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Hu Z, Cheng S, Sun S, Wang Y, Lou M, Ma R, Gong M, Yang F, Zheng G, Zhang Y, Dong J. Numerical and experimental evaluation of nasopharyngeal aerosol administration methods in children with adenoid hypertrophy. Int J Pharm 2024; 653:123906. [PMID: 38365069 DOI: 10.1016/j.ijpharm.2024.123906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/03/2024] [Accepted: 02/13/2024] [Indexed: 02/18/2024]
Abstract
Administering aerosol drugs through the nasal pathway is a common early treatment for children with adenoid hypertrophy (AH). To enhance therapeutic efficacy, a deeper understanding of nasal drug delivery in the nasopharynx is essential. This study uses an integrated experimental, numerical modelling approach to investigate the delivery process of both the aerosol mask delivery system (MDS) and the bi-directional delivery system (BDS) in the pediatric nasal airway with AH. The combined effect of respiratory flow rates and particle size on delivery efficiency was systematically analyzed. The results showed that the nasopharyngeal peak deposition efficiency (DE) for BDS was approximately 2.25-3.73 times higher than that for MDS under low-flow, resting and high-flow respiratory conditions. Overall nasopharyngeal DEs for MDS were at a low level of below 16 %. For each respiratory flow rate, the BDS tended to achieve higher peak DEs (36.36 % vs 9.74 %, 37.80 % vs 14.01 %, 34.58 % vs 15.35 %) at smaller particle sizes (15 µm vs 17 µm, 10 µm vs 14 µm, 6 µm vs 9 µm). An optimal particle size exists for each respiratory flow rate, maximizing the drug delivery efficiency to the nasopharynx. The BDS is more effective in delivering drug aerosols to the nasal cavity and nasopharynx, which is crucial for early intervention in children with AH.
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Affiliation(s)
- Zhenzhen Hu
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China; School of Engineering, RMIT University, Bundoora, VIC 3083, Australia; Institute for Sustainable Industries & Liveable Cities, Victoria University, PO Box 14428, Melbourne, VIC 8001, Australia
| | - Shaokoon Cheng
- School of Engineering, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109, Australia
| | - Siping Sun
- Zhejiang Cuize Pharmtech Co. Ltd., Hangzhou, Zhejiang 310000, China
| | - Yusheng Wang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Miao Lou
- Department of Otorhinolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China
| | - Ruiping Ma
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Minjie Gong
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Feilun Yang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Guoxi Zheng
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China
| | - Ya Zhang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China.
| | - Jingliang Dong
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, China; Institute for Sustainable Industries & Liveable Cities, Victoria University, PO Box 14428, Melbourne, VIC 8001, Australia; First Year College, Victoria University, Footscray Park Campus, Footscray, VIC 3011, Australia.
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Hua HL, Deng YQ, Huang H, Tang YC, Han JB, Li F, Wang Y, Tao ZZ. Inflammatory endotypes of adenoidal hypertrophy based on a cluster analysis of biomarkers. Int Immunopharmacol 2024; 127:111318. [PMID: 38086270 DOI: 10.1016/j.intimp.2023.111318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/08/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE To identify adenoid inflammatory endotypes based on inflammatory markers, match endotypes to phenotypes, and predict endotypes. METHODS This cross-sectional study included 72 children with adenoid hypertrophy. Thirteen inflammatory markers and total immunoglobulin E (TIgE) in adenoid tissue were analyzed using Luminex and enzyme-linked immunosorbent assay (ELISA) for performing cluster analysis. Correlation analysis was used to examine the characteristics of each cluster. Receiver operating characteristic (ROC) curve analysis was performed to screen for preoperative characteristic data with predictive value for adenoid inflammation endotype. RESULTS The patients were divided into four clusters. Cluster 1 exhibited non-type 2 signatures with low inflammatory marker concentrations, except for the highest expression of Th1-related cytokines. Cluster 2 showed a non-type 2 endotype with the highest concentration of interleukin (IL)-17A and IL-22. Cluster 3 exhibited moderate type 2 inflammation, with the highest concentration of neutrophil factors. Cluster 4 demonstrated significant type 2 inflammation and moderate neutrophil levels. The proportions of AR and serum TIgE levels increased from clusters 1 to 4, and there was a gradual increase in the prevalence of chronic sinusitis from low to high neutrophilic inflammation. The area under the ROC curve for serum TIgE was higher than those for combined or other separate preoperative characteristics for predicting non-type 2 and type 2 inflammation in the adenoid tissue. CONCLUSIONS The evaluation of cytokines in adenoid tissue revealed four endotypes. Serum TIgE level was an important indicator of the endotype of adenoid inflammation. Identification of adenoid inflammatory endotypes can facilitate targeted treatment decisions.
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Affiliation(s)
- Hong-Li Hua
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jie-Fang Road, Wuhan, Hubei 430060, PR China
| | - Yu-Qin Deng
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jie-Fang Road, Wuhan, Hubei 430060, PR China
| | - Huan Huang
- School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei 430072, PR China
| | - Yu-Chen Tang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jie-Fang Road, Wuhan, Hubei 430060, PR China
| | - Ji-Bo Han
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jie-Fang Road, Wuhan, Hubei 430060, PR China
| | - Fen Li
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jie-Fang Road, Wuhan, Hubei 430060, PR China
| | - Yan Wang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jie-Fang Road, Wuhan, Hubei 430060, PR China.
| | - Ze-Zhang Tao
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jie-Fang Road, Wuhan, Hubei 430060, PR China; Department of Otolaryngology-Head and Neck Surgery, Central Laboratory, Renmin Hospital of Wuhan University, 238 Jie-Fang Road, Wuhan, Hubei 430060, PR China.
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Tamir SO, Schwarz Y, Hazan I, Cohen Michael O, Tshori S, Marom T. Medical treatment does not reduce surgery rates in children with adenoid hypertrophy. Int J Pediatr Otorhinolaryngol 2024; 176:111836. [PMID: 38154416 DOI: 10.1016/j.ijporl.2023.111836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/01/2023] [Accepted: 12/22/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE We sought to study adenoidectomy rates in children with adenoid hypertrophy (AH) who were either treated with medical therapy or not during a 2-year follow-up period in a longitudinal population-based study. METHODS We retrospectively identified healthy children aged 1-18 years between 2014 and 2020 with AH diagnosis from the Clalit Health Services database, the largest healthcare maintenance organization in Israel. The main outcome was adenoidectomy alone or in combination with other procedures performed within 2 years after diagnosis. The treatment group consisted of children who received medical therapy, defined as a pharmacy purchase of montelukast, nasal steroid sprays and/or antihistamines (medical therapy aimed to reduce AH) for ≥2 consecutive months, while the control group consisted of untreated children. RESULTS We identified 68,356 unique children with AH, of them 56 % were boys, with a mean age of 4.9 ± 3.3 years. Of them, 5310 (7.7 %) received medical therapy. Overall, 6633 (9.7 %) underwent adenoidectomy within 2 years following diagnosis. There was no significant difference in surgery referral rates between the treatment and the control groups, 10 % vs. 9.7 %, respectively (p = 0.3). When adjusted for age and sex, the likelihood of undergoing adenoidectomy was similar in both groups (HR = 0.98, 95 % CI = 0.90-1.07, p = 0.6). Among operated children, the average time from diagnosis to surgery was statistically significantly longer in the treatment group than in the control group, 346 ± 180 vs 311 ± 175 days (p < 0.001). CONCLUSION Prescribing montelukast, nasal steroids and/or oral antihistamines was not associated with a reduction in adenoidectomy rates and was associated with an average surgery delay of 35 days.
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Affiliation(s)
- Sharon Ovnat Tamir
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ashdod, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Yehuda Schwarz
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ashdod, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel; Clalit Health Services, Tel Aviv, Israel
| | - Itai Hazan
- Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel; Joyce and Irvin Goldman Medical School, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er-Sheva, Israel
| | - Ori Cohen Michael
- Joyce and Irvin Goldman Medical School, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er-Sheva, Israel
| | - Sagi Tshori
- Research Authority, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Tal Marom
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ashdod, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel; Clalit Health Services, Tel Aviv, Israel.
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Ma Y, Xie L, Wu W. The effects of adenoid hypertrophy and oral breathing on maxillofacial development: a review of the literature. J Clin Pediatr Dent 2024; 48:1-6. [PMID: 38239150 DOI: 10.22514/jocpd.2024.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/12/2023] [Indexed: 01/23/2024] Open
Abstract
According to modern epidemiological surveys, the prevalence of adenoid hypertrophy in children and adolescents ranges from 42% to 70%. Adenoid hypertrophy can lead to airway obstruction; thus forces a child to breathe through their mouth, thus affecting the normal development of the dental and maxillofacial area, and can lead to malocclusion. Long-term mouth breathing can cause sagittal, vertical and lateral changes in the maxillofacial area. In this article, we review the current research status relating to the association between adenoid hypertrophy, oral breathing and maxillofacial growth and development in children and adolescents. We also discuss the personalized formulation of treatment plans.
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Affiliation(s)
- Yanan Ma
- North China University of Science and Technology, 063000 Tangshan, Hebei, China
| | - Lili Xie
- Department of stomatology, Hebei General Hospital, 050000 Shijiazhuang, Hebei, China
| | - Wenhui Wu
- North China University of Science and Technology, 063000 Tangshan, Hebei, China
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Zhao T, Yang Z, Ngan P, Luo P, Zhang J, Hua F, He H. Association between adenotonsillar hypertrophy and dentofacial characteristics of children seeking for orthodontic treatment: A cross-sectional study. J Stomatol Oral Maxillofac Surg 2023; 125:101751. [PMID: 38145836 DOI: 10.1016/j.jormas.2023.101751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/11/2023] [Accepted: 12/23/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE To compare the dentofacial characteristics of children with and without adenoid and/or tonsillar hypertrophy. METHODS A consecutive sample of orthodontic patients aged 6-12 that took pre-treatment lateral cephalograms were included in this study. Those with history of previous orthodontic treatment, adenoidectomy or tonsillectomy, or craniofacial anomalies were excluded. The diagnosis of adenoid and tonsillar hypertrophy was based on Fujioka's and Baroni's methods, according to which the subjects were divided into four groups: the adenoid hypertrophy only (AHO) group; tonsillar hypertrophy only (THO) group; combined adenoid and tonsillar hypertrophy (AH+TH) group; and no adenoid or tonsillar hypertrophy (NH) group. Cephalograms were used for skeletal and dental measurement. Data were analyzed using one-way ANOVA, LSD post-hoc tests and Chi-square test. RESULTS A total of 598 patients were included. Compared with the NH group, the THO group had significantly larger SNB angle (P < 0.001), as well as significantly smaller ANB angle (P<0.001) and Wits value (P = 0.001). The U1-L1 angle of AHO group was significantly smaller than that in the NH group (P = 0.035). The proportion of adenoid hypertrophy in Class II patients was significantly higher than that in Class III patients (P = 0.001). The proportion of tonsillar hypertrophy in Class III patients was significantly higher than that in Class I patients (P < 0.001) and Class II patients (P < 0.001). CONCLUSION Over 80 % of children seeking orthodontic treatment had either adenoid or tonsillar hypertrophy. Children with adenoid hypertrophy tend to have skeletal Class II malocclusion, while those with tonsillar hypertrophy tend to have skeletal Class III malocclusion.
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Affiliation(s)
- Tingting Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zheng Yang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Peter Ngan
- Department of Orthodontics, School of Dentistry, West Virginia University, Morgantown, WV, United States of America
| | - Ping Luo
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jun Zhang
- Department of Oral Radiology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
| | - Hong He
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Center for Dentofacial Development and Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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Shivnani D, Kobal MR, Raman EV, Shruthi MS. Impact of Chronic Adenoid Hypertrophy on Quality of Life Index in Children and Role of Adenoidectomy. Indian J Otolaryngol Head Neck Surg 2023; 75:3396-3401. [PMID: 37974692 PMCID: PMC10645970 DOI: 10.1007/s12070-023-04000-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 06/16/2023] [Indexed: 11/19/2023] Open
Abstract
Objectives: To analyze the effects of chronic adenoid hypertrophy on quality of life (QOL) of children and caregivers and compare quality of life of child before and after adenoidectomy. Materials & Methods: Prospective, observational before and after questionnaire based assessment study at a pediatric otorhinolaryngology specialty center in a metropolitan quaternary care hospital. Children aged between 2 and 12 years undergoing adenoidectomy were included. Parents were asked to fill the Obstructive Sleep Apnea-18 (OSA-18) Quality of Life Index Questionnaire one day before surgery and after one month of surgery during their scheduled follow-up visit. The study was conducted over a period of 1 year and total of 40 children's assessment was done. Results were tabulated and analyzed. Results: The mean age of presentation was 6 years. Based on OSA-18 quality of life assessment scoring the total pre-operative mean score was 73.3 and post-operative was 40.5. There was significant change in OSA-18 total score and individual domain scores post-operatively indicating significant improvement in QOL post adenoidectomy. The domains most affected due to chronic adenoid hypertrophy were physical suffering, caregiver concerns and sleep disturbance (p value < 0.001).Conclusion: Chronic adenoid hypertrophy has major impact on quality of life of a child along with caregiver concern and they show significant improvement after adenoidectomy. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-04000-z.
