MedWorm: Adenoidectomy

Myringoplasty in children with cleft palate and craniofacial anomaly

International Journal of Pediatric Otorhinolaryngology — Tue, 17 Jan 2012 21:16:10 +0100

Abstract: Objectives: Analyze the anatomical and audiological success rates of myringoplasty in children with craniofacial anomaly, cleft palate and compare them to a control group.Methods: Retrospective review of medical records for all children who underwent myringoplasty between 1997 and 2007. The following data was recorded: sex, age, perforation side, size, location and etiology, surgical approach, type of myringoplasty, graft material, season of surgery, preoperative status of the operated and contralateral ear, history of previous otologic surgery, and adenoidectomy or tonsillectomy.Results: Myringoplasty outcomes of 22 craniofacial anomaly patients (15/22 were cleft palate patients) were compared to 144 controls. Children in the craniofacial anomaly group demonstrated a tendency to...

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The effect of adenotonsillectomy on serum insulin like growth factors and the adenoid/nasopharynx ratio in pediatric patients: A blind, prospective clinical study

International Journal of Pediatric Otorhinolaryngology — Tue, 17 Jan 2012 21:16:09 +0100

Conclusions: The results of the present study indicate that adenotonsillectomy could result in the relief of nasopharyngeal obstruction and have a positive effect on growth in children by decreasing the A/N ratio and increasing IGF-I and IGFBP-3. There was no correlation between the ΔA/N ratio and ΔIGF-I and ΔIGFBP-3 levels. (Source: International Journal of Pediatric Otorhinolaryngology)

Laryngeal mask airway versus endotracheal tube in pediatric adenotonsillectomy

The Laryngoscope — Tue, 17 Jan 2012 05:00:00 +0100

Conclusions:Use of the LMA during pediatric tonsil surgery does not appear to have any major disadvantages compared to use of the ETT. In fact, analysis of safety, comfort, complications, and postoperative problems suggests that LMA may be superior for some outcome variables such as coughing and gagging. Use of spontaneous ventilation is more common among LMA patients, although the significance of this finding is uncertain. (Source: The Laryngoscope)

Is Transnasal Endoscopic Examination Necessary Before and After Adenoidectomy?

Indian Journal of Otolaryngology and Head and Neck Surgery — Thu, 05 Jan 2012 17:01:39 +0100

Abstract The present study aimed to investigate the amount of residual adenoid tissue following the conventional adenoidectomy as compared with preoperative values. A total of 32 girls and 44 boys (range, 3–15 years) in whom adenoidectomy procedure was planned were included in the study. Adenoid tissue sizes before adenoidectomy and residual tissue sizes after conventional curettage adenoidectomy were measured by transnasal endoscopic examination and were recorded. Adenoid tissue size before and after adenoidectomy was compared. The mean age of the patients was 7.7 years (range, 3–15 years). Before adenoidectomy grade 4 adenoid tissue was noted in 43.4% (n = 33), grade 3 was noted in 28.9% (n = 22), grade 2 was noted in 25% (n =&n...

The effects of an antistick phospholipid solution on pediatric electrocautery adenoidectomy.

Ear, Nose and Throat Journal — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Baker JC, Ramadan HH Abstract We conducted a study to determine if coating a suction cautery tip with an antistick phospholipid solution would decrease the amount of time required to complete primary pediatric adenoidectomies. The aim of the study was focused on two main criteria: the amount of surgical time required to complete each procedure and the number of times an operation had to be interrupted because the suction cautery tip needed to be cleaned (each interruption was called a "handback"). We obtained data prospectively during 61 pediatric adenoidectomies performed at our institution from February through June 2009. These patients were randomized to undergo surgery either with (n = 31) or without (n = 30) the use of the antistick phospholipid solution (Electro Lube...

The Importance of Early Diagnosis and Appropriate Treatment in Grisel's Syndrome: Report of Two Cases.

Turkish Neurosurgery — Thu, 29 Dec 2011 18:00:03 +0100

We report two cases of Grisel's syndrome which emphasize on the importance of early diagnosis for appropriate and successful treatment. PMID: 22194139 [PubMed - in process] (Source: Turkish Neurosurgery)

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Routine Goes Awry

AORN Journal — Wed, 28 Dec 2011 18:50:27 +0100

A six-year-old girl with a history of asthma and chronic adenotonsillitis was scheduled for a tonsillectomy and adenoidectomy in an ambulatory surgery center. She was in otherwise good health and was experiencing no acute symptoms at the time of surgery. After an uneventful surgery, the patient was extubated and had spontaneous ventilation and stable vital signs. Within an hour, however, the patient became hypoxic, with an inability to ventilate spontaneously, and she required reintubation. The etiology of the need for reintubation was unclear. The patient ultimately recovered with no additional complications and was discharged home. Her parents expressed concern about the safety of what they believed was a routine surgical procedure performed on children every day. (Source: AORN Journal)

Effect Of Adenotonsillectomy In Children With Sleep-Disordered Breathing

Health News from Medical News Today — Wed, 21 Dec 2011 08:00:00 +0100

Children may have a better quality of life (QOL) and diminished cardiovascular disease risk from the decreased endothelin 1 (ET-1) levels after adenotonsillectomy, according to new research published in the December 2011 issue of Otolaryngology - Head and Neck Surgery. SDB is an increasingly common indication for tonsillectomy and adenoidectomy due to obstructive sleep apnea syndrome (OSAS)... (Source: Health News from Medical News Today)

Methicillin-Resistant Staphylococcus aureus Colonization in Otitis-Prone Children [Original Article]

Archives of Otolaryngology — Mon, 19 Dec 2011 05:00:00 +0100

Conclusions The prevalence of MRSA colonization among otitis-prone children was similar to rates reported among the general pediatric community. Methicillin-resistant S aureus colonization at the time of bilateral myringotomy and tube insertion was not predictive of subsequent otorrhea. (Source: Archives of Otolaryngology)

Otitis media with effusion in children: current management

Paediatrics and Child Health — Fri, 16 Dec 2011 18:26:00 +0100

Abstract: Otitis Media with Effusion (OME, ‘glue ear’) is the commonest cause of childhood hearing loss. Because the condition fluctuates, initial management of otitis media with effusion is audiometric confirmation and quantification of any hearing loss involved, explanation to parents or carers and watchful waiting with continued audiometric monitoring.Neither medical treatments nor “complementary/alternative” treatments have been proven to be effective in the management of otitis media with effusion. Insertion of ventilation tubes (grommets) for children over 3 years of age with a bilateral hearing impairment associated with otitis media with effusion, who have failed watchful waiting, is effective in restoring hearing thresholds. The hearing returns to normal almost immediately...

When to remove tonsils and the alternatives

Paediatrics and Child Health — Fri, 16 Dec 2011 18:26:00 +0100

Tonsillectomy is one of the most frequently performed surgical procedures in UK children, accounting for about 20% of all operations performed by otolaryngologists. Tonsillectomy is performed with or without adenoidectomy and involves complete removal of the palatine tonsils including their capsule by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Adenotonsillectomy is performed in the UK only when there is a specific indication to remove the adenoids as well as the tonsils. (Source: Paediatrics and Child Health)

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Harmonic scalpel versus bipolar tonsillectomy: a double-blind clinical trial

European Archives of Oto-Rhino-Laryngology — Mon, 12 Dec 2011 17:13:18 +0100

Abstract This is a double bind clinical trial which evaluated harmonic scalpel versus bipolar diathermy tonsillectomy The study was conducted at Diyarbakir government hospital, Diyarbakir, Turkey. The study population comprised 144 patients, aged 4–18 years (mean 9 years ± 4.12 SD). All patients underwent tonsillectomy with or without adenoidectomy. The indications for tonsillectomy were obstructive sleep apnea (84 patients [58.3%]) and chronic tonsillitis (60 patients [41.7%]). All 144 patients were randomly divided into two groups: bipolar dissection (81 patients [56.2%] with mean age 8.98 years ± 4.22) and harmonic scalpel (63 patients [43.8%] with mean age 9 years ± 4.02). BD group showed statistically signifi...

Obstructive Sleep Apnea in Infants.

Am J Respir Crit Car... — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Katz ES, Mitchell RB, D'Ambrosio CM Abstract Obstructive sleep apnea in infants has a distinctive pathophysiology, natural history, and treatment compared to older children and adults. Infants have both anatomical and physiological predispositions towards airway obstruction and gas exchange abnormalities; including a superiorly-placed larynx, increased chest wall compliance, ventilation-perfusion mismatching, and ventilatory control instability. Congenital abnormalities of the airway, such as laryngomalacia, hemangiomas, pyriform aperature stenosis, choanal atresia and laryngeal webs may also have adverse effects on airway patency. Additional exacerbating factors predisposing infants towards airway collapse include neck flexion, airway secretions, gastro-esophageal reflux,...

The use of ice‐lollies for pain relief post‐paediatric tonsillectomy. A single‐blinded, randomised, controlled trial

Clinical Otolaryngology — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: Our data suggest that ice‐lollies are a cheap, effective and safe method of reducing postoperative pain up to one hour following paediatric tonsillectomy. (Source: Clinical Otolaryngology)

Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial

Clinical Otolaryngology — Thu, 01 Dec 2011 05:00:00 +0100

(Source: Clinical Otolaryngology)

Adenoidectomy no better than watchful waiting for recurrent URI [HEALTH BRIEFS]

AAP News — Sun, 27 Nov 2011 05:00:00 +0100

(Source: AAP News)

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Biofilm formation by bacteria isolated from upper respiratory tract before and after adenotonsillectomy

APMIS — Fri, 25 Nov 2011 21:34:31 +0100

In conclusion, the rate of isolation and ability to form biofilm decreased in bacteria isolated subsequent to adenoidectomy and/or tonsillectomy. This suggests a role for biofilm in pathogenesis of recurrent and chronic pharyngeal diseases and rhinopharingitis. (Source: APMIS)

Hemorrhage following tonsil surgery: A multicenter prospective study

The Laryngoscope — Fri, 25 Nov 2011 08:39:52 +0100

Conclusions:The occurrence of a postoperative minor bleeding episode increases the risk of a subsequent severe bleeding episode. Laryngoscope, 121:2553–2560, 2011 (Source: The Laryngoscope)

Medical management of children with achondroplasia: Evaluation of an Australasian cohort aged 0–5 years

Journal of Paediatrics and Child Health — Wed, 23 Nov 2011 05:00:00 +0100

Conclusions: Access to geneticists and paediatricians within the first year is high as recommended by the 2005 American Academy of Pediatrics guidelines. Utilisation of craniocervical magnetic resonance imaging/computed tomography, polysomnography studies and formal speech review appears low, reflecting more emphasis on clinical monitoring for cervical cord compression and disordered sleep breathing as well as possible difficulties in accessing services for polysomnography and speech pathology. Grommet insertion, tonsillectomy/adenoidectomy and cervicomedullary decompression rates are similar to results reported previously. Over half of the children accessed physiotherapy and/or occupational therapy services, warranting consideration of these professionals in future guideline recommenda...

Sleep Disordered Breathing is a Risk Factor for Community-Acquired Alveolar Pneumonia in Early Childhood.

