectomy was significantly more effective in children with adenoids in contact with torus tubarius (grade B, C) compared to those with small adenoids without contact (P<0.001). The volume of the adenoids was irrelevant (P=0.146). The size of adenoids did not affect the viscosity of the middle ear secretion. The distribution of mucous and serous secretion was not dependent on the size of adenoids; the efficacy of adenoidectomy was 82% in mucous as well as serous secretion.
CONCLUSION
The relation between adenoids and torus tubarius is more important than the volume of the adenoids. The viscosity of middle ear fluids (serous or mucous) did not influence the rate of treatment efficacy.
Topics: Adenoidectomy; Adenoids; Adolescent; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Hypertrophy; Male; Otitis Media with Effusion
PubMed: 30290997
DOI: 10.1016/j.anorl.2017.11.011 -
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 -
Journal of the American Board of Family... 2016The incidence of obstructive sleep apnea (OSA) has reached epidemic proportions, and it is an often unrecognized cause of perioperative morbidity and mortality. Profound... (Review)
Review
The incidence of obstructive sleep apnea (OSA) has reached epidemic proportions, and it is an often unrecognized cause of perioperative morbidity and mortality. Profound hypoxic injury from apnea during the postoperative period is often misdiagnosed as cardiac arrest due to other causes. Almost a quarter of patients entering a hospital for elective surgery have OSA, and >80% of these cases are undiagnosed at the time of surgery. The perioperative period puts patients at high risk of apneic episodes because of drug effects from sedatives, narcotics, and general anesthesia, as well as from the effects of postoperative rapid eye movement sleep changes and postoperative positioning in the hospital bed. For adults, preoperative screening using the STOP or STOP-Bang questionnaires can help to identify adult patients at increased risk of OSA. In the pediatric setting, a question about snoring should be part of every preoperative examination. For patients with known OSA, continuous positive airway pressure should be continued postoperatively. Continuous pulse oximetry monitoring with an alarm system can help to prevent apneic catastrophes caused by OSA in the postoperative period.
Topics: Adenoids; Adult; Anesthesia, General; Child; Humans; Hypertrophy; Hypnotics and Sedatives; Narcotics; Oximetry; Palatine Tonsil; Patient Positioning; Postoperative Care; Postoperative Complications; Practice Guidelines as Topic; Preoperative Care; Respiratory Insufficiency; Risk Factors; Sleep Apnea, Obstructive; Snoring; Surveys and Questionnaires
PubMed: 26957384
DOI: 10.3122/jabfm.2016.02.150085 -
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 -
Clinics (Sao Paulo, Brazil) Nov 2016Obstructive sleep apnoea syndrome is a type of sleep-disordered breathing that affects 1 to 5% of all children. Pharyngeal and palatine tonsil hypertrophy is the main... (Review)
Review
Obstructive sleep apnoea syndrome is a type of sleep-disordered breathing that affects 1 to 5% of all children. Pharyngeal and palatine tonsil hypertrophy is the main predisposing factor. Various abnormalities are predisposing factors for obstructive sleep apnoea, such as decreased mandibular and maxillary lengths, skeletal retrusion, increased lower facial height and, consequently, increased total anterior facial height, a larger cranio-cervical angle, small posterior airway space and an inferiorly positioned hyoid bone. The diagnosis is based on the clinical history, a physical examination and tests confirming the presence and severity of upper airway obstruction. The gold standard test for diagnosis is overnight polysomnography. Attention must be paid to identify the craniofacial characteristics. When necessary, children should be referred to orthodontists and/or sleep medicine specialists for adequate treatment in addition to undergoing an adenotonsillectomy.
Topics: Adenoids; Child; Child, Preschool; Craniofacial Abnormalities; Humans; Hypertrophy; Palatine Tonsil; Polysomnography; Sleep Apnea, Obstructive
PubMed: 27982168
DOI: 10.6061/clinics/2016(11)08