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Affiliation(s)
- Deepa Shivnani
- Department of Otorhinolaryngology and Head & Neck Surgery, Children’s Airway & Swallowing Center, Manipal Hospital Bangalore, Bangalore, Karnataka India
| | - Mallikarjun R Kobal
- Department of Paediatrics, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka India
| | - E V Raman
- Department of Otorhinolaryngology and Head & Neck Surgery, Children’s Airway & Swallowing Center, Manipal Hospital Bangalore, Bangalore, Karnataka India
| | - M S Shruthi
- Department of Otorhinolaryngology and Head & Neck Surgery, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka India
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Bhise S, Hippargekar P, Kothule S, Dhanwe M, Ngullie O. A Clinical Study of Persistent Adenoid and Its Secondary Effect. Indian J Otolaryngol Head Neck Surg 2023; 75:3507-3513. [PMID: 37974674 PMCID: PMC10645859 DOI: 10.1007/s12070-023-03841-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 04/27/2023] [Indexed: 11/19/2023] Open
Abstract
Persistent adenoid is a common condition that affects many children and adults. This can cause breathing difficulties, snoring, and other respiratory problems. The condition can also affect the development of the facial structure and cause abnormal growth of the jaw and teeth. The study aimed to investigate the clinical and pathological characteristics of persistent adenoid and its secondary effects. A total of 64 patients with adenoid hypertrophy were included in the study, and they were evaluated through various clinical and pathological examinations. Nasal obstruction was present in almost all cases. Ethmoid nasal polyps were seen in 51.6% of participants. The results showed that persistent adenoid can lead to various secondary effects on the respiratory system, including Eustachian tube defect and otitis media in 20.3% of cases. The study highlights the importance of early diagnosis and timely treatment of persistent adenoid to prevent its secondary effects.
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Affiliation(s)
- Sudhir Bhise
- Swami Ramanand Teerth Rural Medical College and Hospital, Ambajogai, Beed, India
| | - Prashant Hippargekar
- Swami Ramanand Teerth Rural Medical College and Hospital, Ambajogai, Beed, India
| | - Shankar Kothule
- Swami Ramanand Teerth Rural Medical College and Hospital, Ambajogai, Beed, India
| | - Mahendra Dhanwe
- Swami Ramanand Teerth Rural Medical College and Hospital, Ambajogai, Beed, India
| | - Orenponi Ngullie
- Swami Ramanand Teerth Rural Medical College and Hospital, Ambajogai, Beed, India
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Berkiten G, Şengiz Erhan S, Çelik C, Tutar B, Atar Y, Aksungur E, Sari H, Uyar Y. An assessment of the effects of adenoid hypertrophy on mucociliary clearance and nasal cytology in children. Int J Pediatr Otorhinolaryngol 2023; 174:111718. [PMID: 37722297 DOI: 10.1016/j.ijporl.2023.111718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/31/2023] [Accepted: 09/06/2023] [Indexed: 09/20/2023]
Abstract
AIM/OBJECTIVE The aim of this study was to demonstrate the benefits of the systematic use of nasal cytology and mucociliary clearance in the diagnostic workup of nasal disorders in children with adenoid hypertrophy (AH) to reach a well-defined diagnosis, establish a rational therapeutic approach, avert from complications, and develop the patient's life quality. MATERIALS/METHODS In this prospective study, a total of 61 pediatric patients (aged 5-12 years) were evaluated. The case group consisted of 31 children with AH symptoms, while the control group comprised 30 children without AH symptoms.Exclusions included previous adenoidectomy/adenotonsillectomy, cardiovascular/neurological diseases, acute/allergic rhinitis, genetic disorders (e.g., Down syndrome), and immunodeficiency. The control group consisted of children without nasal obstruction symptoms and without AH, who admitted for various reasons. Medical history, examinations, fiberoptic nasopharyngoscopy, cephalometric evaluations, AST, and nasal cytology were conducted. RESULTS At the end of the study, a significant increase in the mucociliary clearance time was observed in the group with AH compared to the control group (p < 0.05). Although AH may disrupt MCC, there is no correlation between the size of the hypertrophy and MCC time.When the distribution of cells in the nasal cytology is evaluated, no difference was detected between the AH group and control groups. CONCLUSION Nasal mucociliary clearance has been found to be decreased, particularly in the presence of significant AH.
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Affiliation(s)
- Güler Berkiten
- University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Department of Otorhinolaryngology, Istanbul, Turkey
| | - Selma Şengiz Erhan
- University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Department of Pathology, Istanbul, Turkey
| | - Cem Çelik
- University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Department of Otorhinolaryngology, Istanbul, Turkey
| | - Belgin Tutar
- University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Department of Otorhinolaryngology, Istanbul, Turkey
| | - Yavuz Atar
- Uskudar University, Department of Otorhinolaryngology, Istanbul, Turkey
| | - Elif Aksungur
- Iğdır Dr.Nevruz Erez State Hospital, Department of Otorhinolaryngology, Iğdır, Turkey
| | - Hüseyin Sari
- University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Department of Otorhinolaryngology, Istanbul, Turkey
| | - Yavuz Uyar
- University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Department of Otorhinolaryngology, Istanbul, Turkey
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Abdel-Aziz M, Hady AFA, Sheikhany AR, Yousef AI, Sabry OA, Farag HM. Effect of adenoid size on the post-adenoidectomy hypernasality in children with a normal palate. Eur Arch Otorhinolaryngol 2023; 280:4555-4560. [PMID: 37300643 PMCID: PMC10477120 DOI: 10.1007/s00405-023-08049-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Adenoidectomy, either alone or with tonsillectomy, is a common surgical procedure in the field of pediatric otorhinolaryngology. Resonance function may be altered postoperatively in the form of hypernasality, which is usually transient. This study aimed to investigate the effect of adenoid size on post-adenoidectomy hypernasality in children with a normal palate. METHODS Seventy-one children with different degrees of adenoid hypertrophy were included in this prospective observational study. Endoscopic assessment of the adenoid size and preoperative and postoperative evaluation of speech (at 1 and 3 months) with auditory perceptual assessment (APA) and nasometry were performed. RESULTS APA showed preoperative hyponasality in 59.1% of children and was found to be significantly related to the adenoid size, with more hyponasality in grades 3 and 4. One month postoperatively, hypernasality was detected in 26.7% of patients and was found to be related to the preoperative adenoid size with higher hypernasality in grades 3 and 4. Three months postoperatively, all patients had gained normal nasality except one (1.4%) who was subjected to a longer follow-up period. Nasometric assessment showed significant differences at the three visits (pre, 1, and 3 months postoperatively), with a negative correlation between the grade of adenoid size and nasalance scores preoperatively and a significant positive correlation between them at 1 month postoperatively. However, no significant correlation was detected at 3 months postoperatively. CONCLUSION Transient hypernasality may develop in some patients after adenoidectomy, especially in children with a larger preoperative adenoid size. However, transient hypernasality generally resolves spontaneously within 3 months.
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Affiliation(s)
- Mosaad Abdel-Aziz
- Department of Otolaryngology, KasrAlainy Faculty of Medicine, Cairo University, 2 El-Salam St., King Faisal, Above El-Baraka Bank, Giza, Cairo, Egypt.
| | - Aisha Fawzy Abdel Hady
- Department of Otolaryngology (Unit of Phoniatrics), KasrAlainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ayatallah Raouf Sheikhany
- Department of Otolaryngology (Unit of Phoniatrics), KasrAlainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Ibrahim Yousef
- Department of Otolaryngology, KasrAlainy Faculty of Medicine, Cairo University, 2 El-Salam St., King Faisal, Above El-Baraka Bank, Giza, Cairo, Egypt
| | - Omar Aly Sabry
- Department of Otolaryngology, KasrAlainy Faculty of Medicine, Cairo University, 2 El-Salam St., King Faisal, Above El-Baraka Bank, Giza, Cairo, Egypt
| | - Heba Mahomoud Farag
- Department of Otolaryngology (Unit of Phoniatrics), KasrAlainy Faculty of Medicine, Cairo University, Cairo, Egypt
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Roushdy MM, jalil AAA, Saeed AM. Mometasone Furoate Use for Recurrent Adenoid Hypertrophy: Randomized Controlled Clinical Trial. Indian J Otolaryngol Head Neck Surg 2023; 75:1639-1646. [PMID: 37636767 PMCID: PMC10447813 DOI: 10.1007/s12070-023-03539-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/26/2023] [Indexed: 08/29/2023] Open
Abstract
Background& Objective: Adenoid hypertrophy (AH) in children is one of the most causes of nasal obstruction and is associated with many nasal and respiratory symptoms. Till now, surgery is the main option for managing the associated symptom of AH. The intranasal steroid has an effective role in the control of allergic rhinitis and associated AH. This work aimed to assess the effects of local mometasone on recurrent AH in children. Patients& Methods: A randomized controlled trial enrolled 39 patients aged between 2 and 15 years with recurrent AH. Those patients were randomly subdivided into three groups; group (A) received topical mometasone furoate (MF), group (B) did not receive any medication, and group (C) received topical normal saline. All groups were followed up for 8 weeks. Results: Patients who received Mometasone furoate had temporary relief of adenoid hypertrophy-related symptoms (84.6%) in comparison to the control group and placebo group during the duration of treatment. After cessation of treatment with local steroids, all cases experienced symptoms caused by adenoid hypertrophy, and by the end of the third month of follow up all cases underwent adenoidectomy. Conclusion: Mometasone furoate can temporarily reduce the adenoid size, reducing symptoms related to adenoid hypertrophy.
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Affiliation(s)
| | | | - Ahmed Mahmoud Saeed
- The Department of otolaryngology, Student Hospital, Assiut University, 71515 Assiut, Egypt
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11
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Wang W, Wang X, Xia J, Yang X, Li M, Niu P, Ding C, Hu Y, Gong S, Chen T. The association between nasal mucosa bacteria and serum metals in children with nasal diseases. Ecotoxicol Environ Saf 2023; 262:115343. [PMID: 37562173 DOI: 10.1016/j.ecoenv.2023.115343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/23/2023] [Accepted: 08/05/2023] [Indexed: 08/12/2023]
Abstract
Allergic rhinitis (AR) and adenoid hypertrophy (AH) are common nasal diseases in children. Studies have shown that heavy metals are environmental risk factors for nasal diseases, and the pathogenic mechanisms may be related to dysregulation of nasal mucosal microbiota. However, it is unclear how heavy metal exposure relates to the nasal mucosal microbiota in nasal diseases. Therefore, we explored serum metal exposure levels and nasal mucosal microbiota composition in children with different nasal disease, and further studied the potential correlation between metal exposure and disease-related taxa. There were 64 children recruited for this study. The 23 metals concentrations in serum were measured by inductively coupled plasma mass spectrometry, and nasal mucosal bacteria was identified by 16S rRNA sequencing. Nasal diseases (AR and AH) in children were associated with alterations in the abundance and diversity of the nasal mucosal microbiota. The nasal microbiota of children with AR showed lower diversity, while the microbiota of children with AH showed higher diversity. Linear discriminant analysis Effect Size showed 108 differentially abundant taxa between AR and control groups, 35 differentially abundant taxa among large adenoid, moderate adenoid and small adenoid groups. The serum zinc concentration was negatively correlated with Pielou's eveness index and Simpson's Index in children classified by adenoid size. The spearman correlation analysis showed that multiple disease-related taxa were closely associated with metal concentrations in serum. Our findings may support a link between metal exposure and the diversity and composition of nasal bacteria in children with nasal disease, which present new evidence for the effects of metals on children health.
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Affiliation(s)
- Weiwei Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Friendship Hospital of Capital Medical University, Beijing 100050, China
| | - Xueting Wang
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China
| | - Jiao Xia
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Friendship Hospital of Capital Medical University, Beijing 100050, China
| | - Xin Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China
| | - Menglong Li
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Piye Niu
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China
| | - Chunguang Ding
- National Center for Occupational Safety and Health, NHC (National Center for Occupational Medicine of Coal Industry, NHC), Beijing 102308, China
| | - Yifei Hu
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, Beijing 100069, China.
| | - Shusheng Gong
- Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Friendship Hospital of Capital Medical University, Beijing 100050, China.
| | - Tian Chen
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China.
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Hu Z, Dong J, Lou M, Zhang J, Ma R, Wang Y, Gong M, Wang B, Tong Z, Ren H, Zheng G, Zhang Y. Effect of different degrees of adenoid hypertrophy on pediatric upper airway aerodynamics: a computational fluid dynamics study. Biomech Model Mechanobiol 2023; 22:1163-1175. [PMID: 37256522 DOI: 10.1007/s10237-023-01707-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 02/22/2023] [Indexed: 06/01/2023]
Abstract
To improve the diagnostic accuracy of adenoid hypertrophy (AH) in children and prevent further complications in time, it is important to study and quantify the effects of different degrees of AH on pediatric upper airway (UA) aerodynamics. In this study, based on computed tomography (CT) scans of a child with AH, UA models with different degrees of obstruction (adenoidal-nasopharyngeal (AN) ratio of 0.9, 0.8, 0.7, and 0.6) and no obstruction (AN ratio of 0.5) were constructed through virtual surgery to quantitatively analyze the aerodynamic characteristics of UA with different degrees of obstruction in terms of the peak velocity, pressure drop (△P), and maximum wall shear stress (WSS). We found that two obvious whirlpools are formed in the anterior upper part of the pediatric nasal cavity and in the oropharynx, which is caused by the sudden increase in the nasal cross-section area, resulting in local flow separation and counterflow. In addition, when the AN ratio was ≥ 0.7, the airflow velocity peaked at the protruding area in the nasopharynx, with an increase 1.1-2.7 times greater than that in the nasal valve area; the △P in the nasopharynx was significantly increased, with an increase 1.1-6.8 times greater than that in the nasal cavity; and the maximum WSS of the posterior wall of the nasopharynx was 1.1-4.4 times larger than that of the nasal cavity. The results showed that the size of the adenoid plays an important role in the patency of the pediatric UA.
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Affiliation(s)
- Zhenzhen Hu
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Jingliang Dong
- Institute for Sustainable Industries & Liveable Cities, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia
- First Year College, Victoria University, Footscray Park Campus, Footscray, VIC, 3011, Australia
- School of Engineering, RMIT University, Bundoora, VIC, 3083, Australia
| | - Miao Lou
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Jingbin Zhang
- Department of Imaging, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ruiping Ma
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Yusheng Wang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Minjie Gong
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Botao Wang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Zhenbo Tong
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Hongxian Ren
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Guoxi Zheng
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, Shaanxi, China.
| | - Ya Zhang
- Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, Shaanxi, China.
