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PubMed2004

Lateral neck radiography versus direct video rhinoscopy in assessing adenoid size.

OBJECTIVE: To evaluate the usefulness of adynamic lateral neck radiographs and dynamic video rhinoscopy in assessing adenoid size and the relationship of these methods to associated symptoms and thus the severity of the disease. METHODS: Children with suspected adenoid hypertrophy underwent standard lateral neck soft tissue radiographs: the percentage of airway occlusion, adenoid to nasopharynx (AN) ratio, airway to soft palate ratio, and adenoid thickness were assessed by a radiologist. The percentage of airway closure was assessed by direct fibre-optic rhinoscopy in an ear, nose, and throat clinic. Associated clinical symptoms were assessed by parents using a standardized questionnaire, evaluating the severity of symptoms (snoring, sleep apnea, mouth breathing, and otitis media) to give a total symptom score out of 16. RESULTS: Nonparametric statistical analysis using Spearman's correlation coefficients was performed on 32 patients. There was a weak correlation, which approaches significance, between the percentage of airway occlusion assessed by fibre-optic rhinoscopy and the total symptom score (r = .344, p = .054). However, this correlation becomes significant when the frequency of otitis media is omitted (r = .367, p = .039). There was also a significant correlation between airway occlusion assessed by rhinoscopy and the percentage of airway occlusion as determined by lateral neck radiography (r = .431, p = .014). There was no correlation between any of the measurements taken by lateral soft tissue neck radiography and total symptom score. CONCLUSION: Dynamic video rhinoscopy is more accurate at assessing adenoid hypertrophy, and the percentage of airway occlusion, as estimated by video rhinoscopy, is better correlated to the severity of symptoms than are values obtained by lateral neck radiography.

Adenoidectomy↗
PubMedDate not supplied

Spontaneous DNA synthesis in adenoidal lymphocytes from healthy children and from children with otitis media with effusion.

Spontaneous DNA synthesis (SDS) in adenoidal lymphocytes was investigated in 37 children with particular attention to the relationship between the adenoids and otitis media with effusion (OME). The SDS was measured by [3H]thymidine incorporation under a certain culture condition without any mitogens. Adenoidal lymphocytes showed an extremely higher uptake of [3H]thymidine than did peripheral lymphocytes. SDS in adenoidal lymphocytes was much greater in the 3-5-year-old age group than in the older groups. SDS in patients with OME was also significantly greater than that in patients with no complications. Patients who recovered from OME within 3 months following adenoidectomy showed significantly greater SDS than those with recurrent effusion over 6 months. These results might indicate a relationship between the adenoids and OME.

Adenoidectomy↗
PubMed1991

Mast cells and histamine in adenoid tissue and middle ear.

Biopsy specimens from middle ear mucosa of patients with secretory (SOM) and chronic (COM) otitis media as well as specimens of adenoid and tonsil tissue were studied for mast cells. Effusion fluid, nasopharyngeal secretion and supernatant of crushed adenoid tissue were analyzed for histamine with a radioenzymatic method. Astra blue (AB) safranine stained highly significantly more mast cells than did toluidine blue. Mast cell counts in SOM and COM were similar. There were significantly more mast cells in adenoid subepithelial tissue than in middle ear mucosal subepithelial layer. For epithelium the counts were within the same range in adenoids and middle ear mucosa. Histamine concentrations were significantly higher than plasma levels for SOM fluid and nasopharyngeal secretion. Crushed adenoid tissue showed values over 100 times higher than the histamine level in the secretion.

Adenoids↗
PubMed1993

[Silver-stained nucleolar organizer regions in adenoid cystic carcinoma].

The histological features of adenoid cystic carcinoma are varied. In general, the tumors are classified into 4 histological patterns: tubular, cribriform, trabecular and solid. Numerous previous reports have indicated that the tubular pattern usually represents a favorable prognosis, the solid pattern a poor prognosis and the cribriform pattern an intermediate prognosis. Therefore, the present study was undertaken to determine precisely the proliferative potential of each histological pattern of adenoid cystic carcinomas. A silver colloid technique to identify nucleolar organizer region associated protein (AgNORs) was applied to paraffin sections in a total of 16 adenoid cystic carcinomas. A morphometric analysis of highly magnified photographic images of AgNORs in light microscopic preparations was performed. Of the 16 tumors, 8 showed a mixture of different histological patterns in the same section. In comparing the AgNOR number among different histological patterns in the same section, the value was highest for the solid pattern, lowest for the cribriform pattern and intermediate for the trabecular pattern. Moreover, the mean AgNOR number also showed a stepwise increase from the cribriform pattern (2.3 +/- 0.3) through the trabecular pattern (2.9 +/- 0.2) to the solid pattern (3.3 +/- 0.6). There was a significant difference in AgNOR numbers between cribriform and trabecular and between cribriform and solid patterns. Our results indicate that the proliferative potential of histological patterns of adenoid cystic carcinoma is lowest in the cribriform, highest in the solid, and intermediate in the trabecular pattern area. The AgNOR staining technique appears to be of value in estimating the proliferative activity of adenoid cystic carcinomas.