Chest — Thu, 17 Nov 2011 05:00:00 +0100

CONCLUSIONS:Sleep disordered breathing is common in children with CAAP and is possibly a predisposing risk for CAAP in children <5 years old. We recommend considering SDB in young children diagnosed with CAAP. PMID: 22095312 [PubMed - as supplied by publisher] (Source: Chest)

Benchmarks for the durations of ambulatory surgical procedures in otolaryngology.

The Annals of Otology, Rhinology, and Laryngology — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSIONS: The surgical times for the performance of the most common otolaryngological ambulatory procedures are remarkably consistent in the United States. Given the volume and consistency of these surgical procedures, they are ideal candidates for studies of cost and efficiency. PMID: 22224314 [PubMed - in process] (Source: The Annals of Otology, Rhinology, and Laryngology)

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No link between enlarged adenoids, H pylori, new study finds

Modern Medicine Contemporary Pediatrics — Thu, 27 Oct 2011 04:00:00 +0100

Recent studies are providing insight into causes of enlarged adenoids and their treatment. New research suggests that the bacteria that can cause stomach inflammation and ulcers do not seem to be related to overenlargement of adenoids, despite earlier studies reporting high colonization rates of Helicobacter pylori in adenoids. Why does another study argue that adenoidectomy, one of the most frequently performed surgical procedures in children in the Western world, often doesn’t have the intended results? (Source: Modern Medicine Contemporary Pediatrics)

No link between enlarged adenoids, Helicobacter pylori, new study finds

Modern Medicine Contemporary Pediatrics — Thu, 27 Oct 2011 04:00:00 +0100

Minimally invasive transfrontal sinus approach to resection of large tumors of the subfrontal skull base

The Laryngoscope — Sat, 22 Oct 2011 08:45:31 +0100

Conclusions:The minimally invasive transfrontal sinus approach to the subfrontal region provides ready expeditious access to the base of the anterior cranial fossa without the need for brain retraction, craniotomy or naso‐orbital osteotomies. It represents an excellent alternative in the surgical access of both intra‐ and extradural tumors in this region of the skull base. Laryngoscope, 121:2290–2294, 2011 (Source: The Laryngoscope)

Molecular characterization of Staphylococcus aureus isolated from children with adenoid hypertrophy: Emergence of new spa types t7685 and t7692

International Journal of Pediatric Otorhinolaryngology — Sat, 15 Oct 2011 08:22:29 +0100

Conclusion: This study demonstrates that the prevalence rate of S. aureus in the adenoid tissue of the children assessed was 23%. An interesting point to note was the dominance of the spa type t7685 that has not been previously reported by other studies. (Source: International Journal of Pediatric Otorhinolaryngology)

Activity of soluble aminopeptidase A and dipeptidyl peptidase IV and membrane-bound aminopeptidase B and pyroglutamyl peptidase I in adenoid hyperplasia, tonsillar hyperplasia and chronic tonsillitis

International Journal of Pediatric Otorhinolaryngology — Sat, 15 Oct 2011 08:22:27 +0100

Abstract: Objective: To analyze soluble and membrane-bound peptidase activities in the tonsils and adenoids removed from patients with adenoid hyperplasia, tonsillar hyperplasia and chronic tonsillitis.Methods: A total of 48 tissue samples from patients undergoing adenoidectomy and tonsillectomy for adenoid hyperplasia, tonsillar hyperplasia or chronic tonsillitis were analyzed. The catalytic activity of a pool of peptidases in the soluble (dipeptidyl peptidase IV, aminopeptidase A, aminopeptidase N and cystinyl aminopeptidase) and membrane-bound (prolyl endopeptidase, aspartyl aminopeptidase, aminopeptidase B and pyroglutamyl peptidase I) fractions was measured fluorometrically.Results: The activity of membrane-bound aminopeptidase B was higher in cases of chronic tonsillitis and adenoid ...

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Paraoxonase and arylesterase activity and total oxidative/anti-oxidative status in patients with chronic adenotonsillitis

International Journal of Pediatric Otorhinolaryngology — Sat, 15 Oct 2011 08:22:26 +0100

Abstract: Objectives: The aim of this study was to investigate serum paraoxonase, arylesterase activities along with determination of oxidative status via measurement of total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) in children with recurrent adenotonsillitis during pre- and post-adenotonsillectomy period and to compare results with data from healthy subjects.Methods: We performed a prospective controlled trial on adenoidectomy and/or tonsillectomy patients. A total of 47 subjects, including 22 patients with recurrent adenotonsillitis and 25 healthy controls were enrolled in this study. Peripheral venous blood samples were taken from patients before adenotonsillectomy and a second sample was obtained in first month postoperatively. In the contr...

Incidence of malocclusion between primary and mixed dentitions among Brazilian children.

The Angle Orthodontist — Mon, 10 Oct 2011 04:00:00 +0100

Conclusions: Malocclusion incidence was high. Individuals with previous anterior open bite, greater overjet, and posterior crossbite had greater risk of having the same characteristics in the mixed dentition. PMID: 21981755 [PubMed - as supplied by publisher] (Source: The Angle Orthodontist)

Examination under anaesthesia of post-nasal space +/- adenoidectomy in children

International Journal of Surgery — Thu, 06 Oct 2011 22:52:32 +0100

Introduction: Adenoid size in children has a significant relation to nasal obstruction. This audit aims to evaluate necessity of 'Examination under anaesthesia of Post-Nasal Space +/- adenoidectomy' as a procedure in children and to make a business case to use paediatric nasoendoscope as an alternate. (Source: International Journal of Surgery)

Significance and causes of abnormal preoperative coagulation test results in children

Haemophilia — Tue, 04 Oct 2011 04:00:00 +0100

Summary. To prevent bleeding related to adenoidectomy and tonsillectomy, coagulation screening tests were, until recently, performed routinely in the Czech Republic for all paediatric patients. The aim of this study was to evaluate benefit of preoperative coagulation screening tests in children. We retrospectively analysed laboratory and clinical data of children referred for abnormal preoperative coagulation test results (aPTT, PT) to the outpatient haematology clinic. A total of 274 paediatric patients were retrospectively evaluated due to abnormal preoperative coagulation tests results. In 140 of 274 patients (51.1%), coagulation tests were normal on repeated testing in a specialized haematology clinic. Ten patients had decreased factor XII. Five patients had a suspected bleeding dis...

The use of ice‐lollies for pain relief post paediatric tonsillectomy. A single‐blinded, randomised, controlled trial

Clinical Otolaryngology — Sat, 01 Oct 2011 04:00:00 +0100

Conclusion: Our data suggests that ice‐lollies are a cheap, effective and safe method of reducing post‐operative pain up to one hour following paediatric tonsillectomy. (Source: Clinical Otolaryngology)

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Does Helicobacter Pylori Have a Role in the Etiology of Adenoid Hypertrophy?

Indian Journal of Otolaryngology and Head and Neck Surgery — Wed, 21 Sep 2011 05:53:31 +0100

This study demonstrated the high incidence of nasopharyngeal reflux and gastroesophageal reflux in adenoid hypertrophy and the possible colonisation of H. pylori in the adenoid tissue. This may change the assesment of children with adenotonsillar hypertrophy in near future. However, more placebo controlled and double blind studies and larger series are still needed to support this hypothesis. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s12070-011-0310-yAuthors Emine Aydın, S.B. Ankara Eğitim ve Araştırma Hastanesi 2.KBB Kliniği Ulucanlar Caddesi Altındağ, Ankara, TurkeyFiliz Aydoğan, Department of Otolaryngology, Ankara Training and Research Hospital, Ankara, TurkeyEren Taştan, Department of Otolaryngology, Ankara Training and Research Hospit...

Mayo Clinic Identifies Risk Factors for Repeat Adenoid Removal in Children

Mayo Clinic Rochester News — Tue, 13 Sep 2011 16:16:35 +0100

It isn't unusual for children to have their tonsils and adenoids removed, and the younger those patients are, the greater the risk their adenoids will grow back and they will need to have them taken out again, Mayo Clinic researchers have found. (Source: Mayo Clinic Rochester News)

Immediate Adenoidectomy May Not Reduce URTIs in ChildrenImmediate Adenoidectomy May Not Reduce URTIs in Children

Medscape Today Headlines — Mon, 12 Sep 2011 00:24:09 +0100

In an open randomized trial among children selected for adenoidectomy for recurrent upper respiratory tract infections, immediate surgery was no more beneficial than initial watchful waiting. Medscape Medical News (Source: Medscape Today Headlines)

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Removal Of Children's Adenoids Does Not Prevent Upper Respiratory Infections

Health News from Medical News Today — Wed, 07 Sep 2011 12:00:00 +0100

According to a report published on bmj.com today, surgically removing adenoids in children does not result in them having fewer respiratory tract infections, such as sinusitis and colds. In children, upper respiratory tract infections are very common and several are referred for ear, nose and throat (ENT) surgery. In western countries, the removal of adenoids (adenoidectomy) is one of the most frequently performed surgical procedures among children, the report explains. "One of the main reasons adenoidectomy is performed is to reduce the incidence of upper respiratory tract infections... (Source: Health News from Medical News Today)

Correlation of mucociliary clearance and symptomatology before and after adenoidectomy in children

International Journal of Pediatric Otorhinolaryngology — Wed, 07 Sep 2011 03:24:04 +0100

Abstract: Objective: The goal of this study is to better understand the role of adenoid hypertrophy and its impact on mucociliary clearance as it relates to the symptoms of chronic sinusitis in children. More specifically, the goal is to better understand which symptoms of chronic rhinosinusitis might be most likely to improve in children undergoing an adenoidectomy.Methods: We conducted this study on 35 healthy children (>3 and (Source: International Journal of Pediatric Otorhinolaryngology)

The hemostatic efficacy of Ankaferd Blood Stopper in adenoidectomy

International Journal of Pediatric Otorhinolaryngology — Wed, 07 Sep 2011 03:24:02 +0100

Abstract: Objective: To evaluate the efficacy of Ankaferd Blood Stopper (ABS) in the control of intraoperative and postoperative bleeding in adenoidectomy.Methods: In total, 90 patients underwent traditional cold steel adenoidectomy and were then randomized to receive ABS or 0.9% physiological saline solution to obtain hemostasis. Objective data collected included time of operation and blood loss during operation. Visual analog scales (VAS) were used to record subjective data by the operating surgeon including bleeding following adenoid pack removal and ease of operation.Results: In a comparison between patients in the ABS group (n=46) and the control group (n=44), those in the ABS group had significantly shorter operation times (9.11±1.02 vs. 13.16±3.96min; p (Source: International Jour...

Comparison of two minimally invasive techniques for treating chronic rhinosinusitis in the pediatric population

International Journal of Pediatric Otorhinolaryngology — Wed, 07 Sep 2011 03:24:02 +0100

Conclusion: EGC is an effective treatment for young children with CRS. EGC and MSI are equally effective in obtaining diagnostic cultures. EGC decreases time to symptom resolution, and it lowers the risk of complication when compared to MSI. (Source: International Journal of Pediatric Otorhinolaryngology)

The relationship between repeat tympanostomy tube insertion and adenoidectomy

International Journal of Pediatric Otorhinolaryngology — Wed, 07 Sep 2011 03:23:59 +0100

Abstract: Objectives: To examine the relationship between adenoidectomy and repeat tympanostomy tube placement in the treatment of otitis media, and the relationship between potential risk factors for otitis media and repeat tympanostomy tube placement.Methods: Retrospective, cross-sectional analysis of consecutive patients undergoing tympanostomy tube placement at an academic/teaching hospital with 400+ beds. Utilizing an electronic billing database, patients less than 18 years of age undergoing tympanostomy tube placement between January 1, 2000 and December 31, 2007 were identified. Information regarding initial and repeat tympanostomy tube placement as well as potential risk factors for otitis media were extracted from medical records.Results: 904 children were included in the study. O...