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Almahboob A, Alhussien A, AlAmari K, Khan A, AlFaky Y, Alsaleh S. Does Adenoid Hypertrophy Increase the Risk of Orbital Complication in Children with Acute Sinusitis? Indian J Otolaryngol Head Neck Surg 2023; 75:352-357. [PMID: 37274966 PMCID: PMC10235310 DOI: 10.1007/s12070-022-03269-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022] Open
Abstract
Adenoid hypertrophy (AH) plays a role as a reservoir for bacterial growth and decreases mucociliary clearance which might contribute to the development of an infection. To compare the presence of AH in the pediatric population presenting with orbital complications as a result of ABRS and the control group radiologically. Patients who were diagnosed with OC as a result of ABRS labeled as case group, and the patients who had undergone computed tomography (CT) for indications other than sinonasal diseases were assigned as control group. Both groups were retrospectively reviewed to measure the adenoid, nasopharynx, and adenoid/nasopharynx ratio (ANR) in the axial and mid-sagittal planes. We compared 52 patients from case group to 57 control group. In the CT axial plane, adenoid length was greater in the OC group compared to the control group, with a significant difference (p-value = 0.02) of 14.2 ± 3.5 mm compared to 11.2 ± 7 mm, respectively. The ANRs were 2.9 in the OC group and 2.8 in the control group, with a p-value of 0.089. In the mid-sagittal plane, only the anteroposterior length was significantly greater in the OC group, with a mean of 19.9 ± 5.3 mm compared to 15.2 ± 8.8 mm in the control group (p-value = 0.007). The process of inflammation increased the anteroposterior length of the adenoids. However, the ANR was similar between the two groups, indicating that adenoid hypertrophy is not directly related as a risk factor for OC in pediatric patients with ARBS.
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Affiliation(s)
- Ayshah Almahboob
- Otorhinolaryngology - Head and Neck Surgery Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ahmed Alhussien
- Present Address: Otolaryngology - Head and Neck Surgery Department, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Kholoud AlAmari
- Present Address: Otolaryngology - Head and Neck Surgery Department, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Adeena Khan
- Radiology Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Yasser AlFaky
- Ophthalmology Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saad Alsaleh
- Present Address: Otolaryngology - Head and Neck Surgery Department, College of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
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14
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Chang HH, Zhang XY, An L, Dang PH, Luo J, Wang J. Novel Classification System of Adenoids Based on Appearance and Its Relationship with Drug Therapy. Int Arch Allergy Immunol 2023; 184:634-642. [PMID: 36996773 DOI: 10.1159/000528445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 11/28/2022] [Indexed: 04/01/2023] Open
Abstract
INTRODUCTION Adenoidectomy is a common procedure in children who have adenoid hypertrophy (AH), but anesthesia risks should be considered. We proposed a novel classification system for adenoids based on their appearance. Additionally, we explored whether the novel classification of adenoids correlates with the response to therapy and thus might be helpful for further treatment recommendations. METHODS We used fiberoptic nasal endoscopy to determine the degree and appearance of AH. Obstructive Sleep Apnea Questionnaire (OSA-18) was used to assess the quality of life of children with AH. The adenoids were divided into three types: edematous type, common type, and fibrous type. In adenoid tissues, the eosinophils were counted. Immunohistochemistry and Western blot were done to determine the expression of CysLTR1, CysLTR2, CGR-α, and CGR-β in different types of adenoids. RESULTS 70.67% (106/150) of AH patients presented with allergic rhinitis (AR), and of them, 68% (72/106) of adenoids were the edematous type. The expressions of CGR-α, CGR-β, and eosinophil count were higher in the edematous compared with the common and fibrous types. The expression of the leukotriene receptor was similar in all types. Upon montelukast combined with nasal glucocorticoid therapy, improvement of OSA-18 scores and AH grade was significantly compared to montelukast monotherapy for edematous type. There was not any statistically significant difference between the scores upon montelukast combined with nasal glucocorticoid and montelukast monotherapy for common and fibrous type. We observed a positive correlation between eosinophil count in the blood and in the adenoid tissue. CONCLUSION AR was the risk factor for the development of edematous AH. All subtypes of AH responded to montelukast, while there was an additional effect of nasal glucocorticoid in the edematous type. A combination therapy of nasal glucocorticoid with leukotriene receptor antagonist can be recommended for AH patients with AR, patients with edematous adenoids, and/or patients with increased eosinophils in blood routine.
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Affiliation(s)
- Huan-Huan Chang
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children Hospital of Xi'an Jiao Tong University, Xi'an, China
| | - Xin-Yi Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shaanxi Provincial Hospital of Chinese Medicine, Xi'an, China
| | - Lu An
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children Hospital of Xi'an Jiao Tong University, Xi'an, China
| | - Pan-Hong Dang
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children Hospital of Xi'an Jiao Tong University, Xi'an, China
| | - Juan Luo
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children Hospital of Xi'an Jiao Tong University, Xi'an, China
| | - Jie Wang
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children Hospital of Xi'an Jiao Tong University, Xi'an, China
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15
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Xi L, Wu G, Du X. Analyzing sleep status in children with acute leukemia. Ital J Pediatr 2023; 49:7. [PMID: 36639713 PMCID: PMC9840305 DOI: 10.1186/s13052-023-01409-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/02/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Quality sleep is essential for physical and mental health. We aimed to analyze sleep disorders in children with acute leukemia and explore associated factors. METHODS General data and sleep disorders in children with acute leukemia during chemotherapy were collected by general questionnaires, Children's Sleep Disorders Scale and the Parenting Stress Index-short form. RESULTS In total, 173 valid questionnaires were collected. The total Sleep Disorder Scale score > 39 is considered a sleep disorder, while sleep disorders accounted for 45.66% (79/173). In the cohort, 167 children had acute lymphoblastic leukemia, with 40.12% (67/167) having sleep disorders, while six children had acute non-lymphoblastic leukemia, with 50.00% (3/6) having sleep disorders. Single- and multi-factor regression analyses of age, gender, number of children in the family, and time spent using electronic devices showed that factors influencing sleep disorders in these children were mainly parental scolding and adenoid hypertrophy. Children with sleep disorders had more parental stress than those without sleep disorders (P < 0.05). CONCLUSIONS The high incidence of sleep disorders in children with acute leukemia is related to airway conditions and parental behaviors. Sleep disorders in children can increase parenting stress. Factors potentially affecting sleep quality should be addressed as early as possible, while parental education should be strengthened to better facilitate the physical and psychological recovery of their children.
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Affiliation(s)
- Lu Xi
- grid.411360.1Department of Hematology and Oncology, The Children’s Hospital of Zhejiang University School of Medicine, Zhejiang Pediatric Leukemia Diagnosis and Treatment Technology Center, National Pediatric Health and Disease Clinical Medical Research Center, Hangzhou, 310000 Zhejiang China
| | - Guangsheng Wu
- grid.460074.10000 0004 1784 6600Department of Pediatrics, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongchenqiao Street, Gongshu District, Hangzhou, 310000 Zhejiang China
| | - Xinke Du
- grid.460074.10000 0004 1784 6600Department of Pediatrics, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongchenqiao Street, Gongshu District, Hangzhou, 310000 Zhejiang China
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Uysal P, Güleç Köksal Z, Gönenli Z, Doğan M, Şahin M. The impact of adenoid hypertrophy on pulmonary functions measured using impulse oscillometry in preschool-age children. Eur Arch Otorhinolaryngol 2023; 280:207-217. [PMID: 35907002 DOI: 10.1007/s00405-022-07521-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/20/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE To assess pulmonary impedance [resistance (zR5, zR20, R5-20, Fres, and AX) and reactance (zX5 and zX20)] using impulse oscillometry (IOS) in children with adenoid hypertrophy (AH) and its association with the degree of AH, and to evaluate subsequent changes in pulmonary function 3 months after adenoidectomy. METHODS This prospective cross-sectional study was conducted with 170 preschool-age children [110 with AH and 60 sex- and age-matched healthy controls (HCs)]. Pulmonary function was analyzed using IOS at baseline (1st visit) in all participants and 3 months after adenoidectomy (2nd visit) in patients who underwent the operation. RESULTS The IOS parameters of zR5, zR20, R5-20, Fres, and AX were higher, but zX20 was lower, in children with AH compared to the HCs (p < 0.05 for all). The parameters of zR5, Fres, and AX were higher in children with grade IV AH than in those with grade I (p < 0.001). zR5, zR20, R5-20, Fres, and AX decreased, but zX20 increased, after adenoidectomy (2nd visit) compared to baseline (1st visit) (p < 0.05). Post-adenoidectomy (2nd visit) zR5, AX, Fres values were higher in children with AH compared to baseline values in the HCs (1st visit) (p < 0.05). The area under the ROC curve (AUC) value for estimating adenoidectomy was 0.741 for zX20 (CI 0.648-0.834, p < 0.001) with a cut-off value of ≤ -3.21, sensitivity of 68.8%, and specificity of 70%. CONCLUSION This study shows that IOS is a useful method for demonstrating subclinical bronchial obstruction in preschool-age children with AH with greater pulmonary impedance (resistance and reactance). Pulmonary impedance decreased 3 months after adenoidectomy, but remained higher than in the HCs. The IOS parameter of X20 may be predictive of adenoidectomy. This study evaluated the pulmonary functions of children with adenoid hypertrophy (AH) using impulse oscillometry (IOS) and the association with the scale of AH. Pulmonary functions were analyzed using IOS. The main IOS parameters include resistances (zR5 and zR20), reactance (zX5 and zX20), R5-20 (resistance at 5 Hz minus resistance at 20 Hz), resonant frequency (Fres), and AX. Fres is the point at which reactance is zero and is measured in Hz (1/s). The Reactance Area (AX - "Goldman Triangle") represents the integrated low-frequency respiratory reactance magnitude between 5 Hz and Fres. Faster frequencies of R (~ 20 Hz) reflect larger airways, regarded as resistance around the central airways. Lower frequencies of R (~ 5 Hz) providing information around the entire (small and large) airways. Peripheral (small) airway resistance is defined by R5-20. IOS parameters of zR5, zX20, Fres, and AX differed among AH grades I-IV and compared to the HCs (p < 0.001 for all).
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Affiliation(s)
- Pınar Uysal
- Division of Allergy and Immunology, Department of Pediatric Allergy and Immunology, School of Medicine, Aydin Adnan Menderes University, 09010, Aydin, Turkey.
| | - Zeynep Güleç Köksal
- Division of Allergy and Immunology, Department of Pediatric Allergy and Immunology, School of Medicine, Aydin Adnan Menderes University, 09010, Aydin, Turkey
| | - Zeynep Gönenli
- Department of Pediatrics, School of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - Murat Doğan
- Department of Otorhinolaryngology, School of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
| | - Mustafa Şahin
- Department of Otorhinolaryngology, School of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
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17
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Dange PS, Bhat VK, Yadav M. Adenoid Morphology and Other Prognostic Factors for Otitis Media with Effusion in School Children. Indian J Otolaryngol Head Neck Surg 2022; 74:3649-3653. [PMID: 36742487 PMCID: PMC9895436 DOI: 10.1007/s12070-020-02332-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/14/2020] [Indexed: 02/07/2023] Open
Abstract
Introduction This study aimed to compare the children having enlarged adenoids with and without otitis media with effusion (OME) concerning clinical features like mouth breathing, snoring, recurrent episodes of cold, hearing impairment and specific morphology of adenoid. Further, the flora of adenoid tissue and middle ear fluid were also compared. Methods One hundred and twenty children having clinical features suggestive of enlarged adenoids with [Group A (n = 60)] or without [Group B (n = 60)] OME were included in this cross-sectional study. All patients underwent clinical examination, diagnostic nasal endoscopy, radiography of the nasopharynx, blood absolute eosinophil count and immittance. Core adenoid tissue was subjected to microbiological culture after adenoidectomy. OME fluid was subjected to microbial analysis after myringotomy. Results In group A patients, snoring was present in 90% (p = 0.011), adenoid facies in 76.6% (p < 0.001) and tubal tonsil enlargement in 86.7% (p < 0.001). The parts related to the development of OME were: behind the posterior cushion in 86%, touching the posterior end of septum in 76.7%, inside nasal cavity in 70% and completely covering the Eustachian tube orifices in 95% (p < 0.001 in all of them). Conclusion Specific morphology of adenoid enlargement and tubal tonsil enlargement was more critical in predicting the risk of developing OME and not just the grade of adenoid hypertrophy. The microbial flora in the adenoid core was similar in children with and without OME.
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Affiliation(s)
- Prajwal Shrirang Dange
- Department of Otolaryngology, Head and Neck Surgery, Mysore Medical College, Mysore, India
| | - Vikram Kemmannu Bhat
- Department of Otolaryngology, Head and Neck Surgery, Karnataka Institute of Medical Sciences, Hubli, India
| | - Mona Yadav
- Department of Otolaryngology, Head and Neck Surgery, Karnataka Institute of Medical Sciences, Hubli, India
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18
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Kothekar A, Vallur S. Adenoid Hypertrophy and Endoscopic Adenoidectomy in Adults: Our Experience. Indian J Otolaryngol Head Neck Surg 2022; 74:1067-1072. [PMID: 36452738 PMCID: PMC9701968 DOI: 10.1007/s12070-020-02142-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/07/2020] [Indexed: 10/23/2022] Open
Abstract
Adenoid tissue is considered as first line immunological defence mechanism in childhood. Adenoid hypertrophy in children is a common cause of nasal obstruction. It usually gets atrophied by puberty. Adenoid hypertrophy persisting in adults is a cause of nasal obstruction. A randomized prospective study was conducted on adult patients aged above 20 years of age presenting with bilateral nasal obstruction at a tertiary care hospital, for duration of 20 months from January 2018 to August 2019.The differential diagnosis of adenoid hypertrophy was evaluated and role of endoscopic adenoidectomy was studied. The various associated causes of adenoid hypertrophy in adults showed previous history of adeno-tonsillectomy, allergy, deviated nasal septum and smoking. In all cases endoscopic assisted adenoidectomy was performed. Post adenoidectomy patients were asymptomatic in 21 cases, partial improvement in 6 cases and failure in 3 cases. Enlarged adenoid in adults should be considered in the differential diagnosis of cases suffering from bilateral nasal obstruction, or presenting as a nasopharyngeal mass with aural problems. Endoscopic adenoidectomy is safe and reliable. The nasal endoscope aids in removal of adenoid completely with good haemostasis, without any injury to Eustachian tube.