Adult↗
PubMed2003

The value of radiological examination in the management of adenoidal hypertrophy in a pediatric population.

OBJECTIVE: The objective of this study is to evaluate the role of radiological examination in the management of adenoidal hypertrophy. METHODS: A retrospective study was carried out in the North West Armed Forces Hospital, Tabuk, Kingdom of Saudia Arabia on pediatric patients who had x-ray of lateral naso pharynx to exclude adenoidal hypertrophy, January 2001 to December 2001. The study included; age of the patient, sex and reason for radiology examination and the management rendered. RESULTS: A total of two hundred and ninety-seven pediatric patients were involved. Two hundred and thirteen males (71.7%) and 84 (28.3%) females, age ranged between 2 months and 12 years. The reason given for radiological examination was one or more of the following symptoms, snoring, mouth breathing, recurrent tonsillitis, runny nose, deafness and obstructive sleep apnea. Small adenoids reported in 63 patients (21.2%) and were treated for their complaints by their primary physician. Two hundred and thirty-four patients (78.8%) with large adenoids were referred to the otolaryngology department of these 33 patients lost follow up. One hundred and nineteen referred (40.1%) patients were treated conservatively, while 82 patients (27.6%) who showed resistance to medical treatment under went adenoidectomy with or without other related surgical procedures. CONCLUSION: It was concluded that radiological examination in the management of adenoidal hypertrophy had a limited role, increased Radiological Department workload, wastage of resources in addition to unnecessary radiation exposure.

Adenoids↗
PubMed2003

[Efficacy of the medical treatment of adenoid hypertrophy in children with house dust mite allergy].

Allergic sensitisation of the airways occurs in the mucosa of the shock organ, or in the lymphatic stations draining these structures. The lymphatic structure closest to the nasal mucosa in humans is the adenoid. Pediatric adenoidal obstruction of the nasal airway is associated with significant morbidity and is a frequent indication for surgery. Because efficacious medical alternatives to adenoidectomy are lacking, we assessed the potency of standard-dose topical nasal fluticasone propionate and Cetirizine in reduction of adenoidal obstruction of the nasal airway. To examine the influence of these medicines on the adenoid hypertrophy (AH) we studied 43 children ages 4 to 9 years, who had AH and house dust mite allergy. Properly administered aqueous nasal fluticasone propionate and Cetirizine in standard doses can significantly reduce adenoidal hypertrophy and nasal airway obstructive symptoms in atopic children.

Adenoids↗
PubMed2004

[Relationship between adenoids hypertrophy and secretory otitis media].

OBJECTIVE: To investigae the cause of secretory otitis media resulting from adenoids hypertrophy and the relationship between adenoids hypertrophy and secretory otitis media. METHOD: According to the grades of adenoids hypertrophy, 140 children were divided into two groups: the group of middle-grade and the group of pathological hypertrophy. The effect about the degree of adenoids hypertrophy resulted in the descendent of middle ear function and the difference of incidence of secretory otitis media were analyzed. RESULT: The incidence of secretory otitis media and the pattern of tympanic press were distinct difference in two groups. CONCLUSION: The results suggested that there was a positive correlation among the grades of adenoids hypertrophy, the descendent degree of middle ear function and the incidence of secretory otitis media.

Adenoids↗
PubMedDate not supplied

Adenoid cystic carcinoma of the breast: truly uncommon or easily overlooked?