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Yanking Adenoids Won't Cut Colds in Kids (CME/CE)

MedPage Today Infectious Disease — Wed, 07 Sep 2011 03:13:03 +0100

(MedPage Today) -- Adenoidectomy doesn't decrease the number of colds and sinus infections in young children, according to results of a randomized controlled study. (Source: MedPage Today Infectious Disease)

Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial

BMJ Online First — Mon, 05 Sep 2011 23:00:00 +0100

Objective To assess the effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections.Design Open randomised controlled trial.Setting 11 general hospitals and two... (Source: BMJ Online First)

Adenoidectomy in children with recurrent upper respiratory infections

BMJ Online First — Mon, 05 Sep 2011 23:00:00 +0100

Although recurrent upper respiratory tract infections in childhood are self limiting, with high rates of spontaneous recovery,1 they are associated with high healthcare costs and frequent visits to... (Source: BMJ Online First)

Prevalence of Epstein–Barr virus in tonsils and adenoids of United Arab Emirates nationals

International Journal of Pediatric Otorhinolaryngology — Sat, 27 Aug 2011 16:00:44 +0100

Conclusion: EBV is associated with tonsillar hypertrophy and is prevalent in 43% of our cases. EBV is only detected in B lymphocytes and we believe that B lymphocytes are sites of primary infection and latency. In situ hybridization is the gold standard for the detection of EBV in tissue. (Source: International Journal of Pediatric Otorhinolaryngology)

The Value of Routine Preoperative Testing in the Prediction of Operative Hemorrhage in Adenotonsillectomy

Indian Journal of Otolaryngology and Head and Neck Surgery — Sat, 27 Aug 2011 05:52:00 +0100

Abstract Medical records were reviewed to identify subjects who ranged in age from 1 to 18 years and who had undergone tonsillectomy with or without adenoidectomy. Data obtained included patient demographic information, relevant medical history, history of hemorrhage, family history of hemorrhagic disorders, and drug history. Laboratory data obtained included a baseline coagulation screening to determine prothrombin time, activated partial thromboplastin time, and platelet count. Values were classified as within normal limits or as abnormally prolonged according to the local laboratory reference values. The incidence of postoperative hemorrhage in healthy subjects was evaluated, and the correlation between having a medical history of hemorrhage and an abnormal coagula...

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Health Tip: Recovering from Adenoid and Tonsil Removal

MedlinePlus Health News — Fri, 26 Aug 2011 11:00:00 +0100

Suggestions to help ease discomfortSource: HealthDay Related MedlinePlus Page: Tonsils and Adenoids (Source: MedlinePlus Health News)

Clinical Factors Associated with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections

The Journal of Pediatrics — Fri, 26 Aug 2011 04:00:00 +0100

Conclusion: The identification of clinical features associated with PANDAS should assist in delineating risks for this subtype of obsessive-compulsive disorder/tics. (Source: The Journal of Pediatrics)

Hearing loss in patients with mucopolysaccharidosis II: Data from HOS – the Hunter Outcome Survey

Journal of Inherited Metabolic Disease — Wed, 24 Aug 2011 16:02:02 +0100

Conclusions Hearing impairment is common in MPS II. Early otolaryngological evaluation and intervention is recommended. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s10545-011-9378-5Authors Annerose Keilmann, Department of ORL, Langenbeckstr. 1 Gebäude 102, 55131 Mainz, GermanyTodsaporn Nakarat, Division of Communication Disorders, Department of ORL, University Medical Center, Mainz, GermanyIain A. Bruce, Department of Paediatric ORL, Royal Manchester Children’s Hospital, Manchester, UKDavid Molter, Department of Otolaryngology, Washington University School of Medicine, St. Louis, MO, USAGunilla Malm, Department of Clinical Science, Intervention and Technology Division of Paediatrics, Karolinska University Hospital, Huddinge, 14186 Stock...

Radical mediastinal nodal removal improves disease-free survival for pulmonary low-grade malignant tumors

Lung Cancer — Tue, 16 Aug 2011 04:00:00 +0100

Abstract: Purpose: To investigate the prognostic role of radical lymph node dissection in treatment for pulmonary Low Grade Malignant Tumors (LGMTs); specifically, on the extent of nodal removal and its impact on long-term survival.Methods: A total of 93 LGMTs cases underwent surgical resection and were histopathologically confirmed. Overall survival rates and disease-free survival were respectively calculated according to the extent of lymph node resection and histopathological grades of tumors. Risk factors of nodal involvement and survival predictors were calculated via multivariate analysis. Life table, Kaplan–Meier, and Cox regression models were used for the statistical analysis.Results: Thirty-eight cases of carcinoid, 17 adenoid cystic carcinomas, and 38 mucoepidermoid carcinomas...

Endoscopic nasopharyngeal exploration at the end of conventional curettage adenoidectomy

European Archives of Oto-Rhino-Laryngology — Thu, 11 Aug 2011 06:57:42 +0100

Abstract Adenoid hypertrophy (AH) is a common cause of airway obstruction in children and its recurrence after conventional curettage adenoidectomy is not rare. The purpose of this study is to assess the efficacy of endoscopic nasopharyngeal exploration at the end of curettage adenoidectomy on decreasing the incidence of adenoid re-hypertrophy. Three hundred and fifty children diagnosed as having AH, underwent conventional curettage adenoidectomy by a single surgeon. The cases were randomly divided into two equal groups A and B, group B were further subjected to nasopharyngeal exploration by the nasal endoscope after removal of their adenoids with cauterization of any visible residuals, while group A were not subjected to this endoscopic maneuver. Follow-up was carried out...

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What Are Adenoids? What Is Adenoidectomy?

Health News from Medical News Today — Sun, 07 Aug 2011 00:00:00 +0100

Adenoids, also known as pharyngeal tonsil, or nasopharyngeal tonsil are located at the back of the throat, above the tonsils - they are small lumps of tissue. They form part of the immune system of babies and young children; they protect the body from harmful bacteria and viruses, they fight off infection. Adenoids start growing from birth and reach their peak size when the child is between about 3 and 5 years of age. After the age of 7 they shrink, and are barely detectable during adolescence. They will have disappeared completely by the time a person has become an adult... (Source: Health News from Medical News Today)

How effective is adenoidectomy alone for treatment of obstructive sleep apnoea in a child who presents with adenoid hypertrophy?

Journal of Paediatrics and Child Health — Sun, 31 Jul 2011 23:00:00 +0100

(Source: Journal of Paediatrics and Child Health)

Anti-inflammatory therapy for obstructive sleep apnea in children.

Canadian Family Physician Medecin de Famille Canadien — Sun, 31 Jul 2011 23:00:00 +0100

Authors: Friedman BC, Goldman RD Abstract Question A 4-year-old child was diagnosed by polysomnography as experiencing mild obstructive sleep apnea (OSA). Despite the child being inattentive and distracted during the day at school, his parents prefer to avoid surgical treatment (adenotonsillectomy). Are there any non-surgical treatments for mild OSA in young children? Answer Obstructive sleep apnea in children is caused mainly by adenotonsillar hypertrophy and can lead to considerable morbidities, including neurocognitive and behavioural disturbances. Surgical removal of the tonsils and adenoids is the treatment of choice. In recent years, however, a new understanding of the inflammatory components of OSA has led to the assumption that anti-inflammatory treatment can reduce adenoto...

Risk factors for post-operative complications in Chinese children with tonsillectomy and adenoidectomy for obstructive sleep apnea syndrome

Sleep and Breathing — Sat, 30 Jul 2011 05:56:35 +0100

Conclusion Our results showed that most children with OSAS underwent T&A without complications. The respiratory complication rate was 7%, and desaturation was the most common post-operative complication. Children with higher BMI z score were more likely to have desaturation after T&A (p = 0.014). Hence, careful monitoring with pulse oximeter after T&A should be offered to those who are obese. Content Type Journal ArticlePages 1-3DOI 10.1007/s11325-011-0561-6Authors Alison L. T. Ma, Department of Paediatrics, Kwong Wah Hospital, Hong Kong, SAR, ChinaYuen-yu Lam, Department of Paediatrics, Kwong Wah Hospital, Hong Kong, SAR, ChinaSiu-fong Wong, Department of Paediatrics, Kwong Wah Hospital, Hong Kong, SAR, ChinaDaniel K. Ng, Department of Paediatrics, Kwong Wah Hos...

Risk factors for post-operative complications in Chinese children with tonsillectomy and adenoidectomy for obstructive sleep apnea syndrome.

Sleep and Breathing — Fri, 29 Jul 2011 23:00:00 +0100

CONCLUSION: Our results showed that most children with OSAS underwent T&A without complications. The respiratory complication rate was 7%, and desaturation was the most common post-operative complication. Children with higher BMI z score were more likely to have desaturation after T&A (p = 0.014). Hence, careful monitoring with pulse oximeter after T&A should be offered to those who are obese. PMID: 21805227 [PubMed - as supplied by publisher] (Source: Sleep and Breathing)

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Association of adenoid hyperplasia and bacterial biofilm formation in children with adenoiditis in Taiwan

European Archives of Oto-Rhino-Laryngology — Thu, 21 Jul 2011 18:17:32 +0100

Abstract The adenoid is a bacterial reservoir that contributes to chronic otolaryngologic infections. Staphylococcus aureus (S. aureus) is a common pathogen in the adenoid. The increase of antibiotic resistance in S. aureus has become an important issue in public health. The aim of this study was to compare adenoid hyperplasia and biofilm formation in children with S. aureus adenoiditis in Taiwan. The patients were divided into methicillin-resistant and methicillin-sensitive S. aureus groups according to the S. aureus obtained from adenoid tissue after antibiotic susceptibility testing. Adenoid hyperplasia was assessed by lateral cephalometry, and the severity of sinusitis was evaluated by Water’s view. Microbiological investigation of available S. aureus isolates was perfor...

Endoscopic endonasal transpterygoid nasopharyngectomy

The Laryngoscope — Tue, 19 Jul 2011 23:00:00 +0100

Conclusion:Endoscopic transpterygoid nasopharyngectomy for primary and recurrent nasopharyngeal malignancies is feasible and safe in properly selected patients. Preliminary outcomes compare to that of conventional techniques. Endoscopic resections, however, are demanding; they require specialized equipment and a team versed in endoscopic oncologic surgery. Long‐term follow‐up and reproducibility remain undefined. Laryngoscope, 2011. (Source: The Laryngoscope)

Incidence of revision adenoidectomy in children

The Laryngoscope — Tue, 19 Jul 2011 23:00:00 +0100

Conclusions:Revision adenoidectomy occurs at a rate of 1.3%. Reasons for revision include persistence symptoms ranging from adenoiditis to recurrent otitis to obstructive sleep apnea. Laryngoscope, 2011. (Source: The Laryngoscope)

Suction cautery adenoidectomy (SCA): Is the additional cost justified?