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Affiliation(s)
| | - Srujan Vallur
- Department of ENT, 12 Air Force Hospital, Akash Vihar, Kunraghat, Gorakhpur , 273002 India
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19
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Zuo L, He L, Huang A, Liu Y, Zhang A, Wang L, Song Y, Geng J. Risk factors and antibiotic sensitivity of aerobic bacteria in Chinese children with adenoid hypertrophy. BMC Pediatr 2022; 22:553. [PMID: 36123658 PMCID: PMC9484187 DOI: 10.1186/s12887-022-03613-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bacterial infection of adenoid is currently considered to be an important cause of adenoid hypertrophy (AH) in children. Although several bacteriology studies on adenoid diseases have been reported, the aerobic bacterial study regarding risk factors and antibiotic sensitivity of AH in Chinese children is lacking. This study aims to investigate the risk factors for aerobic bacterial colonization of AH in Chinese children and to elucidate aerobic bacterial profiles and antibiotic sensitivity. METHODS Samples were collected from the adenoid core and surface tissue of 466 children undergoing adenoidectomy. Aerobic cultures and antibiotic sensitivity were observed. The risk factors for bacterial colonization of adenoid were analyzed statistically. RESULTS A total of 143 children could be detected opportunistic pathogens in adenoid surface and/or core tissue, with a carriage rate of 30.7%. The presence of chronic rhinosinusitis, tonsillar hypertrophy and adenoidal size were the risk factors for aerobic bacterial colonization of adenoid in univariate analysis. Multivariate analysis showed that chronic rhinosinusitis and tonsil hypertrophy were significant variables associated with the aerobic bacterial colonization. The most frequently isolated aerobic bacteria were Haemophilus influenzae, followed by Staphylococcus aureus and Streptococcus pneumoniae. There was no statistically significant difference in bacterial species between the adenoid surface and core. The above common bacteria were more sensitive to cephalosporins and quinolones antibiotics, and significantly resistant to penicillin antibiotics and non-β-lactamase inhibitors. CONCLUSION Our results provide recent aerobic bacterial profiles for AH among Chinese children and confirm the risk factors and antibiotic sensitivity. This study contributes to understanding the role of different risk factors in the development of AH and will be helpful to the treatment of AH among Chinese children.
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Affiliation(s)
- Lujie Zuo
- Department of Otolaryngology, Head and Neck Surgery, Pediatric Clinical Research Centre of Hebei Province, Children's Hospital of Hebei Province, No. 133 Jianhua South Street, Yuhua District, Shijiazhuang, Hebei Province, China
| | - Li He
- Department of Otolaryngology, Head and Neck Surgery, Pediatric Clinical Research Centre of Hebei Province, Children's Hospital of Hebei Province, No. 133 Jianhua South Street, Yuhua District, Shijiazhuang, Hebei Province, China
| | - Aiping Huang
- Department of Otolaryngology, Head and Neck Surgery, Pediatric Clinical Research Centre of Hebei Province, Children's Hospital of Hebei Province, No. 133 Jianhua South Street, Yuhua District, Shijiazhuang, Hebei Province, China
| | - Yingying Liu
- Department of Otolaryngology, Head and Neck Surgery, Pediatric Clinical Research Centre of Hebei Province, Children's Hospital of Hebei Province, No. 133 Jianhua South Street, Yuhua District, Shijiazhuang, Hebei Province, China
| | - Aiying Zhang
- Department of Otolaryngology, Head and Neck Surgery, Pediatric Clinical Research Centre of Hebei Province, Children's Hospital of Hebei Province, No. 133 Jianhua South Street, Yuhua District, Shijiazhuang, Hebei Province, China
| | - Li Wang
- Department of Otolaryngology, Head and Neck Surgery, Pediatric Clinical Research Centre of Hebei Province, Children's Hospital of Hebei Province, No. 133 Jianhua South Street, Yuhua District, Shijiazhuang, Hebei Province, China
| | - Yingluan Song
- Department of Otolaryngology, Head and Neck Surgery, Pediatric Clinical Research Centre of Hebei Province, Children's Hospital of Hebei Province, No. 133 Jianhua South Street, Yuhua District, Shijiazhuang, Hebei Province, China.
| | - Jiangqiao Geng
- Department of Otolaryngology, Head and Neck Surgery, Pediatric Clinical Research Centre of Hebei Province, Children's Hospital of Hebei Province, No. 133 Jianhua South Street, Yuhua District, Shijiazhuang, Hebei Province, China.
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Koparal M, Ege B, Sirik M, Kurt MY, Kurt E. Evaluation of the associations between maxillary sinus dimensions and adenoid hypertrophy using multislice computed tomography. J Stomatol Oral Maxillofac Surg 2022; 123:459-464. [PMID: 35728775 DOI: 10.1016/j.jormas.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Adenoid hypertrophy is especially common in childhood, raising the concern that such growth might affect maxillary sinus volumes during the developmental period. This study evaluated the developmental relationships between maxillary sinus volumes and adenoid hypertrophy via computed tomography. MATERIALS AND METHODS It was examined computed tomographic images of 118 individuals: 61 boys and 57 girls. The participants were divided into a healthy control group (n = 59) and an experimental group (with adenoid hypertrophy) (n = 59). Raw data were recorded in DICOM format and analysed using the ITK-SNA algorithm; it was measured the right, left, and total maxillary sinus volumes and adenoid tissue sizes. RESULTS It was found significant between-group differences in the three maxillary sinus volumes and adenoid tissue dimensions (linear maximum anterior and posterior depth; maximum upper and lower height, and maximum width to the right and left) (all p<0.001). On the contrary, there was no significant difference according to sex in terms of either maxillary sinus volumes or linear adenoid tissue measurements. Maxillary sinus volumes increased significantly according to age in both groups. CONCLUSION Adenoid hypertrophy decreases the maxillary sinus volumes, regardless of sex. The impacts of adenoid growth on maxillary sinus aeration and sinus disease should be further investigated.
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Affiliation(s)
- Mehtap Koparal
- Department of Otolaryngology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey.
| | - Bilal Ege
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adiyaman University, Adiyaman, Turkey
| | - Mehmet Sirik
- Department of Radiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Muhammed Yusuf Kurt
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adiyaman University, Adiyaman, Turkey
| | - Ercan Kurt
- Department of Otolaryngology, Adiyaman University Education and Training Hospital, Adiyaman, Turkey
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Atar Y, Atar S, Anarat MEA, Berkiten M, Saricam SS, Demirhan E, Mersinlioglu G, Dıraçoğlu D. Effect of adenoid hypertrophy and adenoidectomy on bite force in children: Twelve month follow-up, case-control study. Cranio 2022:1-9. [PMID: 36018777 DOI: 10.1080/08869634.2022.2116526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE The effects of adenoid hypertrophy (AH) and adenoidectomy on maximal bite force (MBF) in patients were evaluated by comparing them with healthy controls. METHODS A total of 118 children diagnosed with AH and undergoing adenoidectomy (Group A), and healthy controls (Group B) were included. The MBF and nasopharyngeal airway passage distance (NAPD) were recorded. RESULTS There was a correlation between NAPD and MBF at the beginning of the study (r = -0.675 and p < 0.001). The initial mean MBF of Groups A and B were 318.37 ± 70.76 N and 344.04 ± 64.14 N, respectively (p = 0.041). However, there was no significant difference between the groups due to the increase in the MBF of Group A at 12 months (p = 0.165). CONCLUSION The MBF may be negatively affected in proportion to decreased NAPD, and it could also be an indicator for monitoring the status of children with AH.
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Affiliation(s)
- Yavuz Atar
- Department of Otorhinolaryngology, Acibadem Maslak Hospital, Istanbul, Turkey
| | - Sevgi Atar
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Melis Ece Arkan Anarat
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Mustafa Berkiten
- School of Dentistry, Department of Endodontics, Istanbul Health and Technology University, Istanbul, Turkey
| | - Sabire Sitare Saricam
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Esma Demirhan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Gökhan Mersinlioglu
- Department of Otorhinolaryngology, Private Clinic of Otorhinolaryngology, Istanbul, Turkey
| | - Demirhan Dıraçoğlu
- Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
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22
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Calvo-Henriquez C, Martínez-Seijas P, Boronat-Catalá B, Faraldo-García A, Martínez-Capoccioni G, Alobid I, Banegassi IM, Martin-Martin C. Assessing the ability of children and parents to rate their nasal patency. A cross sectional study. Int J Pediatr Otorhinolaryngol 2022; 156:111094. [PMID: 35290944 DOI: 10.1016/j.ijporl.2022.111094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 02/19/2022] [Accepted: 03/01/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Nasal obstruction is a common complaint in pediatric otolaryngology. There are several concerns about how nasal obstruction should be measured. This debate is even more important in children, as they can experience difficulties in being sensitive to their symptoms or even expressing them. In this research we aim to explore the ability of children (and their parents) to assess their nasal obstruction. PARTICIPANTS AND METHODS: An observational cross-sectional study was performed. Four cohorts of children were consecutively selected from a third level referral Hospital. Cohort A (children suffering solely turbinate enlargement), B (adenoid enlargement only), and C (adenoid and turbinate enlargement), while cohort D were healthy controls. Children and parents were asked to rate nasal patency through a Likert scale from 0 (no patency, complete obstruction of the nose) to 10 (complete patency, it is easy to breathe through the nose). All participants underwent rhinomanometry. Results of nasal resistance were relativized according to pediatric reference values per each age subgroup. RESULTS 146 participants were included. Cohort A (54), B (40), C (28), D (24). There is a poor but significant correlation between parents' assessment and nasal resistance (rho = -0.28; p = 0.004). In children, there is no significant correlation with nasal resistance (rho = -0.14; p = 0.17). Stratified by severity, only children (and their parents) with good nasal breathing demonstrated good correlation values with the visual analogue score (VAS). Stratified by age, the correlation is only significant for parents of children older than 12 years old. CONCLUSIONS This study has demonstrated a good ability to rate nasal patency by healthy children and their parents, but a poor ability for children suffering from impaired nasal breathing. We suggest combining subjective assessment of nasal patency with objective measurements such as rhinomanometry in children.
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Abstract
Otitis media with effusion (OME) is amongst the most common pediatric diseases and the most common cause of hearing loss in children. It is accepted that adenoid hypertrophy (AH) is related to OME incidence. Better understanding of the correlation between the relative size of AH and the incidence of persistent OME may provide evidence to support a more standardized approach to the diagnosis and treatment of OME. A retrospective study carried out between April 2016 and April 2018 collected data on 65 children aged 2-12 years, diagnosed with chronic OME and symptoms of AH, where conservative therapy failed. Pre-diagnostic data were collected from patient history, otoscopy, rhinoscopy, and oropharyngoscopy findings. Diagnostic workup included tympanometry, audiometry, and flexible nasal fiberoptic endoscopy. Adenoid grading was performed according to Cassano method after endoscopic visualization. Of the 65 patients, 37 were male and 28 were female. There was no statistically significant difference according to gender or average age. The highest incidence of persistent OME with AH was recorded in the youngest age groups (2-5 and 6-9 years). The most frequent AH grades were grade II (35.38%) and grade III (50.77%), yielding a statistically significant result. The most common presenting symptoms were hearing impairment, snoring, and nasal obstruction (100%, 64.62% and 60%, respectively). Higher AH grades are critical for persistence of OME and may cause conservative therapy failure.
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Affiliation(s)
- Marta Zrinka Galić
- Department of Otorhinolaryngology, Split University Hospital Centre, Split, Croatia
| | - Marisa Klančnik
- Department of Otorhinolaryngology, Split University Hospital Centre, Split, Croatia
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Pisutsiri N, Vathanophas V, Boonyabut P, Tritrakarn S, Vitayaudom N, Tanphaichitr A, Ungkanont K. Adenoid measurement accuracy: A comparison of lateral skull film, flexible endoscopy, and intraoperative rigid endoscopy (gold standard). Auris Nasus Larynx 2021; 49:222-228. [PMID: 34334217 DOI: 10.1016/j.anl.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/21/2021] [Accepted: 07/06/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the accuracy of lateral skull film, flexible endoscopy, and intraoperative rigid endoscopy in assessment of adenoid size. METHODS A cross-sectional study was conducted in 43 pediatric patients undergoing ENT surgery from July 2017 to December 2018. All patients underwent preoperative lateral skull film, flexible endoscopy, and intraoperative rigid endoscopy. RESULTS The average adenoidal-nasopharyngeal (A/N) ratio obtained from lateral skull film, flexible endoscopy, and intraoperative rigid endoscopy was 72.9, 79.5, and 81.6, respectively. There was a moderate correlation between A/N ratio from lateral skull film and intraoperative rigid endoscopy (Pearson's correlation: 0.567, p˂0.001). Whereas, the A/N ratio from flexible endoscopy compared to intraoperative rigid endoscopy showed a stronger correlation (Pearson's correlation: 0.791, p˂0.001). From linear regression analysis, the intraoperative adenoid measurement was estimated from the results of flexible endoscopy (intraoperative rigid endoscopy: 0.72 [flexible endoscopy] +24.47) and lateral skull film (intraoperative rigid endoscopy = 0.65 [lateral skull film] + 34) CONCLUSION: Flexible endoscopy yields the most accuracy in the assessment of adenoid size and nasopharynx visualization, without radiation exposure or anesthesia. Despite less accuracy, lateral skull film is more availability in every hospital. The correlation of adenoid size measurement in this study can also be applied for the actual size of adenoid.