BACKGROUND: Adenoid cystic carcinoma of the breast is an uncommon histologic form of breast cancer, comprising in most series less than 1% of all mammary cancers. Due to the rarity, little information about its presentation on image studies has been noted in the literature. Here we report two additional cases with emphasis on the intriguing image presentations. CASE ONE: A 67-year-old woman came to our clinic with the chief complaint of mastodynia. No obvious palpable mass of breast was found on physical examination. Mammography showed a small well-defined nodule in the medial part of the left breast without mammographic evidence of malignancy. Ultrasonography showed a 1.5 cm nodule with well-defined margin and heterogenous echogenicity in the medial part of the left breast. Unusually, a painful sensation was experienced on compression by the probe. The final pathological report was adenoid cystic carcinoma. CASE TWO: A 48-year-old woman also came to our clinic with the chief complaint of mastodynia. No obvious palpable mass of breast was found on physical examination. Mammography showed dense mammary tissue with no mammographic evidence of malignancy. Ultrasonography showed two contiguous well-defined nodules with heterogenous echogenicity in the upper, middle part of the left breast. Unusually, a painful sensation was also noted on compression by the probe. Histopathological examination showed typical features of an adenoid cystic carcinoma. CONCLUSION: Adenoid cystic carcinoma of the breast fails to show the typical appearance of invasive ductal carcinoma on both mammogram and ultrasonography, probably due to its relatively well-defined nature with less surrounding architectural disruption and fibrosis. Hence a "negative" finding or a benign-looking breast lesion on mammography cannot completely exclude the existence of this disease. The presence of a painful breast lesion without obvious inflammatory evidence while compressed is a meaningful clue, which should lead to the suspicion of adenoid cystic carcinoma of the breast.

Aged↗
PubMed2005

[Relationship between adenoids hypertrophy and tympanogram/eustachian tube function in children].

OBJECTIVE: To evaluate the correlation between adenoidal-nasopharyngeal ratio (AN ratio) and tympanogram/eustachian tube function in children. METHOD: A prospective clinical study from February 2004 to October 2004 was carried out. A total of 120 children with adenoids hypertrophy and 20 normal children were examined. The relationship between AN ratio and middle-ear pressure was evaluated, the eustachian tube function was compared between the children with adenoids hypertrophy and the normal. RESULT: (1) Middle ear pressures were negative related to the AN ratio (r = -0.41, P < 0.05); (2) the eustachian tube function of the children with adenoids hypertrophy was worse than the normal; (3) the relation between the eustachian tube function and the AN ratio was not statistical difference. CONCLUSION: Eustachian tube dysfunction caused by adenoids hypertrophy is the etiologic factor of secretory otitis media.

Adenoids↗
PubMed2006

[Therapeutic modalities of nasopharyngeal adenoid cystic carcinoma].

OBJECTIVE: To grasp clinical characteristics, therapeutic methods and prognosis of the patients with nasopharyngeal adenoid cystic carcinoma, and explore the optimal therapeutic modalities. METHODS: Twenty one cases with nasopharyngeal adenoid cystic carcinoma were retrospectively reviewed. The treatment results were compared between radiotherapy alone and combined therapy. RESULTS: The cases with nasopharyngeal adenoid cystic carcinoma in T1, T2 phases was 28.6%, the cases in T3, T4 phases was 71.4%. The lymphatic node metastasis rate was 14.3%. The present symptoms were nasal discharge with blood, headache, nasal obstruction, deafness, double vision, facial insensibility, etc. One of 21 cases was lost follow up. Five years free-disease survival rates of the patients with nasopharyngeal adenoid cystic carcinoma was 42.9% (9/21). Five years free-disease survival rate of the patients with radiotherapy alone (RA) and the patients with radiotherapy combining surgery (R + S) were respectively 38.5% (5/12) and 50.0% (4/8), P = 0.472. Ten years free-disease survival rates of the patients was 16.7% (3/18). Ten years free-disease survival rates of the patients with RA and the patients with R + S were respectively 0/12 and 3/6, P = 0.025. The local recurrent rate was 50.0% (10/20). The local recurrent rates of the patients with RA and the patients with R + S were respectively 66.7% (8/12) and 25.0% (2/8), P = 0.085. The distant metastasis rate was 30. 0% (6/20). The distant metastasis rates of the patients with RA and the patients with R + S were respectively 25.0% (3/12) and 37.5% (3/8), P = 0.455. CONCLUSIONS: The course of nasopharyngeal adenoid cystic carcinoma is long, and it is prone to the local recurrence and the distant metastasis in advanced stage. Comparing with the radiotherapy alone, the radiotherapy combining surgery has better 10 years free-disease survival rate.

