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 1,189 records · Page 66Linked to original sources

Pediatric sinusitis: update.

Sinusitis in children is a very common condition. It is being seen more and more by primary care physicians and pediatricians. Children average six to eight colds per year. Of those, 0.5 to 5% will develop a sinus infection. Symptoms of a cold or allergy overlap with those of rhinosinusitis in the child. Distinguishing rhinosinusitis from a cold or allergy may be challenging. It is agreed that if cold symptoms are not improving by 7 to 10 days, a sinus infection should be seriously considered. Plain radiographs can be helpful for maxillary sinusitis especially if an air-fluid level is seen; otherwise, the sensitivity and specificity of plain radiographs are poor. Computed tomography (CT) should not be used for diagnostic purposes. The role of CTis mainly in children with chronic rhinosinusitis when surgery is being considered. In cases of complicated sinusitis, a CT scan is necessary. Treatment of most rhinosinusitis cases in children is medical. Antibiotics constitute the mainstay of medical treatment. Medical treatment should be with an appropriate antibiotic and for at least 14 days. Adjunctive treatment with saline irrigations and topical and systemic decongestants may be helpful. Surgical intervention is necessary for complicated cases and for cases that do not respond to prolonged course of medical management. Currently adenoidectomy and endoscopic sinus surgery are the most common procedures used. Children needing surgical intervention are a small percentage because of the success of medical treatment. When and which surgical procedure to use are discussed in detail.

Adenoidectomy↗

[Adenotonsillectomy in children only under exceptional circumstances].

More and more evidence is becoming available that throws doubt on the value of adenotonsillectomy in children with frequent throat infections or hypertrophic tonsils and adenoids. Tonsillectomy and adenoidectomy have a limited range of indications. Objective symptoms such as the size of the tonsils and subjective symptoms of obstruction and sore throat are not always related to each other. Children with only moderate symptoms should not be operated on.

Adenoidectomy↗

[Quality of life survey in children with obstructive sleep apnea hypopnea syndrome before and after operation].

OBJECTIVE: To evaluate the influence of OSAHS in quality of life (QOL) for children and its changes before and after surgery. METHODS: Pediatric OSAHS disease-specific quality of life survey (OSA-18) and polysomnography (PSG) were used to analysis in 54 cases within 4 weeks before surgery. They were treated by tonsillectomy in 8 cases and adenoid tonsillectomy in 32 cases, adenoidectomy alone in 14 cases and were followed up in 12 to 18 months post-operation. RESULTS: The impact of pediatric OSAHS on QOL was severe in 61.11% patients. There were significant statistically correlation between OSA-18 and AHI, LSaO2 before surgery. After surgery, the total scores of QOL were improved in 75.92% cases in general. The domains of sleep disturbance in 88.89% cases, caregiver concerns in 74.07% and physical suffering in 70.37% were significantly improved, respectively. CONCLUSIONS: Pediatric OSAHS had severely influenced in quality of life of children. There are significant correlations between the survey in quality of life of pediatric OSAHS (OSA-18) and the objective data in PSG. OSA-18 can be a valuable measure in clinical diagnosis and treatment follow-up.

Adenoidectomy↗

[Anesthetic management of a child with Noonan syndrome and hypertrophic obstructive cardiomyopathy].

Noonan syndrome is characterized by facial, skeletal and cardiovascular anomalies. We describe the anesthetic management of a one-year-old boy with Noonan syndrome and hypertrophic obstructive cardiomyopathy scheduled for tonsillectomy and adenoidectomy under general anesthesia. He had a history of congestive heart failure at 5 months of age. Preoperative echocardiogram revealed a hypertrophied septum (12.8 mm) with concentric hypertrophy of the left ventricle. Mild mitral regurgitation was also noted. Our anesthetic goal was set to maintaining adequate preload and afterload as well as adequate anesthesia depth to avoid LV outflow tract obstruction. Intravenous fluid was started the day before surgery. Anesthesia was induced with fentanyl 30 microg and midazolam 2 mg and maintained with propofol 8 mg x kg(-1) x hr(-1), fentanyl 30 microg, ketamine 4 mg, and sevoflurane 1-2%. Intraoperative monitoring included 12-lead electrocardiogram and direct measurement of arterial pressure. Intra- and post-operative course was uneventful.

Adenoidectomy↗

[Airway obstruction caused by massive swelling of the tongue following bilateral tonsillectomy for sleep apnea syndrome].

A case of airway obstruction caused by the tongue swelling is reported. The patient is a 5-year-old boy scheduled for bilateral tonsillectomy for sleep apnea syndrome. Anesthesia was slowly induced by sevoflurane and maintained with nitrous oxide, fentanyl and sevoflurane. Bilateral tonsillectomy and adenoidectomy were performed uneventfully under general anesthesia. The operation time was 2 hours and 30 minutes. Following the surgical procedure, the endotracheal tube was removed. Shortly after the extubation, the patient complained of difficult articulation and paradoxical respiration. Trachea was intubated immediately. Oxygen saturation was within normal limits throughout all the procedures. Swelling of the tongue was aggravated and was not relieved by steroid infusion. Massive swelling of the face and neck was observed on the next day. CT scan and fiberoptic scope examination showed the swollen tongue obstructing the upper airway. Additional administration of steroid was continued. On the third postoperative day, edema was relieved and the endotracheal tube was removed. Clinical course after the extubation was uneventful. No laboratory data was obtained suggesting the allergic basis. Extubation should be performed carefully and respiratory condition should be observed cautiously following the oral surgery of even a short duration.

Adenoidectomy↗

[The practice guideline 'Otitis media with effusion' (second revision) from the Dutch College of General Practitioners; a response from the perspective of general practice].

The usefulness of tympanotomy tubes in children with otitis media with effusion who also have speech and language retardation is doubtful in view of the natural development. The second revision of the practice guideline 'Otitis media with effusion' from the Dutch College of General Practitioners is still not in complete agreement with this. The indications for performing an adenoidectomy are now more limited. Pneumatic otoscopy and tympanometry are diagnostic aids that may deserve a permanent place in the general practitioner's medical practice in the future.

Acoustic Impedance Tests↗

[Late infantile GM1 gangliosidosis with progressive dilatation of common bile duct and obstructive apnea--an autopsy case].

We report a 5-year-old autopsy case of late infantile type of GM1 gangliosidosis,which developed rare respiratory and intestinal complications. Obstructive apnea by adenoidal hypertrophy was improved by adenoidectomy, but the right bronchus was compressed by hilar lymph node swellings. The lymph nodes could not be treated surgically because of her poor general condition. There was hyperplasia showing foamy histiocyte including mucopolysaccharide which demonstrated a vacuolar formation containing irregular arranged fibrillar material on electron microscopy. Cerebral atrophy progressed gradually, and epileptic apnea developed, which was intractable to all antiepileptic drugs administered. Glycolipid accumulation, showing membranous cytoplasmic body on electron microscopy, seemed to lead to neurodegeneration. Abdominal distension due to hepatosplenomegaly, common bile duct dilatation compressed by lymph node swelling of the caput pancreatis part, and enteroparalysis was uncontrolled. These findings suggest that severe glycolipid deposition in lymphoreticular organs can induce various complications in patients with late infantile type of GM1 gangliosidosis.

Adenoidectomy↗

Obstructive sleep apnea in children with Down syndrome.

Children with Down syndrome have many predisposing factors for the obstructive sleep apnea syndrome (OSAS), yet the type and severity of OSAS in this population has not been characterized. Fifty-three subjects with Down syndrome (mean age 7.4 +/- 1.2 [SE] years; range 2 weeks to 51 years) were studied. Chest wall movement, heart rate, electroculogram, end-tidal PO2 and PCO2, transcutaneous PO2 and PCO2, and arterial oxygen saturation were measured during a daytime nap polysomnogram. Sixteen of these children also underwent overnight polysomnography. Nap polysomnograms were abnormal in 77% of children; 45% had obstructive sleep apnea (OSA), 4% had central apnea, and 6% had mixed apneas; 66% had hypoventilation (end-tidal PCO2 greater than 45 mm Hg) and 32% desaturation (arterial oxygen saturation less than 90%). Overnight studies were abnormal in 100% of children, with OSA in 63%, hypoventilation in 81%, and desaturation in 56%. Nap studies significantly underestimated the presence of abnormalities when compared to overnight polysomnograms. Seventeen (32%) of the children were referred for testing because OSAS was clinically suspected, but there was no clinical suspicion of OSAS in 36 (68%) children. Neither age, obesity, nor the presence of congenital heart disease affected the incidence of OSA, desaturation, or hypoventilation. Polysomnograms improved in all 8 children who underwent tonsillectomy and adenoidectomy, but they normalized in only 3. It is concluded that children with Down syndrome frequently in have OSAS, with OSA, hypoxemia, and hypoventilation. Obstructive sleep apnea syndrome is seen frequently in those children in whom it is not clinically suspected. It is speculated that OSAS may contribute to the unexplained pulmonary hypertension seen in children with Down syndrome.