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Affiliation(s)
| | - Vannipa Vathanophas
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Panrasee Boonyabut
- Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand
| | - Sirion Tritrakarn
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nichanun Vitayaudom
- Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Archwin Tanphaichitr
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kitirat Ungkanont
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Kumral TL, Dikker O, Yıldırım G, Karaketir S, Altındağ C, Çakın MC, Sarı H, Özcan D. The role of thymic stromal lymphopoietin in the development of chronic otitis media with effusion. Eur Arch Otorhinolaryngol 2021. [PMID: 34279733 DOI: 10.1007/s00405-021-06995-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/12/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE To investigate the effect of thymic stromal lymphopoietin on the development of chronic otitis media with effusion MATERIALS AND METHODS: This study was conducted on 40 patients who had adenoidectomy operation. The objects were divided into two groups. Group 1; adenoidectomy with chronic serous otitis media, group 2; adenoidectomy without chronic serous otitis media. Serum and tissue thymic stromal lymphopoietin levels were measured by ELISA. Serum and tissue TLSP levels, mast cell count, adenoid size were compared between the groups. RESULTS Twenty-four (60%) of patients were female and 16 (40%) were male. Twenty patients (55%) had adenoid hypertrophy with chronic serous otitis media, and 18 (45%) had adenoid hypertrophy without chronic serous otitis media. The mean age of the patients was 6.21 ± 2.31 years. The mean mast cell count was significantly higher in group 1 compared with group 2 (p = 0.017). The mean tissue thymic stromal lymphopoietin measurement was also significantly higher in group 1 than group 2 (p = 0.023). However, there was no significant difference in regards to serum levels between the groups (p = 0.480). CONCLUSION The number of mast cells as well as thymic stromal lymphopoietin levels in the adenoids of children was significantly high in the chronic serous otitis media patients. The release of thymic stromal lymphopoietin from the adenoid tissue plays a role in initiating and maintaining a local inflammatory reaction in the eustachian tube that may lead eventually to middle ear effusion in non-atopic patients.
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Feng X, Lie SA, Hellén-Halme K, Shi XQ. Effect of Rapid Maxillary Expansion on Upper Airway Morphology: A Retrospective Comparison of Normal Patients versus Patients with Enlarged Adenoid Tissue. J Clin Pediatr Dent 2021; 45:208-15. [PMID: 34192749 DOI: 10.17796/1053-4625-45.3.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives The present study evaluated the effect of rapid maxillary expansion (RME) on the morphology of the upper airway (UA) by calculating cross-sectional areas and volumes and comparing the effect in patients with a normal-sized adenoid with the effect in patients with an enlarged adenoid. Study design: Seventeen patients met the inclusion criteria. We constructed 3D models of the UA on cone-beam computed tomography images to calculate cross-sectional areas and volumes at the levels of the nasopharyngeal, retropalatal, and retroglossal airways. Patients were divided into two groups: group 1 was comprised of patients with an adenoidal nasopharyngeal (AN) ratio < 0.6 and group 2 with an AN ratio ≥ 0.6. Paired samples t-tests assessed any area and volumetric changes of the UA after RME. Changes in degree of nasal obstruction, calculated as the AN ratio, was then compared for the two groups. An independent samples t-test compared volumetric changes in the nasopharynx between the two groups before and after RME. Results Changes in cross-sectional areas and volumes of the UA due to RME were not significant. The effects of RME on AN ratio (11 % vs 0 %) and nasopharyngeal volume (36.8 % vs 5.97%) were somewhat larger in group 2 patients who had adenoid-associated nasal obstruction compared with group 1 patients with a normal-sized adenoid; however, the differences were not significant. Conclusions After RME, the patients with an enlarged adenoid had more increases in nasopharyngeal volume compared with those with normal adenoid, despite there was no significant difference.
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Arslan E, Tulaci KG, Canakci H, Arslan S, Yazici H. Evaluation of the intranasal steroid treatment outcomes in adenoid tissue hypertrophy with or without allergic rhinitis. Am J Otolaryngol 2021; 42:102983. [PMID: 33610082 DOI: 10.1016/j.amjoto.2021.102983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/14/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To compare the intranasal steroid (INS) treatment outcomes in patients with adenoid tissue hypertrophy (ATH) with or without allergic rhinitis (AR). MATERIALS AND METHODS Medical records of 96 children diagnosed with ATH were retrospectively examined. The pediatric version of the Score for Allergic Rhinitis (SFAR) questionnaire was used to determine the AR status of the patients and classify them. The children were divided into two groups based on the questionnaire: Group 1, low probability of AR (SFAR<9); and Group 2, high probability of AR (SFAR≥9). Intranasal mometasone furoate (100 μg/mL) was used to treat ATH for at least 3 months. The severity of nasal obstruction and snoring was evaluated using the visual analog scale (VAS) score, the adenoid/choana (A/C) ratios before and after treatment were compared, and the rate of patient referral to surgery was recorded among groups. RESULTS The change in the A/C ratio within the group between before and after treatment was significant (both P < 0.001). However, the reduction in the adenoid size was more significant in Group 1 than in Group 2 (P = 0.025). A significant improvement in the VAS scores was observed between before and after treatment in both groups (P < 0.001). Furthermore, the rate of surgical referral of Group 1 was significantly lower than that of Group 2 (P = 0.035). CONCLUSIONS INS treatment was found more successful for reducing A/C ratio in ATH without AR. Related with this, when considering the INS treatment for ATH, AR status should be kept in mind for predicting the treatment success.
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Yang Y, Li X, Ma Q, Fu Z, Su K. Detecting epidemiological relevance of adenoid hypertrophy, rhinosinusitis, and allergic rhinitis through an Internet search. Eur Arch Otorhinolaryngol 2021. [PMID: 34104981 DOI: 10.1007/s00405-021-06885-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/13/2021] [Indexed: 11/06/2022]
Abstract
Purpose This study aimed to detect the epidemiological relevance between adenoid hypertrophy (AH) and rhinosinusitis, and AH and allergic rhinitis (AR) through an Internet search. Methods Internet search query data from January 2011 to December 2019 in China were retrieved from the Baidu Index (BI). Spearman’s correlation coefficients were used to detect the correlation among the search volumes of AH, rhinosinusitis, and AR. We also collected search data from the first 5 months of 2020, when quarantine was implemented in China due to the coronavirus disease 2019 epidemic. Then, we compared the search data to those obtained during the same period in 2019 to assess the effects of isolation on AH and AR. Results Statistically significant relevance was found between the search variations of AH and rhinosinusitis during 2011–2019 (R = 0.643, P < 0.05). However, the relationship between AH and AR was weak (R = − 0.239, P < 0.05) and that between rhinosinusitis and AR (R = − 0.022, P > 0.05) was not relevant. The average monthly search volume of AH and rhinosinusitis had a strong correlation (R = 0.846, P < 0.01), but AH and AR and rhinosinusitis and AR were not correlated (R = – 0.350, P > 0.05; R = – 0.042, P > 0.05, respectively). AH and rhinosinusitis search volumes decreased consistently during the first 5 months of 2020 (isolation), whereas that for AR increased during January–February. Conclusion AH had an epidemiological relationship with rhinosinusitis, which was not consistent with AR. The decrease in public gathering effectively reduced the morbidities of AH and rhinosinusitis but not those of AR.
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Duse M, Santamaria F, Verga MC, Bergamini M, Simeone G, Leonardi L, Tezza G, Bianchi A, Capuano A, Cardinale F, Cerimoniale G, Landi M, Malventano M, Tosca M, Varricchio A, Zicari AM, Alfaro C, Barberi S, Becherucci P, Bernardini R, Biasci P, Caffarelli C, Caldarelli V, Capristo C, Castronuovo S, Chiappini E, Cutrera R, De Castro G, De Franciscis L, Decimo F, Iacono ID, Diaferio L, Di Cicco ME, Di Mauro C, Di Mauro C, Di Mauro D, Di Mauro F, Di Mauro G, Doria M, Falsaperla R, Ferraro V, Fanos V, Galli E, Ghiglioni DG, Indinnimeo L, Kantar A, Lamborghini A, Licari A, Lubrano R, Luciani S, Macrì F, Marseglia G, Martelli AG, Masini L, Midulla F, Minasi D, Miniello VL, Del Giudice MM, Morandini SR, Nardini G, Nocerino A, Novembre E, Pajno GB, Paravati F, Piacentini G, Piersantelli C, Pozzobon G, Ricci G, Spanevello V, Turra R, Zanconato S, Borrelli M, Villani A, Corsello G, Di Mauro G, Peroni D. Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases. Ital J Pediatr 2021; 47:97. [PMID: 33882987 PMCID: PMC8058583 DOI: 10.1186/s13052-021-01013-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/26/2021] [Indexed: 01/08/2023] Open
Abstract
Background In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research.
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Affiliation(s)
- Marzia Duse
- Department of Pediatrics, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy.
| | | | | | | | - Lucia Leonardi
- Maternal, Infantile and Urological Sciences Department, Sapienza University, Rome, Italy
| | - Giovanna Tezza
- Pediatric Department, Franz Tappeiner Hospital, Meran, Italy
| | - Annamaria Bianchi
- Pediatric Unit, Department of Women's and Children's Health, San Camillo Forlanini Hospital, Rome, Italy
| | - Annalisa Capuano
- Department of Experimental Medicine, University "Luigi Vanvitelli", Regional Centre of Pharmacovigilance Campania, Naples, Italy
| | - Fabio Cardinale
- Pediatric and Emergency Unit Giovanni XXIII Pediatric Hospital University of Bari, Bari, Italy
| | | | - Massimo Landi
- Family Pediatrician Local Health Unit, Turin and IRIB-CNR, Palermo, Italy
| | | | | | - Attilio Varricchio
- Allergy Centre, Department of Pediatric Sciences IRCCS Gaslini Institute, Genova, Italy
| | - Anna Maria Zicari
- Departmental Operative Unit of Diagnostic and Surgical Videoendoscopy of the Upper Airways, Asl Napoli 1 Center, Naples, Italy
| | - Carlo Alfaro
- Maternal, infantile and urological sciences Department, Pediatric Allergic Unit, Sapienza University, Rome, Italy
| | - Salvatore Barberi
- Paediatrics Unit, Reunited Hospitals Castellammare of Stabia, Naples, Italy
| | | | | | - Paolo Biasci
- Pediatric Unit San Giuseppe Hospital, Empoli, Florence, Italy
| | - Carlo Caffarelli
- Family Paediatrician, Local Health Unit, FIMP National President, Livorno, Italy
| | | | - Carlo Capristo
- Pediatric Unit, Department of Mother and Child, AUSL-IRCCS, Reggio Emilia, Italy
| | - Serenella Castronuovo
- Department of Woman, Child and of General and Specialized Surgery, University "Luigi Vanvitelli", Naples, Italy
| | - Elena Chiappini
- Family Paediatrician Local Health Unit Nettuno-Anzio, Rome, Italy.,Paediatric Infectious Disease Unit, Meyer Children's University Hospital, Department Of Health Sciences, University of Florence, Florence, Italy
| | - Renato Cutrera
- Pediatric Pulmonology Unit, Academic Department of Paediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giovanna De Castro
- Departmental Operative Unit of Diagnostic and Surgical Videoendoscopy of the Upper Airways, Asl Napoli 1 Center, Naples, Italy
| | | | - Fabio Decimo
- Pediatric Unit, Department of Mother and Child, AUSL-IRCCS, Reggio Emilia, Italy
| | | | - Lucia Diaferio
- Department of Paediatrics, Aldo Moro University of Bari, Bari, Italy
| | - Maria Elisa Di Cicco
- Paediatrics Unit, University Hospital of Pisa, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Caterina Di Mauro
- General Paediatrics and Paediatric Acute and Emergency Unit, University Hospital San Marco, University of Catania, Catania, Italy
| | - Cristina Di Mauro
- Department of Experimental Medicine, University "Luigi Vanvitelli", Regional Centre of Pharmacovigilance Campania, Naples, Italy
| | - Dora Di Mauro
- Family Paediatrician Local Health Unit, Ausl, Modena, Italy
| | | | - Gabriella Di Mauro
- Department of Experimental Medicine, University "Luigi Vanvitelli", Regional Centre of Pharmacovigilance Campania, Naples, Italy
| | - Mattia Doria
- Primary Care Paediatrician, Local Health Unit, National Secretary for the Scientific and Ethical Activities of FIMP, Chioggia, Italy
| | - Raffaele Falsaperla
- Neonatal Intensive Care Unit and Neonatal Accompaniment Unit, University Hospital San Marco, University of Catania, Catania, Italy
| | - Valentina Ferraro
- Unit of Paediatric Allergy and Respiratory Medicine Women's and Children's Health Department, University Hospital Padua, Padua, Italy
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Neonatal Pathology and Neonatal Section, AOU and University of Cagliari, Monserrato (CA), Italy
| | - Elena Galli
- Pediatric Allergy Unit, Department of Paediatric Medicine, S. Pietro Hospital Fatebenefratelli, Rome, Italy
| | - Daniele Giovanni Ghiglioni
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, UOSD Paediatric Highly Intensive Care Unit, Milan, Italy
| | - Luciana Indinnimeo
- Department of Pediatrics, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Ahmad Kantar
- Pediatric Asthma and Cough Center Istituti Ospedalieri Bergamaschi, Gruppo Ospedaliero San Donato, Ponte San Pietro, Bergamo, Italy
| | | | - Amelia Licari
- Paediatric and Neonatology Unit Santa Maria Goretti Hospital, Department of Pediatrics, University of Pavia, Pavia, Italy
| | - Riccardo Lubrano
- Paediatric and Neonatology Unit Santa Maria Goretti Hospital, Department of Pediatrics, Sapienza University, Rome, Italy
| | - Stefano Luciani
- Pediatric and Neonatal Intensive Care Unit Fatebenefratelli Isola Tiberina, Rome, Italy
| | - Francesco Macrì
- Allergist Pediatrician National Secretary of Italian Federation for Medical Scientific Societies (FISM), Rome, Italy
| | - Gianluigi Marseglia
- Paediatric and Neonatology Unit Santa Maria Goretti Hospital, Department of Pediatrics, University of Pavia, Pavia, Italy
| | | | - Luigi Masini
- Pediatric Pulmonology and Subintensive Respiratory Therapy Unit Department of Pediatrics Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Fabio Midulla
- Maternal, Infantile and Urological Sciences Department, Sapienza University, Rome, Italy
| | - Domenico Minasi
- Pediatric Unit Great Metropolitan Hospital Reggio Calabria, Reggio Calabria, Italy
| | - Vito Leonardo Miniello
- Department of Biomedical Science and Human Oncology, University of Bari, Children's Hospital "Giovanni XXIII", Bari, Italy
| | | | | | | | - Agostino Nocerino
- Department of Translational Medical Sciences, Pediatric Pulmonology, Federico II University, Naples, Italy
| | - Elio Novembre
- Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | | | - Francesco Paravati
- Department of Human Pathology in Adult and Development Age, Pediatric Unit, University of Messina, Messina, Italy
| | | | - Cristina Piersantelli
- Paediatric Section Department of Surgery, Dentistry, Paediatrics and Gynaecology University of Verona, Verona, Italy
| | - Gabriella Pozzobon
- Family Pediatrician, Paediatric Allergy, Local Health Unit TO1, Turin, Italy
| | | | | | - Renato Turra
- Family Pediatrician Local Health Unit, Caselle Torinese, Vicenza, Italy
| | | | - Melissa Borrelli
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Alberto Villani
- Unit of Pediatric Allergy and Respiratory Medicine Women's and Children's Health Department University Hospital, Padua, Italy
| | | | | | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy
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Liu H, Feng X, Sun Y, Fan Y, Zhang J. Modified adenoid grading system for evaluating adenoid size in children: a prospective validation study. Eur Arch Otorhinolaryngol 2021; 278:2147-53. [PMID: 33797600 DOI: 10.1007/s00405-021-06768-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/17/2021] [Indexed: 01/19/2023]
Abstract
Nasal endoscopy is the best choice for evaluation of adenoid size, but very few studies published on the endoscopic quantitative assessment. This study aimed to newly propose and validate a modified adenoid grading system (MAGS) with the existing endoscopic scoring methods of adenoid size. A prospective study on children with chronic mouth breathing and having endoscopic nasal examination was conducted. Digital images obtained during endoscopic examination were evaluated with the traditional method and the MGAS. Adenoid size was also evaluated by intraoperative nasal endoscopy among those underwent adenoidectomy. One hundred and thirty patients were enrolled. The MAGS showed high inter-rater reliability with a Kappa score of 0.869. Sixty of 130 patients underwent adenoidectomy and assessed with intraoperative nasal endoscopy. The MAGS significantly correlated to the percentage of nasopharyngeal obstruction of intraoperative endoscopy (Spearman's r = 0.796, gamma coefficient = 0.94), and the percentage of choanal obstruction of preoperative endoscopy (Spearman's r = 0.816, gamma coefficient = 0.859). Our findings suggest that the MAGS has high reliability and validity for assessment of adenoid size. It may be a more suitable and reliable grading system for endoscopic evaluation of adenoid size.