International Journal of Pediatric Otorhinolaryngology — Wed, 13 Jul 2011 17:18:58 +0100

I read with great interest the article titled “Suction cautery adenoidectomy (SCA): Is the additional cost justified?” by Hajr et al. I agreed partially with authors’ opinion that the suction cautery technique was superior at reducing operative time, increasing cost-effectiveness and decreasing the risk of postoperative complications. However, I do not accept authors’ suggestion that suction cautery may be the most appropriate method for adenoidectomy because they did not compare its long-term effect. (Source: International Journal of Pediatric Otorhinolaryngology)

Velopharyngeal dysfunction and 22q11.2 deletion syndrome: A longitudinal study of functional outcome and preoperative prognostic factors.

The Cleft Palate-Craniofacial Journal — Thu, 07 Jul 2011 23:00:00 +0100

Conclusions: In this chart review of patients with 22q11.2DS and VPD, residual hypernasality persisted in many patients after velopharyngoplasty. None of the preoperative factors that were studied had prognostic value for the outcome. Key words: 22q11.2 deletion syndrome, velopharyngeal dysfunction, velopharyngoplasty, resonance. PMID: 21740170 [PubMed - as supplied by publisher] (Source: The Cleft Palate-Craniofacial Journal)

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Prevalence and Persistence of Sleep Disordered Breathing Symptoms in Young Children: A 6-Year Population-Based Cohort Study

Sleep — Sat, 02 Jul 2011 16:02:49 +0100

Conclusions:This is the first natural history study of the primary symptoms of SDB across a key 6-year period in the development of SDB symptoms. Snoring rates are higher and spike earlier than previously reported. Symptoms are dynamic, suggesting the need for early and continued vigilance in early childhood.Citation:Bonuck KA; Chervin RD; Cole TJ; Emond A; Henderson J; Xu L; Freeman K. Prevalence and persistence of sleep disordered breathing symptoms in young children: a 6-year population-based cohort study. SLEEP 2011;34(7):875-884. (Source: Sleep)

Functional endoscopic sinus surgery in children: predictive factors of outcome

European Archives of Oto-Rhino-Laryngology — Sat, 25 Jun 2011 15:52:55 +0100

In conclusion, postoperative improvement was significantly correlated with extent of preoperative disease, adenoidectomy and second look operation and not significantly correlated with type of the preoperative disease or previous surgery. The results of PESS are influenced by age group, a younger age group is associated with more adhesions and recurrences and an older age group is associated with blood loss and higher surgical score. All these variables are contributing in the outcome of PESS. Content Type Journal ArticlePages 1-5DOI 10.1007/s00405-011-1680-1Authors Asser A. El Sharkawy, Department of Otorhinolaryngology, Mansoura University, Mansoura, EgyptShawky M. Elmorsy, Department of Otorhinolaryngology, Mansoura University, Mansoura, EgyptHesham M. Eladl, Department of Ot...

Guideline: Polysomnography For Sleep-Disordered Breathing Prior To Tonsillectomy In Children

Health News from Medical News Today — Wed, 15 Jun 2011 09:00:00 +0100

A multidisciplinary clinical practice guideline, "Polysomnography for Sleep-Disordered Breathing Prior to Tonsillectomy in Children" will be published as a supplement to the July issue of Otolaryngology - Head and Neck Surgery, the official scientific journal of the American Academy of Otolaryngology - Head and Neck Surgery Foundation (AAO-HNSF). This guideline provides otolaryngologists with evidence-based recommendations for using polysomnography in assessing children, aged 2 to 18 years, with sleep-disordered breathing and who are candidates for tonsillectomy, with or without adenoidectomy... (Source: Health News from Medical News Today)

Polysomnography for sleep-disordered breathing prior to tonsillectomy in children

EurekAlert! - Social and Behavioral Science — Wed, 15 Jun 2011 04:00:00 +0100

(American Academy of Otolaryngology - Head and Neck Surgery) A multidisciplinary clinical practice guideline, "Polysomnography for Sleep-Disordered Breathing Prior to Tonsillectomy in Children" will be published as a supplement to the July issue of Otolaryngology -- Head and Neck Surgery. This guideline provides otolaryngologists with evidence-based recommendations for using polysomnography in assessing children, aged 2 to 18 years, with sleep-disordered breathing and who are candidates for tonsillectomy, with or without adenoidectomy. (Source: EurekAlert! - Social and Behavioral Science)

Tonsillectomy for PFAPA?

The Journal of Pediatrics — Tue, 14 Jun 2011 15:12:59 +0100

Garavello et al performed a systematic review of published studies evaluating the benefit of tonsillectomy with or without adenoidectomy in resolution of periodic fever aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome. Studies totaled only 15 and treated children only 149; 13 were observational, non-comparative (11 of which were retrospective) and 2 were prospective, randomized, controlled trials (RCTs) (total subjects = 33). Other limitations were variability in criteria for diagnosis, surgical procedure (tonsillectomy or tonsillectomy plus adenoidectomy), and duration of follow up. Using complete resolution as the primary outcome, “meta”-analysis of the two RCTs showed OR for complete resolution following surgery of 13 (95% CI, 4-43). Overall, resolution following surg...

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Hospitalisation for surgical procedures is lower among immigrants than among non-immigrant preschool children: results from a region-wide study in Italy

Journal of Epidemiology and Community Health — Wed, 08 Jun 2011 23:00:00 +0100

Conclusion Hospitalisation rates for the most frequent surgical procedures are significantly lower among immigrants compared to non-immigrant preschool children. Reduced surgery rates among immigrants might result from a complex interplay between parental attitudes and knowledge of paediatric conditions, language barriers and access to primary care. (Source: Journal of Epidemiology and Community Health)

Assessment of Operative Blood Loss and the Factors Affecting it in Tonsillectomy and Adenotonsillectomy

Indian Journal of Otolaryngology and Head and Neck Surgery — Fri, 03 Jun 2011 05:59:20 +0100

Abstract To estimate the average operative blood loss in tonsillectomy and adenotonsillectomy and the various factors affecting it. A prospective study of estimation of blood loss in 100 patients who underwent tonsillectomy and adenotonsillectomy. Data collected included the age, sex, operative indication, clotting time, Hb levels and usage of pre-operative antibiotics. Cold knife dissection method for tonsillectomy and curettage method for adenoidectomy were used. Measurement by calorimetric method of estimation being simple and accurate was used for estimation. Study undertaken at a tertiary referral hospital catering to an urban, semi-urban and rural populace. Blood loss was more in males and increases as age advances both in adenotonsillectomy and tonsillectomy. Blood ...

Choanal adenoid in adults with persistent nasal symptoms: endoscopic management to avoid misdiagnosis and unsuccessful surgeries

European Archives of Oto-Rhino-Laryngology — Mon, 23 May 2011 17:04:48 +0100

We present a series of 64 adult patients (18–37 years: 40 males, 24 females). All patients had persistent bilateral nasal obstruction and recurrent nasal infections. There was history of repeated medical and surgical unsuccessful procedures. Choanal adenoid was confirmed by nasal endoscopy and CT scanning. Absence of adenoid tissues in the nasopharynx was confirmed in all cases. Surgical removal of choanal adenoids was undertaken in all cases endoscopically. Some other surgical procedures like straightening of a deviated septum or reduction of a hypertrophied turbinate were undertaken in some indicated cases. Most of the cases experienced complete relief from obstruction and return of a patent nasal airway, and improvement of associated complaints such as dry mouth and persist...

Eponym

European Journal of Pediatrics — Mon, 23 May 2011 17:04:10 +0100

We report a case of an 8-year-old girl with a typical evolution of this unusual complication. In our case, the most important element for diagnosis was the 3D CT scanner, and the treatment was conservative with a successful outcome. Pediatricians should be aware of this rare but potentially serious entity to establish the correct treatment and avoid complications. Content Type Journal ArticlePages 1-4DOI 10.1007/s00431-011-1493-7Authors Graciela Ortega-Evangelio, Department of Pediatrics, Consorcio Hospital General Universitario, Valencia, SpainJose Juan Alcon, Department of Pediatrics, Consorcio Hospital General Universitario, Valencia, SpainJulio Alvarez-Pitti, Department of Pediatrics, Consorcio Hospital General Universitario, Valencia, SpainVicente Sebastia, Department of Phy...

Tonsil Removal Might Cure Bedwetting in Some Kids with Sleep Apnea

MedlinePlus Health News — Mon, 16 May 2011 18:00:00 +0100

Study shows additional benefit of the surgery for certain children Source: HealthDay Related MedlinePlus Pages: Bedwetting, Sleep Apnea, Tonsils and Adenoids (Source: MedlinePlus Health News)

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[Tonsillotomy and adenotonsillectomy in childhood : Study on postoperative pain therapy.]

Der Anaesthesist — Sat, 14 May 2011 23:00:00 +0100

CONCLUSION: The combination of i.v. paracetamol and i.v. ketoprofen provides superior postoperative analgesia compared to the single use of paracetamol. PMID: 21607780 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)

Reply to Letter to the Editor: Is nasal saline just a placebo!

International Journal of Pediatric Otorhinolaryngology — Thu, 12 May 2011 18:18:20 +0100

We, authors, thank to Acar et al. for their interest and critical evaluation of our study published in International Journal of Pediatric Otorhinolaryngology. The study and control groups in the investigation consisted of patients with obstructive hypertrophied adenoids without clear-cut rhinosinusitis. The purpose of the study was to demonstrate the shrinkage effect of transnasal application of fluticasone propionate drops on the hypertrophied adenoid tissues located in the nasopharynx. The patients also have been followed up for the elimination of the surgical indication of adenoidectomy. Inflammatory reactions within the nose developing secondary to obstructive adenoids were not the subject of the study. In all our patients there was no clear infectious problem at all, because those pat...

Pediatric myringoplasty: A study of factors affecting outcome

International Journal of Pediatric Otorhinolaryngology — Thu, 12 May 2011 18:18:13 +0100

Conclusion: The type of previous otologic surgery in the operated ear was found to have an impact on anatomical success. The outcome for myringoplasty was more favourable when the etiology of the previous surgery was a benign one. We advocate early myringoplasty, preferably above the age of 6. Delaying surgery can cause permanent damage to the inner ear. All other factors evaluated were not found to be statistically significant for anatomical or audiological success. (Source: International Journal of Pediatric Otorhinolaryngology)

The effects of desflurane and sevoflurane on the peri- and postoperative bleeding of adenotonsillectomy patients

International Journal of Pediatric Otorhinolaryngology — Thu, 12 May 2011 18:18:11 +0100

Conclusion: Desflurane, which is one of the volatile anesthetics, leads to a lower amount of intraoperative bleeding than sevoflurane during tonsillectomy and adenoidectomy operations. (Source: International Journal of Pediatric Otorhinolaryngology)

Routine Electrocardiography Request in Adenoidectomy: Is it necessary?

Indian Journal of Otolaryngology and Head and Neck Surgery — Sat, 07 May 2011 15:45:26 +0100

Abstract To evaluate the relevance of routine electrocardiographic request in pre-operative work-up of children undergoing adenoidectomy. This is a two year prospective study of children with obstructive adenoid that had adenoidectomy. This is a tertiary hospital based study at the Otorhinolaryngology Department of University College Hospital, Ibadan. Children (≤12 years) with clinical and radiological evidence of an obstructive adenoid were investigated. Information obtained with an interviewer assisted questionnaire included the biodata, clinical presentation of the patients, ECG findings, echocardiographic findings, cardiothoracic ratio, palatal airway and ratio of adenoid diameter to the nasopharyngeal diameter. The adenoid volume was measured after adenoidectomy...

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Comparison of the Surface and Core Bacteria in Tonsillar and Adenoid Tissue With Beta-Lactamase Production

Indian Journal of Otolaryngology and Head and Neck Surgery — Fri, 06 May 2011 16:25:18 +0100

This study was carried out for investigating the microbial flora of the tonsils and adenoids regarding to core and surface microorganisms and also pathogen microrganisms’ beta-lactamase production rate. Cultures were taken from the core and surface of tonsils and adenoids of the 91 patients at the time of the surgery for tonsillectomy and adenoidectomy. Aerobic and anaerobic cultures were inoculated and identified. Beta-lactamase production was detected also. The most frequently isolated aerobic microorganisms were Streptococcus viridans and Neisseria spp. The number of the microorganisms isolated from the tonsil core compared to the surface of the tonsils was found statistically insignificant (P > 0.05). The number of the adenoid surface aerobic microorganisms was foun...

PFAPA syndrome in siblings. Is there a genetic background?

European Journal of Pediatrics — Mon, 02 May 2011 14:58:13 +0100

Conclusion: PFAPA syndrome is the most common recurrent periodic fever disorder described in childhood. Its genetic background has not been elucidated yet. Our contribution with two siblings affected with PFAPA syndrome further support the genetic basis for the entity. Content Type Journal ArticlePages 1-6DOI 10.1007/s00431-011-1479-5Authors Pilar Antón-Martín, Department of Pediatrics, Division of Infectious Diseases, Hospital Universitario de Getafe, Madrid, SpainRoberto Ortiz Movilla, Department of Pediatrics, Division of Infectious Diseases, Hospital Universitario de Getafe, Madrid, SpainSara Guillén Martín, Department of Pediatrics, Division of Infectious Diseases, Hospital Universitario de Getafe, Madrid, SpainLuis M. Allende, Department of Immunology, Hospital Universit...

Changes in facial morphology after adenotonsillectomy in mouth‐breathing children

International Journal of Paediatric Dentistry — Sat, 30 Apr 2011 23:00:00 +0100

Conclusion. After the MB rehabilitation, children between 3 and 6 years old presented significant normalization in the mandibular growth direction, a decrease in the mandible inclination, and an increase in the posterior facial height. Instead, they still persisted with a dolichofacial pattern when compared with nasal breathers. (Source: International Journal of Paediatric Dentistry)

In reference to is polysomnography required prior to tonsillectomy and adenoidectomy for the diagnosis of obstructive sleep apnea versus mild sleep‐disordered breathing in children?

The Laryngoscope — Tue, 26 Apr 2011 14:44:32 +0100

(Source: The Laryngoscope)

The clinical status of the eardrum: An inclusion criterion for the treatment of chronic secretory otitis media in children

International Journal of Pediatric Otorhinolaryngology — Tue, 19 Apr 2011 17:12:39 +0100

Abstract: Objective: To investigate if the clinical status of the eardrum could be an inclusion criterion for the therapy of chronic secretory otitis media (CSOM). To compare the results of treating CSOM by adenoidectomy and by adenoidectomy in combination with tympanostomy tubes in two groups of patients chosen according to that criterion.Methods: 161 ears in 87 children were treated for CSOM. An otomicroscopic examination showed there were no pathological changes on the tympanic membrane (signs of adhesive process, malleus rotation, and dangerous attic retractions). The patients were randomly divided into two groups: the first group of 59 ears was treated by myringotomy and tympanostomy tubes and adenoidectomy, while the other group of 102 ears was treated only by adenoidectomy. At least...

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Obstructive sleep apnea in poorly controlled asthmatic children: Effect of adenotonsillectomy

Pediatric Pulmonology — Sun, 03 Apr 2011 23:00:00 +0100

ConclusionsThe prevalence of OSA is markedly increased among PCA children and treatment of OSA appears to be associated with substantial improvements in the severity of the underlying asthmatic condition. Pediatr. Pulmonol. © 2011 Wiley‐Liss, Inc. (Source: Pediatric Pulmonology)

A study to detect Helicobacter pylori in adenotonsillar tissue.

Ear, Nose and Throat Journal — Thu, 31 Mar 2011 23:00:00 +0100

Authors: Toros SZ, Toros AB, Kaya KS, Deveci I, Ozel L, Naiboğlu B, Habeşoğlu T, Egeli E We conducted a prospective study to investigate the possibility of Helicobacter pylori colonization on tonsillar and adenoid tissues. Our study group was made up of 84 consecutively presenting children aged 4 to 12 years who had undergone adenotonsillectomy or adenoidectomy with or without ventilation tube insertion. The excised specimens were analyzed by rapid urease testing and histopathologic examination to detect H pylori. Histologic sections were subjected to hematoxylin and eosin staining and Giemsa staining as performed in routine gastric biopsies. We found no H pylori colonization in any specimen. Therefore, we consider the possibility of H pylori colonization of adenotonsillar tissue un...

Detection of Helicobacter pylori in adenotonsillar tissue of children with chronic adenotonsillitis using rapid urease test, PCR and blood serology: A prospective study

International Journal of Pediatric Otorhinolaryngology — Tue, 29 Mar 2011 16:35:37 +0100

Conclusions: Based on our findings it seems that adenotonsillar tissue may constitute an extra-gastric reservoir for H. pylori in symptomatic children with chronic adenotonsillitis. RUT was found to be of less accuracy than PCR in H. pylori detection in an extra-gastric location, thus results of previous studies using this test alone for detection of oral H. pylori should be treated with caution. (Source: International Journal of Pediatric Otorhinolaryngology)

Antral lavage using the luma transilluminaton wire and vortex irrigator—A safe and effective advance in treating pediatric sinusitis

International Journal of Pediatric Otorhinolaryngology — Tue, 29 Mar 2011 16:35:31 +0100

Conclusion: We found this technique to give the surgeon a reliable, safe, versatile, and efficacious alternative before consideration of more invasive procedures in the pediatric population with chronic sinusitis. (Source: International Journal of Pediatric Otorhinolaryngology)

In response to is polysomnography required prior to tonsillectomy and adenoidectomy for the diagnosis of obstructive sleep apnea versus mild sleep‐disordered breathing in children?

The Laryngoscope — Mon, 28 Mar 2011 23:00:00 +0100

(Source: The Laryngoscope)

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Increased Prevalence of Obstructive Sleep Apnea in Patients With Cleft Palate [Original Article]

Archives of Otolaryngology — Mon, 21 Mar 2011 00:00:00 +0100

Conclusions An increased prevalence of SDB and/or OSA exists in the population with cleft palate, with an even greater prevalence in patients with Pierre Robin syndrome. Definitive diagnosis of OSA by PSG is underused. We suggest that surgical management of SDB and/or OSA be followed by PSG to demonstrate resolution or persistence of symptoms to ensure appropriate further management. (Source: Archives of Otolaryngology)

Tonsillectomy linked to excess weight gain in kids

ScienceDaily Headlines — Wed, 02 Mar 2011 10:00:00 +0100

Children seem to gain extra weight after having their tonsils removed

washingtonpost.com - Health — Tue, 01 Mar 2011 04:55:03 +0100

A study analyzes data from nine studies, involving 795 children who had a tonsillectomy, with or without adenoid removal, before they turned 18. (Source: washingtonpost.com - Health)

Suction cautery adenoidectomy (SCA): Is the additional cost justified?

International Journal of Pediatric Otorhinolaryngology — Tue, 01 Mar 2011 00:00:00 +0100

This study aimed to compare adenoidectomy using suction-cautery adenoidectomy (SCA) to curettage with respect to operative time, postoperative complications, and cost-effectiveness.Methods: The data for this retrospective case control study were retrieved from the Medical Records Department at one of the few medical centers that perform this technique in the Kingdom of Saudi Arabia. The data for each case included the following: patient demographic features, type of procedure, time of operation, occurrence of any postoperative complications, length of hospital stay and cost of the procedure. To minimize the sources of variance in our data, all adenoidectomies were performed by the same consultant otolaryngologist, using either SCA or curettage.Result: Of the 86 patients who underwent adeno...

Altered dipeptidyl peptidase IV and prolyl endopeptidase activities in chronic tonsillitis, tonsillar hyperplasia and adenoid hyperplasia

International Journal of Pediatric Otorhinolaryngology — Tue, 01 Mar 2011 00:00:00 +0100

Conclusions: These data indicate the involvement of dipeptidyl peptidase IV and prolyl endopeptidase in the mechanisms underlying chronic tonsillitis, tonsillar hyperplasia and adenoid hyperplasia. (Source: International Journal of Pediatric Otorhinolaryngology)

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Cranial conjoined twins: Surgical and anesthetic challenges for a routine procedure: Adenoidectomy and examination of ears

International Journal of Pediatric Otorhinolaryngology — Tue, 01 Mar 2011 00:00:00 +0100

We present the surgical, airway and anesthetic challenges in craniopagus conjoined twins, in which one of the twins underwent adenoidectomy for obstructive sleep breathing disorder. The surgical procedure required a special setting from an anesthetic perspective whereby both children needed anesthesia due to the complex physiology of their brains and cardiovascular systems. As well, we took the opportunity to do bilateral ear examinations of both twins. (Source: International Journal of Pediatric Otorhinolaryngology)

Aspiration pneumonia and esophagotracheal fistula secondary to button battery ingestion

Forensic Science, Medicine, and Pathology — Wed, 09 Feb 2011 17:26:53 +0100

We report a case of acute bronchopneumonia and esophagotracheal fistula caused by a swallowed button battery in a 3-year-old girl. It was unclear exactly how long the battery had been trapped in the esophagus. The patient had undergone a tonsillectomy and adenoidectomy 3 weeks before the battery was finally exposed on an X-ray film. She refused to eat solid food after the surgery and stopped eating completely 10 days later. Three weeks after surgery, she presented to the Emergency Department with vomiting and acute respiratory distress, experienced cardiopulmonary arrest in the intensive care unit and could not be resuscitated. Postmortem examination revealed severe acute bronchopneumonia and massive blood aspiration due to an esophagotracheal fistula secondary to a button ...

Anti-inflammatory medications for obstructive sleep apnea in children.

Cochrane Database of Systematic Reviews — Wed, 02 Feb 2011 16:15:07 +0100

Authors: Kuhle S, Urschitz MS Obstructive sleep apnea (OSA) is characterized by partial or complete upper airway obstruction during sleep. Approximately 1% to 4% of children are affected by OSA, with adenotonsillar hypertrophy the most common underlying risk factor. Surgical removal of enlarged tonsils and adenoids is the most commonly used treatment for OSA. Given the perioperative risk of the intervention and an estimated recurrence rate of up to 20%, there has recently been an increased interest in non-surgical treatment modalities. As the enlarged adenoids and tonsils consist of hypertrophied lymphoid tissue, anti-inflammatory agents have been proposed as a useful non-invasive treatment option in children with OSA. PMID: 21249687 [PubMed - in process] (Source: Cochrane Database...