Adult↗
PubMed2006

[Analysis of differential expression genes related to different metastasis potential of adenoid cystic carcinoma using restriction fragments differential display PCR].

OBJECTIVE: To construct differential expression profiles of adenoid cystic carcinoma cell lines for screening candidate genes related to metastasis and to verify some candidate genes in adenoid cystic carcinoma. METHODS: Restriction fragments differential display PCR (RFDD-PCR) was used to set up gene expression profiles of adenoid cystic carcinoma cell lines-ACC-M and ACC-2, with high and low metastasis potential respectively. Candidate genes were screened through bioinformatics analysis. Then, a gene family of these candidate genes was checked using semi-quantitative reverse transcription-PCR(RT-PCR). RESULTS: Two gene expression profiles including 5420 gene fragments were constructed, 12 genes of a family called matrix metalloproteinase genes (MMPs) were observed obvious differentially expressed between two cell lines. Results of semi-quantitative RT-PCR also identified this different expression of MMP2,MMP7,MMP9,MMP14,MMP15 and MMP24. CONCLUSION: The construction of gene expression profiles of ACC-M and ACC-2 cell lines makes the foundation for seeking the target genes of adenoid cystic carcinoma. MMP2,MMP7,MMP9 and MMP15 may be relevant with carcinogenesis, development and metastasis of adenoid cystic carcinoma, and different metastasis potential may result from different subtype of MMPs gene family.

Carcinoma, Adenoid Cystic↗
PubMed1977

Characterization of human adenoid cells using surface and functional markers for lymphocyte subpopulations.

Adenoid lymphocytes from children undergoing adenoidectomy were compared with blood cells from the same children using techniques for identifying T cells and B cells. A high proportion of adenoid lymphocytes were immunoglobulin positive cells. Of these only a minor fraction carried receptors for the Fc part of IgG. Adenoid B lymphocytes respond poorly if at all to polyclonal B-cell activators, such as LPS or PPD, which show a different reactivity compared to human splenic cells. The response to anti B2-microglobulin was also different; blood cells responded better than adenoid cells. Thus distinct subpopulations of B lymphocytes reside in different lymphoid organs. The adenoid lymphocyte reactivity might reflect their function in the defence mechanism against infections.

Adenoids↗
PubMed1987

Adenoid hypoplasia in the velo-cardio-facial syndrome.

The velo-cardio-facial syndrome is one of the most comprehensively studied congenital malformation syndromes of clefting. More than 20 features have been described to date. The purpose of this investigation is to report evidence for congenital hypoplasia of the adenoids in over 80% of the cases studied. Radiographic and nasopharyngoscopic studies of 30 children with velo-cardio-facial syndrome were reviewed along with 30 age- and sex-matched children with nonsyndromic cleft palate to determine the size of their adenoid masses. Eighty-three percent of the subjects with velo-cardio-facial syndrome were found to have small or absent adenoids, whereas only 20% of the controls were found to have small adenoids. None of the control sample had total adenoid absence. These findings may have significant implications for the hypernasal speech patterns often found in individuals with velo-cardio-facial syndrome and may also be related to histories of frequent upper respiratory illnesses in this group.

Adenoids↗
PubMed1983

Penetration of cefaclor to adenoid tissue and middle ear fluid in secretory otitis media.

Seventy-nine patients that had persistent or recurrent secretory otitis media for over 3 months and were scheduled for myringotomy and/or adenoidectomy received a single dose of cefaclor (20 or 40 mg/kg) orally 0.5-4 hours before surgery. Cefaclor concentrations were determined in serum, middle ear fluid and/or blood-free adenoid tissue homogenate using microbiological methods. Concentrations in adenoid homogenate ran parallel to those in serum, indicating a rapid penetration to adenoid tissue. Penetration to middle ear fluid was delayed in comparison. In the 51 patients receiving 20 mg/kg, peak levels occurred after 0.5 hour in serum as well as in adenoid homogenate and middle ear fluid with mean values of 29, 7.5 and 5.1 mg/l, respectively. Concentrations in the middle ear fluid were greater than 2.0 mg/l from 0.5 to 3 hours after this dose. In the 28 patients receiving 40 mg/kg, concentrations levelled after 0.5 hour in serum and in adenoid homogenate, with mean values of 21-33 mg/l and 6.3-12 mg/l, respectively. Concentrations in the middle ear fluid reached 7.8 mg/l 2 hours after this dose. A dose of 20 mg/kg appears to be suitable for treatment of respiratory tract infections on a b.i.d. basis.

Adenoids↗
PubMed1994

Adenoidectomy: indirect visualization of choanal adenoids.

A retrospective review of adenoidectomies was carried out at the Montreal Children's Hospital, Montreal, Quebec. From April 1, 1990, to November 14, 1992, the senior author (JJM) was involved in 330 adenoidectomies with or without concurrent tonsillectomy or pressure equalization tube (PET) insertion. In all cases, adenoid surgery was performed with proper soft palate retraction and indirect visual inspection using laryngeal mirrors. A subgroup of 31 patients (9.4%) was identified as having adenoid tissue extending from the nasopharynx into the choanae and posterior nasal cavity: "choanal adenoids." The characteristics of this subgroup are outlined in the hope that features may be useful in identifying potential choanal adenoids preoperatively. Furthermore, the use of indirect visualization, as opposed to the traditional "blind adenoidectomy," is proposed so that no significant residual adenoid tissue remains post-adenoidectomy.

Adenoidectomy↗
PubMed1996

Profile of immunoglobulin production in adenoid and tonsil lymphocytes.

The adenoids and tonsils are thought to be essential parts of the system protecting against pathogens invading the upper respiratory tracts. We have examined IgA-spot forming cells (SFC) as well as IgG- and IgM-SFC in human adenoid and tonsil lymphocytes. The majority of SPC were revealed to be IgG type in adenoid and tonsil lymphocytes. However, when the changes in the number of SFC were examined following 6 days of incubation in the presence of LPS and Con A, an increase in IgA-SFC was noted in both adenoid and tonsillar lymphocytes, suggesting that adenoid and tonsillar lymphocytes differentiate into IgA forming cells under appropriate conditions.

Adenoids↗
PubMed1997

Adenoidal width and HIV factors.

PURPOSE: To determine the factors that correspond to adenoidal hypertrophy, often prominent in human immunodeficiency virus (HIV)-positive patients. METHODS: The sagittal T1-weighted MR images of 21 HIV-positive patients (age range, 25 to 50 years; mean, 37 years) and 21 healthy control subjects (age range, 24 to 55 years; mean, 35 years) were reviewed blindly and independently by two radiologists who measured the maximal dimension of the nasopharyngeal lymphoid tissue. Twenty-six additional HIV-positive patients were combined with the original 21 HIV-positive patients, and the hematologic studies of these 47 patients were compared with the adenoidal measurements to assess whether a relationship existed between nasopharyngeal prominence and hematocrit, white blood cell count, and CD4 count. RESULTS: Mean adenoidal width was 6.76 mm (SD, 5.82) in the HIV-positive population, but was only 3.36 mm (SD, 2.48) in the age-matched control group. Age and HIV status correlated with nasopharyngeal width measurements. No relationship between adenoidal width and hematocrit, CD4 count, or white blood cell count was evident. CONCLUSION: After correcting for age, we found that adenoidal lymphoid tissue is more abundant in HIV-positive persons than in control subjects. The hematologic ramifications of this finding remain uncertain.

Adenoids↗
PubMed1997

Induction of tumour differentiation and apoptosis and LeY antigen expression in treatment with differentiation-inducing agent, vesnarinone, of a patient with salivary adenoid cystic carcinoma.

A patient with locally-advanced submandibular adenoid cystic carcinoma with poorly differentiated solid type, was treated with differentiation-inducing agent, vesnarinone, per os at a dose of 60 mg/day daily for 8 weeks. The vesnarinone administration caused marked regression of the tumour. In addition to conversion into the well-differentiated tubular type from the poorly differentiated solid type, the induction of apoptosis and LeY antigen was observed in the treated tumour. These findings indicate that vesnarinone might be a useful therapeutic agent for treatment of salivary cancer. Since we found the new expression of LeY antigen in the well-differentiated tubular lesion in the salivary adenoid cystic carcinoma treated with vesnarinone, we examined the LeY antigen expression in relation to tumour differentiation in five cases of salivary adenoid cystic carcinoma. Consequently, tissue sections from all of the adenoid cystic carcinoma examined showed no positive LeY staining, except for some areas in the tumour lesion with the tubular pattern including the histologically normal-appearing tissue adjacent to the tumour tissue. These findings suggest that there is the intimate relationship between the LeY antigen expression and tumour differentiation in human salivary adenoid cystic carcinoma.

Journal Article↗