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Lin Y, Wang M, Xiao Z, Jiang Z. Hypoxia activates SUMO-1-HIF-1α signaling pathway to upregulate pro-inflammatory cytokines and permeability in human tonsil epithelial cells. Life Sci 2021; 276:119432. [PMID: 33794253 DOI: 10.1016/j.lfs.2021.119432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/09/2021] [Accepted: 03/16/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Adenoid hypertrophy (AH) can cause harmful effects on untreated children, which include mouth breathing, chronic intermittent hypoxia, sleep disordered breathing (SDB), and even some behavioral problems. However, the molecular mechanisms underlying this pathophysiological process have remained poorly understood. METHODS In this study, SUMO was induced silencing and overexpression using RNAi and lentiviral-mediated vector. FITC-Dextran and TEER were performed to examine the role of SUMO in cell permeability. Co-immunoprecipitation (Co-IP) assay was performed to examine the interaction between SUMO1 and HIF-1α. Immunohistochemistry staining was used to examine the expressions of ZO-1, Claudin-1 and occluding respectively. RESULTS We found that a hypoxic condition caused a dramatic upregulation of SUMO-1 expression in a time-dependent manner, a member of the ubiquitin-like protein family. Knockdown of SUMO-1 deeply suppressed the secretions of pro-inflammation cytokines including IL-6, IL-8, and TNF-α, and decreased the permeability of HTECs. Moreover, the HIF-1α inhibitor 2-MeOE2 abolished the function of SUMO-1 in HTECs. Furthermore, results obtained from CO-IP had suggested that SUMO-1 interacted with HIF-1α, and prevented its ubiquitination and degradation in HTECs by sumoylating. Importantly, our data showed that hypoxia-induced inflammation was markedly inhibited by M2 macrophages that possess potent anti-inflammatory function. CONCLUSION Our results suggest that selectively inhibiting the SUMO-1-HIF-1α signaling pathway leads to anti-inflammatory responses in human tonsil epithelial cells, which might be a novel therapeutic approach for managing hypoxia-induced SDB resulting from AH.
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Affiliation(s)
- Yan Lin
- Department of Pediatrics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Mingjing Wang
- Department of Pediatrics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Zhen Xiao
- Department of Pediatrics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
| | - Zhiyan Jiang
- Department of Pediatrics, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
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Feng X, Chen Y, Hellén-Halme K, Cai W, Shi XQ. The effect of rapid maxillary expansion on the upper airway's aerodynamic characteristics. BMC Oral Health 2021; 21:123. [PMID: 33731068 DOI: 10.1186/s12903-021-01488-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/04/2021] [Indexed: 12/20/2022] Open
Abstract
Background The effect of rapid maxillary expansion (RME) on the upper airway (UA) has been studied earlier but without a consistent conclusion. This study aims to evaluate the outcome of RME on the UA function in terms of aerodynamic characteristics by applying a computational fluid dynamics (CFD) simulation. Methods This retrospective cohort study consists of seventeen cases with two consecutive CBCT scans obtained before (T0) and after (T1) RME. Patients were divided into two groups with respect to patency of the nasopharyngeal airway as expressed in the adenoidal nasopharyngeal ratio (AN): group 1 was comprised of patients with an AN ratio < 0.6 and group 2 encompassing those with an AN ratio ≥ 0.6. CFD simulation at inspiration and expiration were performed based on the three-dimensional (3D) models of the UA segmented from the CBCT images. The aerodynamic characteristics in terms of pressure drop (ΔP), maximum midsagittal velocity (Vms), and maximum wall shear stress (Pws) were compared by paired t-test and Wilcoxon test according to the normality test at T0 and T1. Results The aerodynamic characteristics in UA revealed no statistically significant difference after RME. The maximum Vms (m/s) decreased from 2.79 to 2.28 at expiration after RME (P = 0.057). Conclusion The aerodynamic characteristics were not significantly changed after RME. Further CFD studies with more cases are warranted.
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Wang W, Fan X, Huang X, Yan J, Luan J. Serologic false-positive reactions for syphilis in children of adenoidal hypertrophy:2 case reports and review of the literature. Acta Clin Belg 2021; 76:70-74. [PMID: 31368864 DOI: 10.1080/17843286.2019.1649081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Adenoid hypertrophy (AH) is a common disease in children. We describe two cases of AH in children with syphilis enzyme-linked immunosorbent assay (EIA) for false-positive. To our knowledge, there are few reports of false-positive in syphilis EIA in children with AH. Two cases of AH children with syphilis EIA positive samples were confirmed by TPPA and LIA, both showed negative reaction. Therefore, the occurrence of syphilis EIA positive reactions in such diseases should dramatically arouse the attention of docimasters and doctors so as to avoid misdiagnosis caused by false-positive in children with AH.
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Affiliation(s)
- Wei Wang
- Jinling Hospital Department of Blood Transfusion, Nanjing University, School Medicine, Nanjing, China
| | - Xuzhou Fan
- Jinling Hospital Department of Blood Transfusion, Nanjing University, School Medicine, Nanjing, China
| | - Xuelian Huang
- Jinling Hospital Department of Blood Transfusion, Nanjing University, School Medicine, Nanjing, China
| | - Jingmei Yan
- Jinling Hospital Department of Blood Transfusion, Nanjing University, School Medicine, Nanjing, China
| | - Jianfeng Luan
- Jinling Hospital Department of Blood Transfusion, Nanjing University, School Medicine, Nanjing, China
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Jia MY, Zou SZ, Li JR. [Study on the relationship between adenoid and tonsil hypertrophy and obesity in children]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 55:760-763. [PMID: 32791774 DOI: 10.3760/cma.j.cn115330-20200310-00179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the relationship between adenoid hypertrophy, tonsillar hypertrophy and overweight or even obesity in children. Methods: A total of 799 children aged 2 to 12 years with tonsillar and adenoid hypertrophy from January 2015 to December 2019 in the Department of Otolaryngology Head Neck Surgery, the Sixth Medical Center of Chinese PLA General Hospital were selected. The body mass index (BMI) was calculated according to the height and weight measured routinely at the time of admission. The difference of BMI between children and normal children of the same age, and the correlation between adenoid, tonsil hypertrophy and obesity were compared. Chi-square test was used to compare the surgical children's BMI of different genders with normal children of the same age, and Spearman rank correlation was used to analyze the correlation between BMI and adenoid and tonsil hypertrophy. Results: The Spearman correlation coefficient between tonsil hypertrophy and BMI was 0.078, P=0.077, the Spearman correlation coefficient between adenoid hypertrophy and BMI was -0.058(P=0.100). χ(2) test showed that the proportion of overweight and obesity in school-age children (7~12 years old) was significantly higher than that in preschool children (2~6 years old), and the difference was statistically significant (χ(2)(male)=22.386, P(male)<0.001, χ(2)(female)=4.478, P(female)<0.001). Conclusion: There is no obvious correlation between adenoid hypertrophy, tonsil hypertrophy and overweight or obesity in children, but the probability of children overweight or obesity increases with age, and the proportion of obesity in children aged 7-12 years is higher.
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Affiliation(s)
- M Y Jia
- The Sixth Medical center of Chinese PLA General Hospital, College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100048, China
| | - S Z Zou
- The Sixth Medical center of Chinese PLA General Hospital, College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100048, China
| | - J R Li
- The Sixth Medical center of Chinese PLA General Hospital, College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100048, China
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Dziekiewicz M, Cudejko R, Banasiuk M, Dembiński Ł, Skarżyński H, Radzikowski A, Banaszkiewicz A. Frequency of gastroesophageal reflux disease in children with adenoid hypertrophy. Int J Pediatr Otorhinolaryngol 2020; 138:110304. [PMID: 32828019 DOI: 10.1016/j.ijporl.2020.110304] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/01/2020] [Accepted: 08/04/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Recent studies have suggested that the reflux of gastric contents can cause adenoid hypertrophy (AH). The frequency of gastro-oesophageal reflux disease (GERD) in this AH population is unknown, but according to studies using pH-metry it may be as high as 65%. The aim of this study was to estimate the frequency of GERD among children with AH. METHODS This was a cross-sectional, multicentre, prospective study of children with AH selected for adenoidectomy. The diagnosis of AH was made by a single laryngologist using a flexible fiberscope. All children had 24-hr multichannel intraluminal pH-impedance (MII/pH) assessment. A GERD diagnosis was made using BioVIEW software analysis after manual review by a single investigator. RESULTS 38 consecutive patients (21 males, mean age 6.58 years) were enrolled in the study. GERD was diagnosed in 5 (13.2%) patients. A total of 1462 gastro-oesophageal reflux events (GERs) were detected by MII/pH and the majority (60.9%) were acidic. The only significant differences between the GERD-positive and GERD-negative groups were the total number of GERs, and the number of acid GERs. CONCLUSION It is first study using MII/pH to assess the frequency of GERD in children with AH. The data suggest that GERD in children with AH seems to be not as common as it was previously raised. Further studies are needed to confirm these results.
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Affiliation(s)
- Marcin Dziekiewicz
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Zwirki I, Wigury 63A, 02-091, Warsaw, Poland.
| | - Renata Cudejko
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Mokra 17, Kajetany, 05-830, Nadarzyn, Poland
| | - Marcin Banasiuk
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Zwirki I, Wigury 63A, 02-091, Warsaw, Poland
| | - Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Zwirki I, Wigury 63A, 02-091, Warsaw, Poland
| | - Henryk Skarżyński
- Institute of Physiology and Pathology of Hearing, World Hearing Center, Mokra 17, Kajetany, 05-830, Nadarzyn, Poland
| | - Andrzej Radzikowski
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Zwirki I, Wigury 63A, 02-091, Warsaw, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Zwirki I, Wigury 63A, 02-091, Warsaw, Poland
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Ras AE, Hamed MH, Abdelalim AA. Montelukast combined with intranasal mometasone furoate versus intranasal mometasone furoate; a comparative study in treatment of adenoid hypertrophy. Am J Otolaryngol 2020; 41:102723. [PMID: 32950830 DOI: 10.1016/j.amjoto.2020.102723] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/07/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To evaluate the role of combined therapy using montelukast and intranasal mometasone furoate compared to intranasal mometasone furoate alone in treatment of adenoid hypertrophy regarding efficacy and recurrence rate. METHODS The study included 100 children with adenoid hypertrophy, they were randomly assigned to two groups. Group I (50 patients) received combined therapy using montelukast and mometasone furoate nasal spray. Group II (50 patients) received only mometasone furoate nasal spray. Patients were treated for 3 months and observed for 3 months after stoppage of treatment. Patients were evaluated using symptoms scores, Adenoid/Nasopharyngeal ratio and endoscopic grading of adenoid hypertrophy. RESULTS After 3 months of treatment, group I showed significant better scores of main symptoms than group II; (P = 0.001), (P = 0.019) and (P = 0.008) for rhinorrhea, mouth breathing and snoring respectively. The mean A/N ratio was 52.8 ± 11.3 in group I better than 62.88 ± 12.10 in group II (P < 0.001). Regarding the adenoid hypertrophy grading, significant reduction in size was found in group I in 34 (68%) patients better than in group II in 18 (36%) patients (P = 0.001). After further 3 months of follow up, the mean A/N ratio was 58.46 ± 10.05 in group I better than 66.36 ± 10.46 in group II (P < 0.001). Recurrence occurred in 8 (23.5%) cases out of 34 improved cases in group I better than 10 (55.5%) cases out of 18 cases in group II (P = 0.02). CONCLUSION Combining oral montelukast with intranasal mometasone in treatment of adenoid hypertrophy provided better improvements and less recurrence in comparison with single therapy using intranasal mometasone alone.
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Abstract
OBJECTIVES To determine the reliability of ultrasound in the diagnosis of adenoid hypertrophy in children. METHODS The subjects were divided into three groups: Group A: Pre-experiment group: 30 children who were hospitalized for adenoidal hypertrophy were selected, and preoperative ultrasound was used to measure adenoid thickness. Their re-confirmed Adenoid ultrasound measurement thickness was obtained during surgery under the guidance of metal instruments; Group B: Ultrasound screening group: 1898 children aged 3-12 y were selected, and their adenoids were examined by ultrasonography to observe the size, shape, echo and blood flow of adenoids and the thickness of adenoids; Group C: Surgical resection group: 133 hospitalized patients were selected, and their adenoid ultrasound measurement thickness (AUT), the adenoid-nasopharynx (A/N) ratio was calculated based on nasopharyngeal lateral radiographs and obstruction ratio was obtained in electronic nasopharyngoscopy [extent of adenoid-posterior nostril occlusion (EANC)] were compared. RESULTS In Group A, there was no statistical difference in the measurements of the adenoids between the preoperative ultrasound and the ultrasound measurements under the guidance of intraoperative metal instruments (P > 0.05). In Group B, the adenoids of 1898 children aged 3-12 y were measured and were found thickest at 6 y, with an average of 5.035 ± 0.0609 mm. There was no statistical difference in adenoid thickness between boys and girls (P > 0.05). In Group C, there was a linear correlation between AUT and A/N ratio (r = 0.999, P = 0.01) and between AUT and EANC (r = 0.950, P = 0.000). CONCLUSIONS In children between 3 and 12 y of age, AUT greater than 6 mm may be considered for surgical resection of adenoid hypertrophy.
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Alimoglu Y, Altin F, Yorguner NE, Acikalin RM, Yasar H. Predicting the outcome after adenoidectomy-alone for adenoid hypertrophy causing sleep disordered breathing. Am J Otolaryngol 2020; 41:102646. [PMID: 32688182 DOI: 10.1016/j.amjoto.2020.102646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 06/30/2020] [Accepted: 07/04/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE By using preoperative parameters age, body mass index, nasopharyngeal obstruction as assessed using flexible videonasopharyngoscopy, and quality of life scores in patients undergoing adenoidectomy-alone because of adenoid hypertrophy causing sleep disordered breathing, we aimed to examine the relationship between the change in quality of life scores, and preoperative parameters and to develop a tool to predict the change. MATERIALS AND METHODS Patients who were scheduled for adenoidectomy-alone in a 12-month period were included. Flexible videnonasopharyngoscopy of the nasopharynx was performed. Nasopharyngeal obstruction was measured by using Image J software. Preoperative quality of life was evaluated using OSA-18 quality of life survey. OSA-18 survey has 5 subcategories consisting of sleep disturbance (O1), physical suffering (O2), emotional distress (O3), daytime problems (O4), caregiver concerns (O5). A question about the overall quality of life(O6) was added. Postoperative OSA-18 domain scores were obtained at the 3-month-follow-up. Preoperative OSA-18 subscores were compared to postoperative subscores. Linear regression analysis to predict the proportional change in OSA-18 subscores was performed. RESULTS Our study group consisted of 94 cases. Mean postoperative O1, O2,O3, O4 and O5 scores were significantly lower compared to the preoperative scores. Mean postoperative O6 score was significantly higher. Linear regression analysis was carried out for predicting change in O1(r2 = 0.686; p = 0.006), O5(r2 = 0.711; p = 0.003) and O6(r2 = 0.757; p = 0.001). CONCLUSION Change in quality of life scores for sleep disturbance, physical suffering and general quality of life may be predicted by using preoperative parameters.
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Tulaci KG, Arslan E, Tulaci T, Dinek A, Yazici H. Comparison of transnasal and transoral routes of microdebrider combined curettage adenoidectomy and assessment of endoscopy for residue: a randomized prospective study. Eur Arch Otorhinolaryngol 2020; 278:797-805. [PMID: 32989492 DOI: 10.1007/s00405-020-06385-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study is to investigate the frequency and locations of residual adenoid tissue in conventional curettage adenoidectomy (CA) via transnasal endoscopic examination at the end of the operation and to determine the most appropriate technique for residual adenoid tissue removal by transoral or transnasal microdebrider usage. METHODS Sixty-three patients aged 4-12 years who were scheduled for CA were included in this randomized prospective study in a tertiary reference center. Patients who underwent CA had the endoscopic residual tissue exploration at the end of surgery. The amount and locations of residual tissue were recorded. Patients with > 20% residual tissue were divided into two groups according to randomization list for removing the residual tissue, depending on the use of transoral microdebrider (TOMD) and transnasal microdebrider (TNMD). Two procedures were compared in terms of duration, bleeding, pain, post-anesthesia care unit (PACU) transfer time, and complications. RESULTS Residual tissue was detected in 38 patients (60.2%). The most common location of residual tissue was peritubal area (41.3%). The TOMD group had lower surgical duration, blood loss, pain scores and shorter PACU transfer time (p = 0.001, p = 0.002, p˂0.001, and p = 0.006, respectively). CONCLUSION Endoscopic exploration at the end of CA should be considered to avoid residual tissue retention. Furthermore, if residual tissue is present, the use of TOMD is easier, faster, and associated with lower morbidity than the use of TNMD.
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Affiliation(s)
- Kamil Gokce Tulaci
- Departments of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University Health Practice and Research Hospital, 10440, Cagis, Balikesir, Turkey.
| | - Erhan Arslan
- Departments of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University Health Practice and Research Hospital, 10440, Cagis, Balikesir, Turkey
| | - Tugba Tulaci
- Departments of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University Health Practice and Research Hospital, 10440, Cagis, Balikesir, Turkey
| | - Aziz Dinek
- Departments of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University Health Practice and Research Hospital, 10440, Cagis, Balikesir, Turkey
| | - Hasmet Yazici
- Departments of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University Health Practice and Research Hospital, 10440, Cagis, Balikesir, Turkey
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Sogebi OA, Oyewole EA, Ogunbanwo O. Asymptomatic Otitis Media With Effusion in Children With Adenoid Enlargement. J Natl Med Assoc 2020; 113:158-164. [PMID: 32838976 DOI: 10.1016/j.jnma.2020.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To estimate the burden, and clinical factors associated with development of Otitis media with effusion (OME) in children with enlarged adenoids. METHODS Consecutive eligible patients with adenoid (sometimes with tonsillar) enlargement managed operatively in a period of five years. Patients had no complaints suggestive of hearing impairment. Age, sex, clinical diagnosis, and weight of patients were recorded. Otoscopic, audiometric, and radiological examinations findings were recorded. Tympanometry patterns were classified according to Jerger's classification; type B and C tympanograms represented OME. Some patients had Pure Tone Audiometry (PTA). Plain nasopharyngeal X-ray assessed the adenoid: nasopharyngeal (AN) ratio with >0.5 regarded as obstructive adenoid. RESULTS 216 ears of 108 children were assessed. 49.1% of children were in age range 1-3 years, mean 3.6 ± 2.6 years. 62.0% were males, weight ranged from 7.8 to 31.0 kg, mean was 14.3 ± 5.2 kg. 63.9% had associated tonsillar enlargement. Mean AN ratio was 0.69 ± 0.07. Tympanometric findings showed prevalence of OME in all ears was 63/216 = 29.2%, consisting of 30.5% with unilateral (Right ear 19.4%, Left ear 11.1%), and 13.9% with bilateral OME. Acoustic reflexes were absent in both ears in 32 (29.6%) of the patients. There was normal hearing in 16/38 ears (42.1%), while others had different types of hearing loss. Two factors namely increased age and weight were significantly associated with OME in patients with Adenoid enlargement. CONCLUSIONS 29.2% of children with adenoid enlargement had a co-morbidity of asymptomatic OME. The factors associated with OME were increased age and weight of the patients.
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Affiliation(s)
- Olusola Ayodele Sogebi
- Department of Ear, Nose and Throat, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
| | - Emmanuel Abayomi Oyewole
- Department of Ear, Nose and Throat, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | - Olatundun Ogunbanwo
- Department of Ear, Nose and Throat, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
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Zelazowska-Rutkowska B, Skotnicka B, Cylwik B. Vascular endothelial growth factor and transforming growth factor β in hypertrophic adenoids in children suffering from otitis media with effusion. Cytokine 2020; 133:155125. [PMID: 32438279 DOI: 10.1016/j.cyto.2020.155125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The study objective was to assess the levels of VEGF-A and TGF-β cytokines in the children with adenoid hypertrophy concomitant with exudative otitis media (OME) and in children with adenoid hypertrophy (HA) alone. METHODS The study material consisted of hypertrophic adenoids removed during adenoidectomy from 39 children (20 girls and 19 boys), aged 2-7 years suffering from OME. The reference group included 41 children (19 girls and 22 boys), aged from 3 to 9 years with adenoid hypertrophy. The levels of VEGF-A and TGF-β were determined in supernatants obtained from phytohemagglutinin-stimulated cell cultures of the adenoids using a commercial enzyme-linked immunosorbent assay kit. RESULTS The median VEGF-A and mean TGF-β concentrations in the study group were significantly higher than those in the reference group (503 pg/mL versus 201 pg/mL, P < 0.001 and 224 pg/mL versus 132 pg/mL, P < 0.001, respectively). ROC analysis revealed that the area under the curve (AUC) for VEGF-A was 0.952 with diagnostic sensitivity and specificity of 95%, whereas for TGF-β it was 0.902 with 60% sensitivity and the same specificity as for VEGF-A. There was no significant difference between the AUC for VEGF-A and TGF-β (P = 0.573). CONCLUSIONS The changes in the levels of VEGF-A and TGF-β may indicate bacterial pathogen as one of the causes of exudative otitis media in children. Determination of VEGF-A and TGF-β could be used as additional and objective tests to confirm the clinical diagnosis.
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Affiliation(s)
| | - Bozena Skotnicka
- Department of Pediatric Otolaryngology, Medical University of Bialystok, Poland
| | - Bogdan Cylwik
- Department of Pediatric Laboratory Diagnostics, Medical University of Bialystok, Poland
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Pawłowska-Seredyńska K, Umławska W, Resler K, Morawska-Kochman M, Pazdro-Zastawny K, Kręcicki T. Craniofacial proportions in children with adenoid or adenotonsillar hypertrophy are related to disease duration and nasopharyngeal obstruction. Int J Pediatr Otorhinolaryngol 2020; 132:109911. [PMID: 32032918 DOI: 10.1016/j.ijporl.2020.109911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/25/2020] [Accepted: 01/27/2020] [Indexed: 01/17/2023]
Affiliation(s)
| | - Wioleta Umławska
- Department of Human Biology, University of Wroclaw, Ul. Kuźnicza 35, 50-138, Wroclaw, Poland
| | - Katarzyna Resler
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
| | - Monika Morawska-Kochman
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
| | - Katarzyna Pazdro-Zastawny
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
| | - Tomasz Kręcicki
- Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland
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Huang H, Zhang L, Zhang Q, Zhong J, Fu L, Mou Y. Comparison of the efficacy of two surgical procedures on adenoidal hypertrophy in children. Arch Pediatr 2019; 27:72-78. [PMID: 31791828 DOI: 10.1016/j.arcped.2019.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 08/06/2019] [Accepted: 11/11/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The aim of this study was to explore the treatment effects of two surgical procedures, performed with nasal endoscopy, on treating adenoidal hypertrophy in children. METHODS A total of 100 children diagnosed with adenoidal hypertrophy were treated with curettage combined with microwave thermocoagulation and with low-temperature plasma radiofrequency ablation under nasal endoscopic guidance; 6 months after surgery, the effects on snoring, nasal congestion, hearing loss, and gland residue were retrospectively analyzed. RESULTS Differences in snoring and hearing loss between the two groups were not statistically significant (P>0.05), but the differences in nasal congestion and gland residue between the two groups were statistically significant (P<0.05); the therapeutic effect was superior in the low-temperature plasma radiofrequency ablation group than in the curettage combined with microwave thermocoagulation group. CONCLUSION Low-temperature plasma radiofrequency ablation with nasal endoscopy can achieve a better comprehensive effect on treating adenoidal hypertrophy in children than curettage combined with microwave thermocoagulation.
