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Beata Pucher, Jaroslaw Szydlowski, Wieslaw Smoczyk, Katarzyna Jonczyk-Potoczna, Michal Grzegorowski, Aleksandra Korytowska
Tonsillectomy and adenoidectomy are the most common surgical procedures in pediatric otolaryngology. The incidence of primary hemorrhage after tonsillectomy in children ranges from 0.38 to 6%. The prevalence of secondary bleeding occurs in 0.5%-9.3% cases [1]. Authors present a case of an 11-year-old girl who experienced 6 delayed, massive post-tonsillectomy bleedings as a result of presence of vascular malformation and the activation of collateral circulation as a result of the left ECA ligature.
November 2016: International Journal of Pediatric Otorhinolaryngology
Howard Faden, Vincent Callanan, Michael Pizzuto, Mark Nagy, Mark Wilby, Daryl Lamson, Brian Wrotniak, Stefan Juretschko, Kirsten St George
BACKGROUND: Airway obstruction due to enlargement of tonsils and adenoids is a common pediatric problem resulting in sleep disordered breathing. The cause for the relatively abnormal growth of tonsils and adenoids is poorly understood. METHODS: Non-acutely ill children undergoing tonsillectomy and adenoidectomy (T&A) for various reasons were enrolled prospectively in a study to determine the frequency of asymptomatic respiratory viral infections in each lymphoid tissue and to relate the number and types of virus to the degree of airway obstruction...
November 2016: International Journal of Pediatric Otorhinolaryngology
Nikita Kohli, Dana DeCarlo, Nira A Goldstein, Joshua Silverman
OUTCOME OBJECTIVE: For over fifty years, otolaryngologists, allergists, and immunologists have debated the effect of adenoidectomy or adenotonsillectomy on asthma outcomes in children. Although some have suggested that adenotonsillectomy may contribute to the subsequent development of asthma in children, others have argued that a common mechanism may cause both upper and lower airway disease, and that children who have symptoms severe enough to warrant adenotonsillectomy are also at increased risk of asthma and atopic disease...
November 2016: International Journal of Pediatric Otorhinolaryngology
L K Reckley, S A Song, E T Chang, B B Cable, V Certal, M Camacho
OBJECTIVE: To systematically search for studies reporting outcomes for adenoidectomy alone as a treatment for paediatric obstructive sleep apnoea and use the data to perform a meta-analysis. METHODS: Nine databases, including PubMed and Medline, were systematically searched through to 1 April 2016. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed. RESULTS: A total of 1032 articles were screened and 126 full texts were reviewed...
October 6, 2016: Journal of Laryngology and Otology
M Khalid-Raja, K Tzifa
OBJECTIVE: This study aimed to evaluate the activity of paediatric otolaryngology services required for children with Down's syndrome in a tertiary referral centre. METHODS: A review of the paediatric otolaryngology input for children with Down's syndrome was performed; data were obtained from the coding department for a two-year period and compared with other surgical specialties. RESULTS: Between June 2011 and May 2013, 106 otolaryngology procedures were performed on children with Down's syndrome...
October 6, 2016: Journal of Laryngology and Otology
Jeffrey Steinberg, