Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ADENOIDECTOMY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 901 records · Page 50Linked to original sources
PubMed2006

[Trend changes in the adenotonsillar surgery].

UNLABELLED: In order to evaluate possible trend changes in the epidemiological factors of adenotonsillar surgery, a total of 1,958 operations performed between 1992 and 2002 were reviewed. RESULTS: One third of the operations were to remove tonsils in comparison with the two thirds that were to remove adenoids. Three procedures were used: 59% adenoidectomies, 28% adenotonsillectomies and 13% tonsillectomies. During the study period, the percentage of adenotonsillectomies decreased, whereas the number of adenoidectomies increased. In general, this kind of surgery is mainly performed on males. CONCLUSIONS: Although we have not discovered variations regarding gender and average age for the operations, adenotonsillar surgery has increased over recent years and the percentage ratio of the various procedures has altered as a result of new indications.

Adenoidectomy↗
PubMed1990

[Tonsillectomy. Analysis of the data for the 25-year period].

The author analysed the 38734 out of 39653 tonsillectomies performed in region of Gdańsk during the years 1961-85. Age, sex and kind of intervention were evaluated (adenoidectomy, tonsillectomy, adenotonsillectomy and others). The frequency of above mentioned surgery was reduced during these 23 years by 32% (from 14.5 to 9.8 for 10,000). The great majority of this surgery was performed in children aged 3 to 7 years. The rarest age was below 3 and over 40. Under the age of 11 years prevailed boys, over 11 girls. Adenoidectomy represented 65% of cases, adenotonsillectomy only 6.6%. The tonsillotomy was also present. The author discussed the reason of decreasing number of tonsillectomy.

Adenoidectomy↗
PubMed1986

Risks and benefits of adenotonsillectomy for children with Down syndrome.

A questionnaire survey of 74 parents of children with Down syndrome was conducted. Results indicated that adenotonsillectomy benefited their children by eliminating or reducing the symptoms of snoring, sleep apnea, nasal drainage, and mouth breathing. On the basis of parental responses, it appears that in the absence of nasal obstruction, adenotonsillectomy fails to improve drooling or tongue protrusion. Adenoid tissue is physiologically important to the child with Down syndrome and its removal can result in hypernasality. Two children in the survey sample who underwent adenoidectomy and/or tonsillectomy developed this complication. They were given complete speech and language testing and evaluated with cinefluoroscopy. Both structural and functional causes of hypernasality were identified. Structural abnormalities included a high-arched short hard palate and a short soft palate. Hypotonia, slowed motor learning, and oral motor developmental delay were confounding functional factors in these patients. The incidence of postoperative hypernasality found in these patients is higher than in the general population and should be an important consideration before performing an adenoidectomy.

Adenoidectomy↗
PubMed1973

Submucous cleft palate and the general practitioner.

Submucous cleft palate refers to a situation where the soft palate is largely composed of mucosa with little or no muscle. The defect is often not obvious on inspection of the mouth and pharynx. There is considerable clinical variation, with speech ranging from normal or minimal nasality to severe nasality and defective articulation. Many patients who have latent submucous cleft palate have the condition unmasked by an adenoidectomy because the adenoid pad had served as a compensatory factor in effecting palatopharyngeal closure. All physicians who perform tonsillectomy and adenoidectomy should be aware of the signs and symptoms which may suggest the diagnosis.

Adenoidectomy↗
PubMed1983

Odor perception in children in relation to nasal obstruction.

To determine whether nasal obstruction in children results in impaired nasal function, olfactory sensitivity was assessed in 65 children with various degrees of nasal obstruction and in 13 children without nasal obstruction. Overall, olfactory detection thresholds were directly related to clinical ratings of degree of nasal obstruction. Of the subjects with nasal obstruction attributable to adenoid hypertrophy, 28 received adenoidectomy; when retested 2 to 28 months later, 20 of the 28 subjects showed generally commensurate reductions in nasal obstruction ratings and olfactory detection thresholds. In a comparison subgroup of 16 subjects retested after intervals of 5 to 13 months without having received intervening adenoidectomy, both the nasal obstruction ratings and the olfactory detection thresholds remained relatively unchanged. These results suggest that, in children, nasal obstruction of varied degree is associated with commensurate impairment of the ability to smell, and that reduction in the degree of nasal obstruction results in commensurate recovery of the ability to smell. Olfactory function, although hitherto accorded little pediatric attention, deserves consideration both in weighing the importance of nasal obstruction in children and in deciding about therapeutic intervention.

Adenoidectomy↗
PubMed1982

Tonsils and adenoids. When is surgery indicated?

The efficacy of tonsillectomy and/or adenoidectomy in the management of urgent problems such as cor pulmonale, acute airway obstruction, or functional impairment of nasal respiration, speech, or swallowing is unquestioned. However, relative indications for surgery such as odynophagia, otalgia, or otitis media with effusion are more controversial. The limitations and risks of tonsillectomy and adenoidectomy in these patients are explored.

Adenoidectomy↗
PubMed1978

Pre-morbid factors in Hodgkin's disease. II. BCG-vaccination status, tuberculosis, infectious diseases, tonsillectomy, and appendectomy.

In young adults with Hodgkin's disease, cell mediated immunity (CMI) was evaluated retrospectively from their health records. The register of records from the school health service of the Copenhagen Council was scrutinized in order to find the records of those with HD born between 1930 and 1950 in whom the disease had been diagnosed between 1943 and 1975. Whenever possible, three controls were selected from the register for each case; they were comparable in respect of sex, year and month of birth and socio-economic background. The material consisted of 63 cases and 182 controls. Information regarding BCG-vaccinations, tuberculin skin-tests, the frequency of tuberculosis, bacterial and viral diseases, and of tonsilectomy, adenoidectomy and appendectomy was obtained from the school health records. 2 HD patients have had tuberculosis versus none in the control group. Complications to or prolonged course of viral diseases were reported neither in HD patients nor in controls. No significant differences were found in the frequency of BCG-vaccination, tuberculin reactivity, viral and bacterial diseases, adenoidectomy, tonsilectomy and appendectomy. Therefore our findings do not support the concept of a pre-morbid CMI deficiency state in HD.

Adenoidectomy↗
PubMedDate not supplied

[Microbiological study of the nasopharynx].

A microbiological study of the posterior wall of the nasopharynx have been carried out in 90 children subjected to adenoidectomy by chronically hypertrophied and infected adenoids. Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pyogenes and Staphylococcus aureus are the most important pathogens responsible for upper respiratory tract infection. Adenoidectomy produces a physiological effect on the nasopharyngeal microflora by converting an abnormal flora into a nearly normal one. It has been found out that there is a relation between nasopharyngeal pathogens and the seasonal periods, showing a decrease in summer.

Adenoidectomy↗
PubMed1994

The long term outcome of secretory otitis media in children and the effects of surgical treatment: a ten year study.

Two hundred and twenty two children with bilateral secretory otitis media were allocated at random for adenoidectomy, adenotonsillectomy or for neither procedure. In all cases only a unilateral grommet was inserted. The contralateral unoperated ear was examined during a ten year period to show otoscopic clearance, change in tympanometric status and improvement in mean hearing threshold. Adenoidectomy or insertion of a grommet alone produces similar improvement but in combination are more effective than either procedure in isolation. The unoperated ear in cases not receiving either procedure reflects the natural history of the condition. It shows a steady improvement in all outcome measures as time passes.

Acoustic Impedance Tests↗
PubMed1994

Functional-anatomic correlation of eustachian tube obstruction related to the adenoid in a patient with otitis media with effusion: a case report.

Prospective randomized clinical trials have shown modest but significant reductions in morbidity from otitis media with effusion following adenoidectomy. However, the precise role of the adenoid in the pathogenesis of otitis media with effusion remains unknown. Some authors have hypothesized that the adenoid may compress or obstruct the Eustachian tube lumen, thereby causing middle ear underpressures and subsequent effusion formation. Functional-anatomic correlation for this theory is lacking. Herein, we present a single case of a pediatric patient with otitis media with effusion and manometrically proven active and passive Eustachian tube obstruction which was relieved by adenoidectomy. Photographic anatomic correlation is presented.

Adenoidectomy↗
PubMed1996

Clinical audit on tonsils and adenoid surgery. Is day surgery a reasonable option?

Four hundred and five patients who underwent tonsillectomy and/or adenoidectomy over a 27-month period were reviewed retrospectively to determine local patient characteristics and complication rates. The predominance of adult patients (mean age of 23.8 years), male subjects (male to female ratio of 2:1), and tonsillectomy cases (85.4%) were in contrast to studies reported in Western countries. Chronic tonsillitis or adenoiditis was the most common indication for surgery and the most frequent complications encountered were fever (20.0%) and haemorrhage (5.2%). Three patients (0.7%) had significant haemorrhage requiring a return to the operating theatre for haemostasis. Bleeding occurred within 6 hours in 2 patients and on the third postoperative day in 1 patient. The rate of haemorrhage was significantly higher in male patients (P = 0.038). The average duration of hospitalisation was 3.6 days. The main reasons for delayed discharge from hospital were retention for observation of pain and fever or for social or administrative purposes. Based on the results of the survey, day surgery for tonsillectomy and adenoidectomy would be feasible in Singapore provided patients are carefully selected and actively monitored for at least 6 hours after the operation.

Adenoidectomy↗
PubMed2000

Anatomical basis of sleep-related breathing abnormalities in children with nasal obstruction.

OBJECTIVE: To define, in a group of children with nasal obstruction, the anatomical differences that differentiate those with quiet, unobstructed nocturnal respiration from those with obstructive sleep-related breathing abnormalities (snoring and obstructive sleep apnea). DESIGN: Case series. PATIENTS: Fifty-nine children aged 3 to 13 years (35 boys and 24 girls) with nasal obstruction and without tonsillar hypertrophy, known craniofacial syndromes, or neuromuscular diseases were included in the study. MAIN OUTCOME MEASURES: Each patient was categorized as to severity of nocturnal obstructive breathing symptoms. Angular and linear cephalometric measurements were used for assessment of craniofacial features. Clinical symptom scores were correlated with the cephalometric measurements. RESULTS: Significant craniofacial abnormalities were identified in patients prone to obstructive breathing patterns: increased flexure of the cranial base and bony nasopharynx, opening of the gonial angle, shortened mandibular length, dorsocaudal location of the hyoid, reduced posterior airway space, and increased velar thickness. CONCLUSIONS: A number of anatomical abnormalities may contribute to sleep-related abnormal breathing in otherwise normal children with nasal obstruction. Our results suggest that symptomatic children show some of the same skeletal and soft-tissue configurations that are found in adults with obstructive sleep apnea. While adenoidectomy is generally an effective treatment in children with obstructive sleep-related breathing abnormalities, the underlying craniofacial variances that remain after adenoidectomy may predispose these patients to redevelopment of obstructive breathing abnormalities in adulthood.

Adolescent↗
PubMed2003

The role of Chlamydia pneumoniae infection in children with chronic sinusitis.

BACKGROUND: Chlamydia pneumoniae infection is a frequent cause of lower respiratory disease in both adults and children. However, its role in upper respiratory disease, including sinusitis, is less clear. OBJECTIVE: To determine the role of infection with C. pneumoniae in chronic sinusitis in children. DESIGN: Prospective collection of specimens. SETTING: Tertiary care academic medical center. PARTICIPANTS: Children with clinical and radiologic evidence of chronic sinusitis unresponsive to medical management undergoing adenoidectomy, maxillary sinus lavage, or endoscopic sinus surgery for treatment. Intervention Nasopharyngeal and middle meatal swabs and portions of surgical specimens were obtained and cultured for C. pneumoniae. RESULTS: Specimens were obtained from 20 children (14 boys and 6 girls) aged 3 through 16 years. Thirteen bilateral endoscopic ethmoidectomies with maxillary antrostomies, 10 adenoidectomies, and 3 bilateral maxillary sinus lavages were performed. Chlamydia pneumoniae was isolated from the nasopharyngeal swab and adenoid tissue of 1 child (aged 6 years); however, his middle meatal swabs and maxillary sinus aspirates were negative. After 10 days of treatment with clarithromycin, repeat nasopharyngeal cultures were negative for C. pneumoniae. CONCLUSIONS: With the use of sensitive culture methods, C. pneumoniae was not isolated from sinus specimens of children enrolled in this study. This preliminary study suggests that C. pneumoniae does not play a significant role in chronic sinusitis in children.

Adolescent↗
PubMed1981

Physicians measure up. A study of 13 surgical procedures.

The Colorado Foundation for Medical Care Professional Standards Review Organization performed a six-month study in the latter half of 1978 to determine if the following surgical procedures were performed in accordance with the appropriate indications: primary appendectomy, cataract surgery, cholecystectomy, coronary arteriography, uterine dilation and curettage, surgical repair of hiatal hernia, abdominal hysterectomy, vaginal hysterectomy, lumbar disk excision, meniscectomy, tonsillectomy, adenoidectomy, and tonsillectomy and adenoidectomy. Data were collected concurrently by nurse reviewers on 4,850 hospitalized Medicare and Medicaid patients in Colorado hospitals. Cases that did not meet explicit indications were referred to physician reviewers for final determination. The 4,728 cases (97%) either met indications for these procedures or were justified by physician review. The conclusion from the study was that Colorado physicians are performing these procedures appropriately.

Colorado↗
PubMed2005

Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children.

BACKGROUND: Otitis media with effusion (OME), or 'glue ear', is very common in children, especially between the ages of one and three years with a prevalence of 10% to 30% and a cumulative incidence of 80% at the age of four years. OME is defined as middle ear effusion without signs or symptoms of an acute infection. OME may occur as a primary disorder or as a sequel to acute otitis media. The functional effect of OME is a conductive hearing level of about 25 to 30 dB associated with fluid in the middle ear. Both the high incidence and the high rate of spontaneous resolution suggest that the presence of OME is a natural phenomenon, its presence at some stage in childhood being a normal finding. Notwithstanding this, some children with OME may go on to develop chronic otitis media with structural changes (tympanic membrane retraction pockets, erosion of portions of the ossicular chain and cholesteatoma), language delays and behavioural problems. It remains uncertain whether or not any of these findings are direct consequences of OME. The most common medical treatment options include the use of decongestants, mucolytics, steroids, antihistamines and antibiotics. The effectiveness of these therapies has not been established. Surgical treatment options include grommet (ventilation or tympanostomy tube) insertion, adenoidectomy or both. Opinions regarding the risks and benefits of grommet insertion vary greatly. The management of OME therefore remains controversial. OBJECTIVES: To assess the effectiveness of grommet insertion compared with myringotomy or non-surgical treatment in children with OME. The outcomes studied were (i) hearing level, (ii) duration of middle ear effusion, (iii) well-being (quality of life) and (iv) prevention of developmental sequelae possibly attributable to the hearing loss (for example, impairment in impressive and expressive language development (measured using standardised tests), verbal intelligence, and behaviour). SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2003), MEDLINE (1966 to 2003), EMBASE (1973 to 2003) and reference lists of all identified studies. The date of the last systematic search was March 2003, and personal non-systematic searches have been performed up to August 2004. SELECTION CRITERIA: Randomised controlled trials (RCTs) evaluating the effect of grommets on hearing, duration of effusion, development of language, cognition, behaviour or quality of life. Only studies using common types of grommets (mean function time of 6 to 12 months) were included. DATA COLLECTION AND ANALYSIS: Data from studies were extracted by two reviewers and checked by the other reviewers. MAIN RESULTS: Children treated with grommets spent 32% less time (95% confidence interval (CI) 17% to 48%) with effusion during the first year of follow-up. Treatment with grommets improved hearing levels, especially during the first six months. In the randomised controlled trials that studied the effect of grommet insertion alone, the mean hearing levels improved by around 9 dB (95% CI 4 dB to 14 dB) after the first six months, and 6 dB (95% CI 3 dB to 9 dB) after 12 months. In the randomised controlled trials that studied the combined effect of grommets and adenoidectomy, the additional effect of the grommets on hearing levels was improvement by 3 to 4 dB (95% CI 2 dB to 5 dB) at six months and about 1 to 2 dB (95% CI 0 dB to 3 dB) at 12 months. Ears treated with grommets had an additional risk for tympanosclerosis of 0.33 (95% CI 0.21 to 0.45) one to five years later. In otherwise healthy children with long-standing OME and hearing loss, early insertion of grommets had no effect on language development or cognition. One randomised controlled trial in children with OME more than nine months, hearing loss and disruptions to speech, language, learning or behaviour showed a very marginal effect of grommets on comprehensive language. AUTHORS' CONCLUSIONS: The benefits of grommets in children appear small. The effect of grommets on hearing diminished during the first year. Potentially adverse effects on the tympanic membrane are common after grommet insertion. Therefore an initial period of watchful waiting seems to be an appropriate management strategy for most children with OME. As no evidence is yet available for the subgroups of children with speech or language delays, behavioural and learning problems or children with defined clinical syndromes (generally excluded from the primary studies included in this review), the clinician will need to make decisions regarding treatment for such children based on other evidence and indications of disability related to hearing impairment. This review does not resolve the discrepancy between parental and clinical observation of a beneficial treatment effect and the results in the reviewed RCT showing only a short-term effect on hearing and virtually no effect on development. Is the perceived, often dramatic, effect of grommets only a short-term one? Are some children more sensitive to OME-related hearing loss than others? If so, how do we identify them?Further research should focus upon indications. Studies should use sufficiently large sample sizes to show significant interactions. There is a need to determine the most suitable variables and appropriate "softer" outcomes to be the subject of these interaction tests. Interesting options include measures of speech-in-noise and binaural hearing. The generally modest results in the trials which are included in this review should make it easier to justify randomisation of more severely affected and higher-risk children in appropriately constructed trials. Randomised controlled trials are necessary in these children before more detailed conclusions about the effectiveness of grommets can be drawn.

Child↗
PubMed2007

Rhabdomyomatous hamartomata of the pharyngeal region with bilateral microtia and aural atresia: a new association?

BACKGROUND: Bilateral microtia with aural atresia is rare. Rhabdomyomatous hamartomata containing salivary tissue, situated bilaterally and symmetrically simulating the palatine (faucial) tonsils, has apparently not been reported. We present the combination of these findings in two unrelated patients. CASES: In the first case, the patient was exposed prenatally to 13-cis-retinoic acid (isotretinoin) and has typical features of this exposure, including bilateral microtia with aural atresia and bilateral 7th nerve palsies. Due to symptoms of obstructive sleep apnea, patient 1 had a "tonsillectomy" and adenoidectomy. Histopathologic studies demonstrated rhabdomyomatous hamartomata containing salivary and striated muscle tissue in place of the palatine tonsils. In the second case, the patient had been prenatally exposed to alcohol, cocaine, and marijuana. He has been noted to have developmental delay and behavioral issues in addition to bilateral microtia with aural atresia. "Tonsillectomy" and adenoidectomy were performed to alleviate chronic upper respiratory infections and snoring. Again, histopathologic studies of the tissue submitted as "tonsil" demonstrated rhabdomyomatous hamartomata containing salivary and muscle tissue. Although an extended banded karyotype and subtelomere panel were normal, a genetic etiology for the second patient's features cannot be excluded. CONCLUSIONS: We hypothesize that the findings of bilateral microtia with aural atresia and rhabdomyomatous hamartomata containing salivary and muscle tissue in the area of the palatine tonsils may represent a newly recognized association, which may have a teratogenic and/or genetic etiology.

Child↗
PubMed1996

Granistron and dexamethasone provide more improved prevention of postoperative emesis than granisetron alone in children.

PURPOSE: Dexamethasone decreases chemotherapy-induced emesis when added to antiemetic regimens. This study was designed to compare the effectiveness of granisetron and dexamethasone with granisetron alone in the prevention of post-operative vomiting after strabismus repair, tonsillectomy with or without adenoidectomy in children. METHODS: In a randomized, double-blind study, 60 healthy children, 4-10 yr of age, received either granisetron 40 micrograms.kg-1 and saline (Group S) or granisetron 40 micrograms.kg-1 and dexamethasone 4 mg (Group D) iv immediately after the induction of anaesthesia. All subjects received anaesthetics consisting of sevoflurane and nitrous oxide in oxygen Postoperative pain was treated with acetaminophen pr or pentazocine iv. Postoperatively, during the first 24 hr after anaesthesia, the frequencies of retching and vomiting, and the incidence of adverse events were recorded by nursing staff. RESULTS: There were no differences between the treatment groups with regard to demographics, surgical procedure, anaesthetic administered or analgesics used for postoperative pain. The frequency of the symptoms was 27% and 7% in Groups S and D, respectively (P < 0.05). The incidence of adverse events was comparable in the two groups. CONCLUSION: The prophylactic administration of granisetron and dexamethasone was more effective than granisetron alone in the prevention of postoperative vomiting in paediatric subjects undergoing strabismus repair, tonsillectomy and adenoidectomy.

Antiemetics↗
PubMed1982

Indications for the use of ventilating tubes for secretory otitis media.

Seventy-seven children (147 ears) with secretory otitis media (S.O.M.) were surgically treated by myringotomy with aspiration, insertion of ventilating tubes, and adenoidectomy, if indicated. The results of treatment for S.O.M. were analyzed according to the degree of mastoid pneumatization and complications with or without ipsilateral sinusitis. The present study was performed in order to establish indications for the use of ventilating tubes. The results of treatment for S.O.M. in poorly developed mastoids were poor. With an ipsilateral sinusitis the prognosis of S.O.M. was also poor. In some cases of S.O.M., particularly those in well-developed mastoids, either adenoidectomy alone or myringotomy with aspiration alone proved effective for recovery from middle ear effusions. Ventilating tubes are most suitable for the following conditions: (1) in cases of sclerotic or poorly developed mastoids; (2) in cases with ipsilateral sinusitis; and (3) in cases with recurrent effusions after a first myringotomy with aspiration.

Adolescent↗