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Affiliation(s)
- H Huang
- Chengdu University of TCM, Chengdu, Sichuan Province, China; Department of ENT, Sichuan Provincial Integrated Traditional Chinese and Western Medicine Hospital, Chengdu, Sichuan Province, China.
| | - L Zhang
- Department of Aesthetic and Plastic Surgery, Affiliated Hospital of Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Q Zhang
- Department of ENT & HN, Affiliated Hospital of Chengdu University of TCM, Chengdu, Sichuan Province, China.
| | - J Zhong
- Chengdu University of TCM, Chengdu, Sichuan Province, China; Department of ENT & HN, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - L Fu
- Chengdu University of TCM, Chengdu, Sichuan Province, China; Department of ENT & HN, Affiliated Hospital of Chengdu University of TCM, Chengdu, Sichuan Province, China
| | - Y Mou
- Chengdu University of TCM, Chengdu, Sichuan Province, China
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Xiao H, Huang J, Liu W, Dai Z, Peng S, Peng Z, Liang R, Ma R, Wen Y, Li J, Wen W. The cost-effectiveness analysis of drug therapy versus surgery for symptomatic adenoid hypertrophy by a Markov model. Qual Life Res 2019; 29:629-638. [PMID: 31782019 PMCID: PMC7028839 DOI: 10.1007/s11136-019-02374-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2019] [Indexed: 12/26/2022]
Abstract
Purpose Adenoid hypertrophy (AH) is common among young children. Adenoid-based surgery and drug therapy could be applied for symptomatic AH patients, yet the treatment decision is difficult to make due to the diverse cost and efficacy between these two treatments. Methods A Markov simulation model was designed to estimate the cost-effectiveness (CE) of the adenoid-based surgery and the drug therapy for symptomatic AH patients. Transition probabilities, costs and utilities were extracted from early researches and expert opinions. Simulations using two set of parameter inputs for China and the USA were performed. Primary outcome was cost per QALY gained over a 6-year period. Deterministic and probabilistic sensitivity analyses were also conducted. Results The utility for the surgery group and the drug group were 4.10 quality-adjusted life years (QALYs) and 3.58 QALYs, respectively. The cost of the surgery group was more than that of the drug group using model parameters specific to China ($1069.0 vs. $753.7) but was less for the USA ($1994.4 vs. $3977.7). Surgery was dominant over drug therapy when US specific parameters were used. Surgery group had an ICER of $604.0 per QALY when parameters specific to China was used. Conclusion Surgery is cost-effective in the simulations for both China and the USA at WTP thresholds of $9633.1 and $62,517.5, respectively. Electronic supplementary material The online version of this article (10.1007/s11136-019-02374-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Han Xiao
- Division of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jinqiang Huang
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Weifeng Liu
- Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zihao Dai
- Department of Liver Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Sui Peng
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhenwei Peng
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ruiming Liang
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Renqiang Ma
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yihui Wen
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Li
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| | - Weiping Wen
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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Abdel-Aziz M, El-Fouly M, Elmagd EAA, Nassar A, Abdel-Wahid A. Adenoid hypertrophy causing obstructive sleep apnea in children after pharyngeal flap surgery. Eur Arch Otorhinolaryngol 2019; 276:3413-3417. [PMID: 31520163 DOI: 10.1007/s00405-019-05633-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/03/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Pharyngeal flap surgery used for treatment of velopharyngeal insufficiency (VPI) may be followed by obstructive sleep apnea (OSA) especially if the patient has developed adenoid hypertrophy. However, adenoidectomy may adversely affect speech in these patients. The aim of this study was to assess the effectiveness of transnasal endoscopic power-assisted adenoidectomy in relieving OSA in patients with adenoid hypertrophy who underwent pharyngeal flap surgery, and the impact of the procedure on their speech. METHODS Transnasal endoscopic power-assisted adenoidectomy for nine children presenting with adenoid hypertrophy was performed. The patients had previously undergone pharyngeal flap surgery for treatment of VPI. Flexible nasopharyngoscopy was used in the diagnosis of adenoid hypertrophy. Pre- and postoperative polysomnography with measurement of apnea-hypopnea index (AHI) was done. Additionally, auditory perceptual assessment of speech (APA) and nasalance scores was measured pre- and postoperatively. RESULTS All patients were shown to have OSA by polysomnography, and a larger adenoid size was significantly associated with a higher AHI. We achieved a significant improvement in AHI after adenoidectomy. However, six patients still demonstrated OSA, albeit with a reduced severity. Speech was not adversely affected postoperatively as the APA and nasalance scores showed non-significant changes. CONCLUSION Adenoid hypertrophy may be encountered in children who undergo pharyngeal flap surgery, which may cause OSA. Transnasal endoscopic power-assisted adenoidectomy is a safe and effective method for treatment of OSA in those patients without prejudicing the pharyngeal flap, and it has no adverse effect on speech.
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Affiliation(s)
- Mosaad Abdel-Aziz
- Department of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Mahmoud El-Fouly
- Department of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Ahmed Nassar
- Department of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Assem Abdel-Wahid
- Department of Otolaryngology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
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Yang W, Zhao Y, Wang J, Yan XH, Shen T, Qiao Y, Ren J, Cheng D, Chen M. Peripheral blood immunological parameters of children with adenoid hypertrophy with otitis media with effusion: propensity score matching. Eur Arch Otorhinolaryngol 2019; 276:3073-80. [PMID: 31471654 DOI: 10.1007/s00405-019-05610-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/16/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE To evaluate peripheral blood immunological parameters and the possible correlation with age, gender and adenoid size in children with adenoid hypertrophy with OME. METHODS A total of 664 children with adenoid hypertrophy were initially enrolled in our study, of which 83 had concomitant OME. To minimize selection bias, we performed one to two propensity score matching (PSM) between children with and without OME. After PSM, 80 children with OME (OME group) and 157 children without OME (adenoid hypertrophy [AH] group) were selected. The patients' peripheral blood samples were prepared prior to surgery and their immunological parameters were compared between groups. RESULTS Compared to the AH group, the serum level of C3 was significantly higher in the OME group (0.88 ± 0.01 g/L vs. 0.94 ± 0.02 g/L; p = 0.014), which was the only independent risk factor for OME (odds ratio 13.58, 95% confidence interval 1.25-147.99; p = 0.032). However, no such difference was seen for serum immunoglobulin (IgG, IgA, IgM, IgE), T cell subsets (CD3+, CD4+ and CD8+ T cells), or lymphocytes and monocytes. Further subgroup analyses showed that in children ≤ 5 years old, the C3 level was significantly higher in OME patients (p = 0.023). A subgroup analysis based on sex indicated that there was a significantly higher level of serum C3 (p = 0.009) and lower CD3+ and CD4+ T cells (p = 0.010 and p = 0.021, respectively) in girls with OME compared to those without OME. No association between immunological parameters and adenoid size was found. CONCLUSIONS There were no significant differences in cellular immunology and humoral immune indicators in children with adenoid hypertrophy with or without OME. In children ≤ 5 years old, significantly higher serum C3 levels in patients with OME demonstrate excessively activated C3 in comparison to patients without OME. For girls, a higher serum level of C3 with a lower amount of CD3+ and CD4+ T cells may be associated with OME.
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Durgut O, Dikici O. The effect of adenoid hypertrophy on hearing thresholds in children with otitis media with effusion. Int J Pediatr Otorhinolaryngol 2019; 124:116-119. [PMID: 31176025 DOI: 10.1016/j.ijporl.2019.05.046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/24/2019] [Accepted: 05/30/2019] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Otitis media with effusion is common middle ear mucosa disease that can cause hearing loss in children. Adenoid hypertrophy can cause recurrent acute otitis media in addition to otitis media with effusion as a result of eustachian tube dysfunction and primary infection focus. The aim of this study was to investigate the effect of adenoid hypertrophy on the hearing threshold in children suffering from otitis media with effusion. METHODS Children of school age with otitis media with effusion were included in the study. The size and location of the adenoid tissue were determined by examination with a flexible endoscope. Four adenoid size groups were determined according to the percentage of choanal closure. The coverage was 0-25% in the first group, 26-50% in the second group, 51-75% in the third group and 76-100% in the 4th group. The location of the adenoid tissue in the nasopharynx was divided into three groups. In group A, the adenoid tissue was not in contact with torus tubarius. In group B, the adenoid tissue was in contact with the torus tubarius but did not cover it. In group C, the adenoid tissue covered the torus tubarius completely. Bone and air conduction thresholds were determined using standard procedures. The statistical relationship between the size and location of adenoid tissue and the hearing thresholds was investigated. RESULTS The study was conducted with the 88 ears of 50 children aged 5-15 years. The median values of mean air conduction thresholds at 500 Hz, 1000 Hz, and 2000 Hz in the adenoid tissue size groups 1-4 were 22 dB HL, 20 dB HL, 15 dB HL, and 20 dB HL respectively. The median values of the mean air conduction thresholds were 20 dB HL, 20 dBHL and 18 dB HL in the adenoid location group A-C, respectively. No significant correlation was found between the groups (p:0.213) and the relevant hearing values (p:0.670). Type B tympanogram was identified in 46 ears and type C tympanogram in 42 ears. The mean hearing thresholds were significantly higher in the ears with a type B tympanogram in the otitis media with effusion cases. (P < 0.001).There was no significant correlation between the duration of effusion and the adenoid size (p:0.931), adenoid location (p:0.626) and hearing threshold (p:0.815). CONCLUSION We concluded that adenoid tissue size and location have no effect on hearing thresholds and the duration of effusion in otitis media with effusion. We suggest caution before deciding on adenoidectomy in otitis media with effusion cases. Adenoidectomy should not be performed in children over 4 years of age unless there is a definite indication such as nasal obstruction or chronic adenitis.
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Affiliation(s)
- Osman Durgut
- Health Science University, Bursa Yuksek Ihtisas Training and Research Hospital, Turkey.
| | - Oğuzhan Dikici
- Health Science University, Bursa Yuksek Ihtisas Training and Research Hospital, Turkey
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Ghafar MHA, Mohamed H, Mohammad NMY, Mohammad ZW, Madiadipoera T, Wang DY, Abdullah B. Mometasone furoate intranasal spray is effective in reducing symptoms and adenoid size in children and adolescents with adenoid hypertrophy. Acta Otorrinolaringol Esp (Engl Ed) 2019; 71:147-153. [PMID: 31400807 DOI: 10.1016/j.otorri.2019.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/14/2019] [Accepted: 04/26/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The use of mometasone furoate (MF) intranasal spray in treating adenoid hypertrophy (AH) has a variable outcome due the different methods of adenoid size evaluation. The aim of our study was to evaluate the effect of MF intranasal spray in children and adolescents with AH using a reliable and consistent endoscopic evaluation. MATERIAL AND METHOD A prospective interventional study was conducted. Evaluation took place during the first visit (week 0) and second visit (week 12). Symptoms of nasal obstruction, rhinorrhoea, cough and snoring were assessed, and an overall total symptoms score was obtained. A rigid nasoendoscopic examination using a four-grading system of adenoid size from 1 to 4 was performed. Patients were treated with MF intranasal spray for 12 weeks. Patients' aged 7-11-years old used 1 spray in each nostril once daily, while patients aged 12-17 used two sprays in each nostril once daily. Reassessment was carried out during the second visit (week 12). RESULTS A total of 74 patients was recruited. There were significant improvements from week 0 to week 12 in the symptoms' score for nose obstruction, rhinorrhoea, cough, snoring including the total nasal symptoms' score (p<0.001). AH significantly reduced in size from week 0 (2.89±.87) to week 12 (1.88±.83) (p<0.001). CONCLUSION MF intranasal spray is effective in improving the symptoms attributed to AH as well as reducing the adenoid size. MF intranasal spray is advocated as a treatment option before adenoidectomy is considered.
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Affiliation(s)
- Muhammad Hazim Abdul Ghafar
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Hazama Mohamed
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Nik Mohd Yunus Mohammad
- Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Zahiruddin Wan Mohammad
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Teti Madiadipoera
- Department of Otorhinolaryngology, Hasan Sadikin Hospital, Faculty of Medicine, Padjadjaran University, Indonesia
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Baharudin Abdullah
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
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Jain G, Barik AK, Banerjee A, S N, Chug A. Airway challenges in bilateral temporomandibular joint ankylosis with adenoid hypertrophy: a case report. J Oral Biol Craniofac Res 2019; 9:256-258. [PMID: 31245271 DOI: 10.1016/j.jobcr.2019.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 06/12/2019] [Indexed: 11/25/2022] Open
Abstract
Temporomandibular joint ankylosis is one of the most challenging airway disorders associated with varying anatomical abnormalities like adenotonsillar hypertrophy, craniofacial malformations, macroglossia, etc. This case highlights the intubation difficulties confronted during the airway management of a 10-year-old girl presenting lately with bilateral temporomandibular joint ankylosis, hypoplastic mandible, and adenoid hypertrophy. This patient was intubated successfully by using a suction catheter assembly to negotiate the endotracheal tube across the adenoid, and an unmatched-size flexible intubation fiberscope through a "separate insertion" technique and external laryngeal manipulation. This case emphasises the significance of a comprehensive preoperative evaluation in preparing the anaesthetic plan of an anticipated difficult airway in a paediatric population, having diverse anatomical hurdles presenting concurrently.
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Affiliation(s)
- Gaurav Jain
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India
| | - Amiya Kumar Barik
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India
| | - Amrita Banerjee
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India
| | - Naveen S
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India
| | - Ashi Chug
- Department of Dentistry and Craniomaxillofacial Surgery, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India
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Abstract
OBJECTIVE To assess the relationship between mouth breathing and growth disorders among children and teenagers. DATA SOURCE Search on MEDLINE database, over the last 10 years, by using the following terms: "mouth breathing", "adenotonsilar hypertrophy", "allergic rhinitis", "sleep disturbance" AND "growth impairment", "growth hormone", "failure to thrive", "short stature", or "failure to thrive". DATA SUMMARY A total of 247 articles were identified and, after reading the headings, this number was reduced to 45 articles, whose abstracts were read and, of these, 20 were deemed important and were included in the review. In addition of these articles, references mentioned in them and specific books on mouth breathing deemed important were included. Hypertrophy of palatine and/or pharyngeal tonsils, whether associated with allergic rhinitis, as well as poorly controlled allergic rhinitis, are the main causes of mouth breathing in children. Respiratory sleep disorders are frequent among these patients. Several studies associate mouth breathing with reduced growth, as well as with reduced growth hormone release, which are reestablished after effective treatment of mouth breathing (clinical and/or surgical). CONCLUSIONS Mouth breathing should be considered as a potential cause of growth retardation in children; pediatricians should assess these patients in a broad manner.
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Affiliation(s)
- Mario Morais-Almeida
- Centro de Alergia dos Hospitais CUF, Lisbon, Portugal; Sociedade Portuguesa de Alergologia e Imunologia Clínica, Lisbon, Portugal
| | - Gustavo Falbo Wandalsen
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Pediatria, São Paulo, SP, Brazil
| | - Dirceu Solé
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Pediatria, São Paulo, SP, Brazil.
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