Adenoidectomy↗

Emergence airway complications in children: a comparison of tracheal extubation in awake and deeply anesthetized patients.

We compared the differences in oxygen saturation and airway-related complications after tracheal extubation in pediatric patients undergoing elective strabismus surgery or adenoidectomy and/or tonsillectomy who were awake versus anesthetized. Seventy otherwise healthy patients between 2 and 8 yr of age were studied. Anesthesia was induced with halothane or thiamylal and maintained with nitrous oxide and halothane. After induction of anesthesia, the patients were randomly assigned to group 1 (awake extubation) or group 2 (anesthetized extubation). Oxygen saturation was measured continuously and recorded 10 min before extubation and at 1, 2, 3, 5, 7, 10, 15, 20, 25, and 30 min after tracheal extubation. Supplemental oxygen was administered when oxygen saturation values were less than 90% while breathing room air. Oxygen saturation levels were higher in group 2 than in group 1 at 1, 2, 3, and 5 min after extubation. There were no differences between the two groups in the number of patients requiring supplemental oxygen. The incidence of airway-related complications such as laryngospasm, croup, sore throat, excessive coughing, and arrhythmias was not different between the two groups. We conclude that the anesthesiologist's preference or surgical requirements may dictate the choice of extubation technique in otherwise healthy children undergoing elective surgery.

Adenoidectomy↗

Current treatment of otitis media in children.

Otitis media is a common childhood disease with a spectrum of pathology ranging from acute, painful infection to persistent middle ear effusion to chronic negative middle ear pressure and development of cholesteatoma. Amoxicillin remains the initial empiric drug of choice with TMP-SMZ or erythromycin-sulfisoxazole used for penicillinallergic patients or for amoxicillin therapy failures. Amoxicillin-clavulante, cefuroxime axetil (no elixir form available) or cefixime may then be tried keeping in mind relative costs, side effects, dosing frequency and drug formulation. Prophylactic amoxicillin or sulfisoxazole at one-half the usual daily dose given once a day throughout the URI season is effective in reducing the number of episodes of AOME. Prolonged sulfonamide use should be carefully monitored. Tympanostomy tube insertion is indicated for frequently recurring otitis media and for persistent middle ear effusions. Adenoidectomy is an adjunctive procedure shown to be effective in children requiring a second set of tubes for recurrent infections or for children four years old or older with persistent middle ear fluid. Tympanoplasty may be necessary to prevent ossicular chain damage due to severe cases of MEVD or to repair non-healing perforations. Cholesteatomas must be surgically removed and may require elaborate reconstructive techniques.

Adenoidectomy↗

Infection of Waldeyer's ring: value of pernasal retropharyngeal swabs.

The value of pernasal retropharyngeal swabs in chronic adenoid and tonsillar disease was assessed in a prospective study involving 52 patients. Prior to adenoidectomy (34 patients) or adenotonsillectomy (17 patients), pernasal and tonsillar swabs were taken and the culture compared to the bacteriology profile obtained in the adenoid and tonsil tissue following surgery. The pernasal swab correctly identified 76% of pathogens isolated in the adenoid tissue. In addition, pernasal swabs forecast the presence of pathogens in 64% of core tonsil specimens, compared to an accuracy of 38% when superficial tonsil swabs were compared to the microbes in the deep tonsil. H. influenzae was the predominant organism isolated in all cultures. Our results clearly demonstrate that pernasal swabs give a representative picture of the adenoid bacterial content. Pernasal swabs are also superior to superficial tonsil swabs in indicating the deep tonsillar organisms.

Adenoidectomy↗

Bleeding/bruising symptomatology in children with and without bleeding disorders.

A questionnaire, designed to assess bleeding/bruising tendencies, was administered to 251 otherwise healthy children undergoing a tonsillectomy and/or adenoidectomy. 23 children with excessive bleeding during or after the operation, with a long bleeding time or who reported taking aspirin recently were excluded, to give a population of 228 non-bleeders. For comparative purposes, 31 patients with bleeding disorders (von Willebrand's disease and/or platelet function defects) were studied. A considerable proportion of "non-bleeding" children reported easy bruising (24%), had bruises at least once a week (36%) and suffered from nosebleeds (39%). The respective frequencies (67%, 68% and 69%) for children with bleeding disorders were significantly higher. Occurrence of bruises usually on more than one part of the body, frequent large bruises or hematomas were rare in "non-bleeders" (4.9%, 3.5% and 2.7% respectively), but more common in "bleeders" (38.5%, 29.6% and 21.7% respectively).

Adenoidectomy↗

[New clinico-therapeutic directions in upper airway pathology].

The main issues regarding the pathology of the primary airways in children, such as persistent rhinitis, recurrent disease of the pharynx and laryngitis, have been re-examined and updated on the basis of the latest findings regarding immunology and respiratory physiopathology as well as recent technological progress in the field of diagnosis. As far as rhinitis is concerned, recently demonstrations that nasal mucosa, like bronchial mucosa, responds to different kinds of stimuli with the same type of inflammation, have led to a new nosographic viewpoint: apart from classic allergic rhinitis, multifactorial forms are now recognised. They have been defined as nonallergic persistent rhinitis having a particular subgroup: nonallergic rhinitis with eosinophils. The fact that different factors contribute to bringing about the same inflammatory process is also confirmed by a personal study carried out on 132 asthmatic children with rhinitis: the results showed, in fact, that there are no differences regarding the nasal mucosa of allergic children (positive prick) and nonallergic children (negative prick). This observation therefore diminishes the importance of rhinoscopy in the etiologic diagnosis of rhinitis. As far as the obstructive syndrome caused by adenotonsillar hypertrophy is concerned, extremely polymorphic clinical pictures can be identified: from the slightest nocturnal hypoventilation to the apnea syndrome during sleep, even to the most severe forms with cardiocirculatory insufficiency. Personal data on 42 children helped to define both the anamnestic and objective findings necessary for making the diagnosis. It was therefore found that the most indicative and specific observations were those made either by the mothers (heavy breathing noises) or by the physician (inspiratory retractions) while the children were sleeping. Clinical data are therefore usually sufficient for making the diagnosis; however, in the first two years of life, a period in which surgical operations are usually delayed if possible, it is necessary to make an instrumental evaluation of the degree of hypoventilation. By means of radiological examination, pharyngoscopy and capnography, it is possible to record the degree of obstruction and therefore decide whether or not to delay surgery. Apart from the obstructive respiratory syndrome with hypoventilation, that requires surgery at all costs, other conditions were examined that can profit by adenoidectomy, such as affections of the middle ear, chronic sinusitis and craniofacial dysmorphisms. As far as laryngitis is concerned, the importance of radiology and endoscopy in rapidly diagnosing epiglottic laryngitis is reported. This in turn sometimes facilitates quick pharmacological treatment so as to avoid more invasive interventions, such as tracheostomy.

Adenoidectomy↗

[Sevoflurane anesthesia for a patient with arthrogryposis multiplex congenita].

We reported an anesthetic experience of a 6-year-old male patient with arthrogryposis multiplex congenita who underwent tonsillectomy and adenoidectomy. The induction and maintenance of anesthesia were smoothly performed with inhalation of 1-5% sevoflurane in nitrous oxide and oxygen. Emergence from anesthesia was also smooth. Halothane and succinylcholine chloride were not used to avoid possible hyperthermia. Anesthetic management of patients with arthrogryposis multiplex congenita was discussed citing literature references.

Adenoidectomy↗

[Case reports and discussion on anterior open bite].

Anterior openbites cause impaired masticatory, malfunction of tongue, speech defects, disuse atrophy of teeth and periodontal tissue, esthetic problem. It is corrected by some available orthodontic methods according to its etiologic factors and growth stage. Removable appliances with tongue crib, spring loaded occlusal bite block, M.E.A.W. with rubber elastics, vertical chin cap and high pull head gear are selected for its correction. Extraction is considered for preventing wedging effect and Adenoidectomy is performed as adenoid cause mouth breathing. In the case of treatment of anterior openbites, combined therapy acquire better results than single treatment method. Removal of etiologic factors and accurate diagnosis is the best way of prevention of its recurrence.

Adenoidectomy↗

[Pectus excavatum from chronic upper airway obstruction].

4 patients with enlarged tonsils and adenoids associated with pectus excavatum are presented. 2 also had signs of pulmonary hypertension and congestive heart failure. All 4 underwent adenoidectomy and tonsillectomy. Respiratory distress and congestive heart failure were rapidly relieved, while the pectus deformity improved gradually and completely disappeared in 6 months to 2 years after surgery.

Adenoidectomy↗