Link Between Tonsillectomy And Excess Weight Gain In Children

Health News from Medical News Today — Wed, 02 Feb 2011 10:00:00 +0100

Tonsillectomy is the most common major surgical procedure performed in children. Children who undergo the surgical removal of their tonsils (tonsillectomy), with or without the removal of their adenoids (adenoidectomy), are at increased risk for becoming overweight after surgery, according to new research published in the February 2011 issue of Otolaryngology - Head and Neck Surgery. Pediatric obesity has increased overwhelmingly over the last 20 years, with recent data suggesting that as many as 33 percent of American children are overweight and 17 percent obese... (Source: Health News from Medical News Today)

Tonsillectomy May Lead To Weight Gain In Kids

Medical Headlines From Ivanhoe.com — Wed, 02 Feb 2011 05:00:00 +0100

(Ivanhoe Newswire) -- Children who undergo the surgical removal of their tonsils (tonsillectomy), with or without the removal of their adenoids (adenoidectomy), are at increased risk for becoming overweight after surgery, according to new research. (Source: Medical Headlines From Ivanhoe.com)

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Tonsillectomy linked to weight gain

Health News - UPI.com — Wed, 02 Feb 2011 04:47:02 +0100

ST. LOUIS, Feb. 1 (UPI) -- Children who had tonsillectomies -- with or without the removal of adenoids -- have an increased risk of becoming overweight, U.S. researchers say. (Source: Health News - UPI.com)

Tonsillectomy linked to excess weight gain

Medicineworld.org: New Article Alert — Tue, 01 Feb 2011 14:03:38 +0100

Alexandria, VA � Tonsillectomy is the most common major surgical procedure performed in children. Children who undergo the surgical removal of their tonsils (tonsillectomy), with or without the removal of their adenoids (adenoidectomy), are at increased risk for becoming overweight after surgery, as per new research reported in the February 2011 issue of Otolaryngology � Head and Neck Surgery....... (Source: Medicineworld.org: New Article Alert)

Tonsillectomy linked to excess weight gain in kids

EurekAlert! - Social and Behavioral Science — Tue, 01 Feb 2011 05:00:00 +0100

(American Academy of Otolaryngology - Head and Neck Surgery) Tonsillectomy is the most common major surgical procedure performed in children. Children who undergo the surgical removal of their tonsils (tonsillectomy), with or without the removal of their adenoids (adenoidectomy), are at increased risk for becoming overweight after surgery, according to new research published in the February 2011 issue of Otolaryngology -- Head and Neck Surgery. (Source: EurekAlert! - Social and Behavioral Science)

Tonsillectomy, Adenoidectomy Tied to Weight Gain

Modern Medicine — Tue, 01 Feb 2011 00:00:00 +0100

Normal and overweight children who undergo tonsillectomy or adenoidectomy gain a greater amount of weight than expected after the operation, according to a review published online Jan. 4 in Otolaryngology -- Head and Neck Surgery. (Source: Modern Medicine)

Comparative study of nasopharyngeal soft-tissue characteristics in patients with Class III malocclusion

American Journal of Orthodontics and Dentofacial Orthopedics — Tue, 01 Feb 2011 00:00:00 +0100

Conclusions: This study suggests new lines of investigation about the relationship between skeletal and dental anomalies and airway obstruction, and possible specific respiratory characteristics for each type of malocclusion. (Source: American Journal of Orthodontics and Dentofacial Orthopedics)

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Sleep Evaluation May Help Identify Children At Risk For Respiratory Complications After Tonsil Surgery

Health News from Medical News Today — Thu, 20 Jan 2011 13:00:00 +0100

Performing polysomnography (sleep study) prior to pediatric adenotonsillectomy (surgical removal of the tonsils and adenoids) may help identify children at a higher risk of developing postoperative respiratory complications, according to a report in the January issue of Archives of Otolaryngology - Head Neck Surgery, one of the JAMA/Archives journals. "Pediatric adenotonsillectomy is a safe outpatient procedure; however, there is a subset of patients who do not meet the criteria for outpatient surgery," according to background information in the article... (Source: Health News from Medical News Today)

Relative nasopharyngeal patency index as possible objective indication for adenoidectomy in children with orthodontic problems

International Journal of Pediatric Otorhinolaryngology — Wed, 19 Jan 2011 15:59:04 +0100

Conclusions: Relative nasopharyngeal flow below 38% should constitute an indication for adenoidectomy, due to the exceeded adaptive capabilities of the body. (Source: International Journal of Pediatric Otorhinolaryngology)

Late-onset laryngomalacia: A cause of pediatric obstructive sleep apnea

International Journal of Pediatric Otorhinolaryngology — Wed, 19 Jan 2011 15:59:03 +0100

Conclusions: Late-onset laryngomalacia may act alone or in concert with additional dynamic or fixed lesions to cause pediatric OSAS. Although there is no specific pre-operative indicator to diagnose late-onset laryngomalacia, it can be readily identified intra-operatively and effectively treated with supraglottoplasty, with or without concurrent adenotonsillectomy. (Source: International Journal of Pediatric Otorhinolaryngology)

Tympanoplasty in children: A review of 91 cases

Auris, Nasus, Larynx — Wed, 19 Jan 2011 15:58:24 +0100

Conclusions: This study shows that tympanoplasty is a valid treatment modality for tympanic membrane perforation in the pediatric population. A tympanic membrane perforation can be closed at any age. There is no age limit below which perforation should not be closed. A previous adenoidectomy in children older than 10 years seems to be an independent predictor of functional success. (Source: Auris, Nasus, Larynx)

Sleep evaluation may help identify kids at risk for respiratory complications after tonsil surgery

ScienceDaily Headlines — Tue, 18 Jan 2011 10:00:00 +0100

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Monopolar Suction Diathermy Adenoidectomy: Technical Note

Indian Journal of Otolaryngology and Head and Neck Surgery — Sat, 15 Jan 2011 00:57:13 +0100

Abstract Monopolar suction diathermy allows controlled resection of the adenoids in a near bloodless field. In this article the author describes some technical points to make the procedure safe. Content Type Journal ArticlePages 1-2DOI 10.1007/s12070-010-0070-0Authors P. Modayil, Department of ENT, St George’s Hospital, London, UKG. O. Modayil, Sri Devaraj URS Medical College, Kolar, IndiaI. Pai, Department of ENT, St George’s Hospital, London, UKC. Van Wykk, Department of ENT, St George’s Hospital, London, UK Journal Indian Journal of Otolaryngology and Head & Neck SurgeryOnline ISSN 0973-7707Print ISSN 0019-5421 (Source: Indian Journal of Otolaryngology and Head and Neck Surgery)

Otitis media with effusion in children

Clinical Evidence — Wed, 12 Jan 2011 23:00:00 +0100

New evidence; conclusions changed for: Corticosteroids (intranasal) versus placebo One RCT added, which compared intranasal mometasone versus placebo in 217 children aged 4 to 11 years. The RCT found no significant difference between intranasal mometasone and placebo in resolution of otitis media in at least one ear at 1 or 3 months as assessed by tympanometry. The sample was from primary care and so generalisable to most children. The cases were bilateral, but the histories were typical of those presenting in primary care. Categorisation changed from Unknown effectiveness to Unlikely to be beneficial. New evidence; conclusion confirmed for: Adenoidectomy One systematic review added (search date 2009). The revie...

Endoscopic Adenoidectomy with Microdebrider

Indian Journal of Otolaryngology and Head and Neck Surgery — Mon, 10 Jan 2011 15:54:35 +0100

Abstract To describe endoscopic power assisted adenoidectomy and review the experience with the procedure demonstrating its safety and efficacy. Prospective study of 44 patients aged between 7 to 15 years undergoing power assisted adenoidectomy between Jan 2004 and July 2006. Tertiary care private teaching hospital. Forty four consecutive children with adenoid hypertrophy undergoing power assisted adenoidectomy. Therapeutic endoscopic adenoidectomy using microdebrider. Operative time, blood loss, complications, completeness and depth of removal, surgeon’s satisfaction and recovery period. The average operative time was 12 min (range: 8–16 min) and average blood loss was 30 ml (range: 24–42 ml). Complete resection was possible under vision wit...

In reference to “Is polysomnography required prior to tonsillectomy and adenoidectomy for diagnosis of obstructive sleep apnea versus mild sleep‐disordered breathing in children?”

The Laryngoscope — Tue, 04 Jan 2011 00:00:00 +0100

(Source: The Laryngoscope)

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Perioperative acupuncture and postoperative acupressure can prevent postoperative vomiting following paediatric tonsillectomy or adenoidectomy: a pragmatic randomised controlled trial.

Acupuncture in Medicine : journal of the British Medical Acupuncture Society — Sat, 18 Dec 2010 00:00:00 +0100

CONCLUSION: This trial indicates the effectiveness of acustimulation as an adjunct to standard treatment. The results should encourage and promote the implementation of acustimulation for postoperative vomiting in children undergoing adenoidectomy or tonsillectomy. PMID: 21169634 [PubMed - as supplied by publisher] (Source: Acupuncture in Medicine : journal of the British Medical Acupuncture Society)

Serological evidence of Merkel cell polyomavirus primary infections in childhood

Journal of Clinical Virology — Mon, 22 Nov 2010 00:00:00 +0100

Conclusion: MCPyV primary infections occur ubiquitously in childhood, and the first exposure takes place at young age. The serology showed no evidence for a causative role of MCPyV in lower respiratory tract infection manifesting as acute wheezing, but was compatible with the notion of MCPyV persistence in tonsils. (Source: Journal of Clinical Virology)

Polysomnography outcomes for partial intracapsular versus total tonsillectomy

International Journal of Pediatric Otorhinolaryngology — Sat, 20 Nov 2010 05:59:55 +0100

Conclusions: Our study demonstrates no clinically or statistically significant differences in PSG and clinical outcomes between PITA and T&A for treatment of pediatric SDB in otherwise healthy children. (Source: International Journal of Pediatric Otorhinolaryngology)

Magnesium sulphate infusion is not effective on discomfort or emergence phenomenon in paediatric adenoidectomy/tonsillectomy

International Journal of Pediatric Otorhinolaryngology — Sat, 20 Nov 2010 05:59:55 +0100

Conclusion: Magnesium sulphate infusion has no influence on sevoflurane-induced discomfort or emergence agitation. (Source: International Journal of Pediatric Otorhinolaryngology)

Otitis media history, surgery and allergy in 60-year perspective: A population-based study

International Journal of Pediatric Otorhinolaryngology — Sat, 20 Nov 2010 05:59:54 +0100

Conclusions: Despite a twofold increase in recurrent OM and OM surgery from 1925 to 1945, the proportion of OM and OM surgery have been stable since 1945. Our findings suggest a shift in clinical practice, most likely indicating a change in surgery from acute infections to otitis media with effusion (OME). (Source: International Journal of Pediatric Otorhinolaryngology)

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Safety implications of the Boyle-Davis mouth gag and tracheal tube position in tonsillectomy

British Journal of Anaesthesia — Tue, 16 Nov 2010 00:00:00 +0100

Conclusions. We believe that this study raises concerns not previously highlighted, on how manipulating a BDG may influence the TT position. It may serve to explain additional mechanisms of potentially fatal anaesthetic complications such as TT dislodgement, unilateral ventilation, and pneumothorax, particularly in paediatric patients, after tonsillectomy. (Source: British Journal of Anaesthesia)

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American Journal of Otolaryngology — Mon, 01 Nov 2010 04:00:00 +0100

In this study, there could be 2 groups: adenoidectomy could be compared with the management method of authors. Thereby, the effect of pure adenoidectomy along with the certain affects of mentioned treatment protocol could be differentiated. (Source: American Journal of Otolaryngology)

Postoperative bleeding in paediatric ENT surgery. First results of the German ESPED trial.

Hamostaseologie — Mon, 01 Nov 2010 00:00:00 +0100

Authors: Bidlingmaier C, Olivieri M, Stelter K, Eberl W, von Kries R, Kurnik K Bleeding after ear-nose-and throat surgery in children is a serious complication. With the help of the German Surveillance Unit for Rare Paediatric Disorders (Erhebungseinheit für seltene pädiatrische Erkrankungen in Deutschland; ESPED) a two year survey was performed to record the incidence, severity, reasons and treatment of haemorrhages. During the study period, 1069 bleeds were reported from 720 paediatric hospitals and departments of otorhinolaryngology after adenoidectomy and tonsillectomy. 713 reports could be analyzed. Two deaths occurred after adenoidectomy. Although laboratory screening was performed in more than 70% of all cases, bleeding complications were neither foreseeable nor preventable. I...

Sleep-disordered breathing

Dental Abstracts — Mon, 01 Nov 2010 00:00:00 +0100

Children with Down syndrome (DS) have multiple neurocognitive deficits that have been attributed by some to underlying genetic anomalies. It is possible that some aspects of DS may result from fragmented sleep patterns or sleep deprivation caused by a sleep disorder. DS is a significant risk factor for sleep-disordered breathing, which affects at least 50% to 80% of children with DS. Not recognizing the relationship between DS and sleep-disordered breathing may contribute to learning and behavioral problems in these children. The characteristics of obstructive sleep apnea (OSA) include episodic obstruction of the upper airway during sleep, causing hypoxemia and frequent arousal; snoring; and daytime sleepiness. Surgery to manage OSA, such as tonsillectomy and adenoidectomy, may not be help...

Changes and consistencies in the epidemiology of pediatric adenotonsillar surgery, 1996-2006

Otolaryngology - Head and Neck Surgery — Tue, 26 Oct 2010 01:12:31 +0100

Conclusion: Although there was an overall increase in the rate of performance of adenotonsillar surgery, population adjusted performance rates of these procedures specifically for infectious indications declined from 1996 to 2006. (Source: Otolaryngology - Head and Neck Surgery)

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Anesthetic management of the pediatric bleeding tonsil.

Paediatric Anaesthesia — Sun, 24 Oct 2010 06:00:48 +0100

Conclusions: We determined our incidence of ventilatory and hemodynamic complications in a relatively large cohort of children with post-tonsillectomy hemorrhage. Transient hypoxemia was the most common complication and was not related to difficult intubation. PMID: 20964765 [PubMed - in process] (Source: Paediatric Anaesthesia)

Assessment of adenoid size: A comparison of lateral radiographic measurements, radiologist assessment, and nasal endoscopy

International Journal of Pediatric Otorhinolaryngology — Tue, 12 Oct 2010 17:48:04 +0100

Abstract: Objectives: Correlate adenoid size as determined by lateral neck radiographs and intra-operative mirror exam. Determine if a radiologist's assessment of the lateral neck X-ray correlates with adenoid size. Assess the correlation of endoscopic findings to the degree of adenoid hypertrophy seen on intra-operative mirror exam. To perform a cost analysis of radiographic and endoscopic evaluations of the adenoids.Study design: Retrospective study.Methods: Patients who underwent adenoidectomy were reviewed. The adenoid size as determined by the adenoid-to-nasopharyngeal (A/N) ratio, radiology report, and flexible nasal endoscopy were compared to the adenoid size as determined by intra-operative mirror nasopharyngeal exam. Compensation rates for each modality were compared.Results: Sixt...

Obstructive sleep disorders in Prader–Willi syndrome: The role of surgery and growth hormone

International Journal of Pediatric Otorhinolaryngology — Tue, 12 Oct 2010 17:48:03 +0100

Conclusions: Our series, and other small case series, have demonstrated that complete resolution of sleep apnea in PWS patients is difficult to obtain with upper airway surgery alone. It is suggested that children with PWS being considered for growth hormone therapy undergo assessment for OSA by polysomnography. Patients identified with OSA should be referred for management by tonsillectomy and/or continuous positive airway pressure (CPAP) and then reassessed for residual airway obstruction prior to instituting hormonal therapy. (Source: International Journal of Pediatric Otorhinolaryngology)

Aerobic and anaerobic bacteriology of chronic adenoid disease in children

International Journal of Pediatric Otorhinolaryngology — Tue, 12 Oct 2010 17:48:01 +0100

Abstract: Bacterial cultures from nasopharyngeal swabs of children after adenoidectomy and from the removed adenoid tissue in the same patient group were compared. At the same time, the colony-forming unit, as a measure of viable bacterial cells and the composition of isolated bacteria were also determined in the case of adenoid tissue. Our findings showed that the culture results of nasopharyngeal swabs and inner part of the adenoid tissue are in close correlation. Polymicrobial aerobic-anaerobic flora was present in all instances. The predominant aerobic isolates in all two groups were S. pneumoniae, H. influenzae and M. catarrhalis. Anaerobic bacteria most commonly recovered in the adenoid were Peptostreptococcus spp., Prevotella spp., and Fusobacterium spp. (Source: International Journ...

PFAPA syndrome in children: A meta-analysis on surgical versus medical treatment

International Journal of Pediatric Otorhinolaryngology — Tue, 12 Oct 2010 17:48:00 +0100

Abstract: Objective: To compare the range of medical and surgical therapies for children with PFAPA syndrome.Methods: A literature search was performed using Medline, Embase, Ovid and Cochrane databases for studies between 1987 and 2010 that compared PFAPA treatment in children (surgical versus medical). Random-effect meta-analytical techniques were conducted for the outcome measures.Results: The use of antibiotics and cimetidine in PFAPA syndrome are ineffective. However, there is evidence that the use of steroids is effective in the resolution of symptoms. Tonsillectomy (+/− adenoidectomy) as a treatment of PFAPA was found to be an effective intervention for resolution of symptoms (P (Source: International Journal of Pediatric Otorhinolaryngology)

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Tonsillectomy for PFAPA syndrome

NLH Specialist Library for ENT and Audiology Latest Content — Mon, 04 Oct 2010 15:06:13 +0100

Authors' conclusions The trials included in this review reported follow up at 18 and six months respectively but it is well-established that children with PFAPA recover spontaneously and treatment can be administered to try and reduce the severity of individual episodes. Therefore, the parents and carers of children with PFAPA must weigh the risks and consequences of surgery against the alternative of a finite period of recurrent episodes of disease at predictable intervals, potentially requiring time off school and the regular use of medication. It is uncertain whether adenoidectomy combined with tonsillectomy adds any additional benefit to tonsillectomy alone. (Source: NLH Specialist Library for ENT and Audiology Latest Content)

A meta-analysis on surgical versus medical treatment for PFAPA syndrome in children

NLH Specialist Library for ENT and Audiology Latest Content — Mon, 04 Oct 2010 14:58:42 +0100

Authors' conclusions: The most effective non-surgical therapy is corticosteroids. However, they do not prevent future fever cycles. The results of this meta-analysis showed that tonsillectomy (+/- adenoidectomy) is the most effective intervention for long-term resolution of PFAPA syndrome symptoms. (Source: NLH Specialist Library for ENT and Audiology Latest Content)

The effect of ibuprofen on postoperative hemorrhage following tonsillectomy in children

European Archives of Oto-Rhino-Laryngology — Sat, 02 Oct 2010 06:01:12 +0100

The objective of the study was to evaluate the effect of ibuprofen on hemorrhage after tonsillectomy in children. All charts of children, who underwent tonsillectomy with or without adenoidectomy, were reviewed. The age at the time of surgery ranged between 3 and 16 years (mean age = 7.55 ± 3.01 years). Children were divided into two groups based on the drugs used for postoperative pain relief. Group I received paracetamol after surgery. Group II received ibuprofen after surgery. A total of 62 patients received ibuprofen and 109 patients were given paracetamol. Post-tonsillectomy hemorrhage occurred in seven (4.1%) children, primary hemorrhage was noted in five patients and secondary hemorrhage occurred in two patients. While 3 of 62 children (4.8%) who...

Tonsillectomy and Adenoidectomy and Myringotomy With Tube Insertion

Pediatrics in Review — Fri, 01 Oct 2010 15:00:44 +0100

(No abstract is available for this citation) (Source: Pediatrics in Review)

Non-pressure therapies for obstructive sleep apnea: surgery and oral appliances.

Respiratory Care — Thu, 30 Sep 2010 23:00:00 +0100

Authors: Woodson BT The first-line treatment of obstructive sleep apnea (OSA) is positive airway pressure (PAP). If PAP fails to adequately treat the OSA, oral appliances that enlarge the airway (mandibular advancement devices primarily, or the tongue retaining device if the patient has no dentition) are the next line of therapy. The third-line treatment of OSA is surgery. Surgeries that have been used to treat OSA include septoplasty, tonsillectomy adenoidectomy, uvulopalatopharyngoplasty, mandibular advancement procedures, tongue reduction surgery, hyoid bone suspension, maxillofacial surgery, and bariatric procedures. There are scant data to support or compare the various procedures. PMID: 20875158 [PubMed - in process] (Source: Respiratory Care)

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Sturge-Weber Syndrome: Ear, Nose, and Throat Issues and Neurologic Status

Pediatric Neurology — Wed, 15 Sep 2010 06:43:14 +0100

We examined the relationships between these issues, secondary surgical interventions, and patients' neurologic status. The most common complaints involved the sinuses and frequent ear infections. Six patients underwent placement of ear tubes, leading to improvements in migraines and stroke-like episodes in one patient, and improved seizure control in four others. Obstructive sleep apnea was confirmed in three patients who underwent sleep studies. Tonsil or adenoid removal occurred in another three patients. Surgery resulted in marked improvements regarding excessive drooling, daytime sleepiness, and breathing problems. These findings suggest that ear, nose, and throat problems occur frequently in patients with Sturge-Weber Syndrome, and when repeated ear infections are associated with unco...

Tonsillectomy for periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA).

Cochrane Database of Systematic Reviews — Sun, 12 Sep 2010 02:48:06 +0100

CONCLUSIONS: The trials included in this review reported follow up at 18 and six months respectively but it is well-established that children with PFAPA recover spontaneously and treatment can be administered to try and reduce the severity of individual episodes. Therefore, the parents and carers of children with PFAPA must weigh the risks and consequences of surgery (hospitalisation, a predictable period of time postoperatively away from school/nursery, the risks of surgery) against the alternative of a finite period of recurrent episodes of disease at predictable intervals, potentially requiring time off school and the regular use of medication. It is uncertain whether adenoidectomy combined with tonsillectomy adds any additional benefit to tonsillectomy alone. PMID: 20824883 [PubMed...

Does preincisional injection of levobupivacaine with epinephrine have any benefits for children undergoing tonsillectomy? An intraindividual evaluation

International Journal of Pediatric Otorhinolaryngology — Fri, 10 Sep 2010 08:25:42 +0100

Abstract: Objective: To evaluate the effects of peritonsillar injection of levobupivacaine with epinephrine in children undergoing adenotonsillectomy, through an intraindividual study.Patients and methods: 20 children (age 6–13 years) undergoing elective tonsillectomy with or without adenoidectomy were enrolled in this prospective, randomized, intraindividual trial. After entubation and just prior to incision, 3ml of 0.25% levobupivacaine with epinephrine was injected into one peritonsillar region while 0.9% saline was being used for the contralateral side. Amount of intraoperative blood loss, duration of tonsillectomy, postoperative pain, otalgia and hemorrhage were assessed for each side separately. Visual analog scale was used for postoperative pain assessment. Heart rate and mean art...

Ketoprofen pharmacokinetics, efficacy, and tolerability in pediatric patients.

Paediatric Drugs — Thu, 02 Sep 2010 04:57:10 +0100

In conclusion, ketoprofen is effective and well tolerated in children for the control of post-surgical pain and for the control of pain and fever in inflammatory conditions. PMID: 20799760 [PubMed - in process] (Source: Paediatric Drugs)

Balloon catheter sinuplasty and adenoidectomy in children with chronic rhinosinusitis.

The Annals of Otology, Rhinology, and Laryngology — Wed, 01 Sep 2010 00:00:00 +0100

CONCLUSIONS: Balloon catheter sinuplasty offers a procedure that is more effective than adenoidectomy and less invasive than endoscopic sinus surgery in the treatment of pediatric CRS. PMID: 21033023 [PubMed - in process] (Source: The Annals of Otology, Rhinology, and Laryngology)

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Taste impairment following tonsillectomy and adenoidectomy: An unusual complication.

Ear, Nose and Throat Journal — Tue, 31 Aug 2010 23:00:00 +0100

Authors: Randall DA Tonsillectomy and adenoidectomy is a relatively safe procedure, but it is nevertheless associated with certain complications. Some of these include throat pain, otalgia, dehydration, hemorrhage, nasopharyngeal stenosis, velopharyngeal insufficiency, burns, soft-tissue injury, dentomandibular trauma, atlantoaxial subluxation, and respiratory compromise. One unusual complication is altered taste. To the best of the author's knowledge, only 29 cases of altered taste associated with palatine tonsillectomy have been previously reported in the literature since 1966. In this article, the author reports a new case and discusses the features of this unlikely complication. PMID: 20859855 [PubMed - in process] (Source: Ear, Nose and Throat Journal)

Role of Adenoidectomy in Otitis Media and Respiratory Function

Current Allergy and Asthma Reports — Wed, 18 Aug 2010 17:44:29 +0100

Abstract Adenoidectomy is among the most frequent surgical procedures performed on children. The rationale for adenoidectomy is to remove a chronically infected or enlarged and obstructing adenoid. Adenoidectomies are performed on children who have recurrent or chronic otitis media with effusion, on children with chronic rhinosinusitis, and on children with nasopharyngeal obstruction causing sleep disturbances and continuous mouth breathing. Various underlying factors that lead to adenoidectomy are also associated with asthma. Asthma is associated with recurrent respiratory tract infections predisposing individuals to recurrent or chronic otitis media and chronic rhinosinusitis. Children with asthma also have an increased risk of sleep-disordered breathing that is treated ...

Adenoidectomy and nasopharyngeal carriage of Streptococcus pneumoniae in young children

Archives of Disease in Childhood — Tue, 17 Aug 2010 16:34:16 +0100

Conclusions Adenoidectomy increases the risk of nasopharyngeal carriage of pneumococci in children younger than 4 years of age. This may be independent of the development of serum IgG capsular polysaccharide antibodies. (Source: Archives of Disease in Childhood)

Dexamethasone Administration and Postoperative Bleeding Risk in Children Undergoing Tonsillectomy [Original Article]

Archives of Otolaryngology — Mon, 16 Aug 2010 19:50:54 +0100

Conclusion In this observational review of children undergoing tonsillectomy or adenotonsillectomy, perioperative dexamethasone administration is not associated with a dose-dependent elevation of postoperative hemorrhage rates after adjusting for age, sex, primary diagnosis, and surgical technique. (Source: Archives of Otolaryngology)

Cost-effectiveness of adenotonsillectomy in reducing obstructive sleep apnea, cerebrovascular ischemia, vaso-occlusive pain, and ACS episodes in pediatric sickle cell disease

Annals of Hematology — Mon, 16 Aug 2010 18:02:25 +0100

This study compares episode recurrence and treatment costs for cerebrovascular ischemia, vaso-occlusive pain, acute chest syndrome (ACS), and obstructive sleep apnea in children who had an adenotonsillectomy (A/T surgery, N = 256; 11.7%) and a matched cohort of those who did not (N = 512; 23.3%) from a cohort of 2,194 children and adolescents with SCD from South Carolina’s Medicaid system. A/T surgery was associated with a significantly reduced rate of visits over time for obstructive sleep apnea and cerebrovascular ischemia (e.g., stroke, transient ischemic attacks), but not with any change in the rate of visits for vaso-occlusive pain or ACS/pneumonia visits. The rate of mean acute (emergency and inpatient) service costs was significantly decreasing over time after an incr...

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Polysomnographic Characteristics of a Referred Sample of Children with Sickle Cell Disease

Journal of Clinical Sleep Medicine : JCSM — Sat, 14 Aug 2010 09:02:22 +0100

Conclusions: Both OSA and PLMs were common in children with SCD. Children with Hb SS experienced more severe nocturnal oxygen desaturation than did those with Hb SC. Post-adenotonsillectomy, most children had OSA, although they experienced fewer obstructive respiratory events and less severe nocturnal oxygen desaturation than did untreated OSA-positive children. Keywords: Adenoidectomy, tonsillectomy, child, adolescent, sickle cell disease, obstructive sleep apnea, periodic limb movement disorder, polysomnography (Source: Journal of Clinical Sleep Medicine : JCSM)

A review of malpractice cases after tonsillectomy and adenoidectomy

International Journal of Pediatric Otorhinolaryngology — Fri, 13 Aug 2010 06:05:36 +0100

Conclusions: A significant portion of malpractice claims following tonsillectomy or adenoidectomy are related to complications not commonly discussed in the literature. (Source: International Journal of Pediatric Otorhinolaryngology)

Dexmedetomidine Infusion for Analgesia and Prevention of Emergence Agitation in Children with Obstructive Sleep Apnea Syndrome Undergoing Tonsillectomy and Adenoidectomy.

Anesthesia and Analgesia — Wed, 11 Aug 2010 23:00:00 +0100

Conclusions: An intraoperative infusion of dexmedetomidine combined with inhalation anesthetics provided satisfactory intraoperative conditions for T&A without adverse hemodynamic effects. Postoperative opioid requirements were significantly reduced, and the incidence and duration of severe emergence agitation was lower with fewer patients having desaturation episodes. PMID: 20705788 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)

Bacteremia during adenoidectomy: a comparison of suction diathermy adenoid ablation and adenoid curettage.

The Annals of Otology, Rhinology, and Laryngology — Sat, 31 Jul 2010 23:00:00 +0100

CONCLUSIONS: A transient bacteremia exists after pediatric adenoidectomy, but does not correlate with symptoms or signs. Neither suction diathermy adenoidectomy nor curettage adenoidectomy offers a particular advantage in terms of decreasing the incidence of bacteremia. PMID: 20860277 [PubMed - in process] (Source: The Annals of Otology, Rhinology, and Laryngology)

Outcome of adenotonsillectomy for obstructive sleep apnea syndrome in children.

The Annals of Otology, Rhinology, and Laryngology — Sat, 31 Jul 2010 23:00:00 +0100

CONCLUSIONS: Adenotonsillectomy is associated with improvements in PSG, behavior, and QOL in children with OSAS. However, it may not resolve OSAS in all children. The efficacy and role of additional therapeutic options require more study. PMID: 20860275 [PubMed - in process] (Source: The Annals of Otology, Rhinology, and Laryngology)

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A cost-effectiveness analysis of coagulation testing prior to tonsillectomy and adenoidectomy in children

Pediatric Blood and Cancer — Wed, 28 Jul 2010 23:00:00 +0100

The American Society of Pediatric Otolaryngology recommends pre-operative coagulation testing only when indicated by history or physical exam. Nevertheless, many surgeons test all children scheduled for tonsillectomy and/or adenoidectomy (T&A). Studies of pre-operative screening have had conflicting results. A decision analysis model was constructed to address the costs and health outcome states of pre-operative screening strategies in children.A 14-day Markov model evaluated three strategies: (1) test all children for coagulation disorders; (2) test only those children with a pertinent history; and (3) perform no pre-operative testing. A literature search and a review of national databases estimated probabilities, costs, and utility data. Parameters then were varied widely in sensitivity ...

Atypical presentation of an impacted radiolucent esophageal foreign body

Journal of Anesthesia — Wed, 07 Jul 2010 06:50:33 +0100

We report a rare case of a child who presented with stridor and obstructive sleep apnea. The cause of respiratory symptoms was thought to be due to enlarged tonsils and adenoids, and the patient was scheduled for tonsillectomy and adenoidectomy. On re-evaluation by the surgeon on the day of surgery, the procedure was changed to diagnostic microlaryngoscopy and bronchoscopy to rule out any other cause. The patient’s respiratory symptoms were resolved when an incidental discovery and retrieval of the radiolucent esophageal foreign body was made. The diagnosis of radiolucent esophageal foreign body can be difficult and can be easily missed without reasonable clinical suspicion. Content Type Journal ArticleCategory Clinical ReportDOI 10.1007/s00540-010-0981-7Authors Tariq Parray...

The Effect of Intraoperative Dexmedetomidine on Postoperative Analgesia and Sedation in Pediatric Patients Undergoing Tonsillectomy and Adenoidectomy.

Anesthesia and Analgesia — Tue, 06 Jul 2010 23:00:00 +0100

Conclusions: The total postoperative rescue opioid requirements were similar in tonsillectomy patients receiving intraoperative dexmedetomidine or morphine. However, the use of dexmedetomidine 1 mug/kg and morphine 100 mug/kg had the advantages of an increased time to first analgesic and a reduced need for additional rescue analgesia doses, without increasing discharge times. PMID: 20610555 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)

Non-surgical treatment of adenoidal hypertrophy: The role of treating IgE-mediated inflammation

Pediatric Allergy and Immunology — Wed, 30 Jun 2010 23:00:00 +0100

This article reviews the epidemiology and pathophysiology of AH with a particular focus on evidence of its association with allergy and allergic rhinitis. Current treatment options are briefly considered with discussion on the rationale and evidence for the use of INS. (Source: Pediatric Allergy and Immunology)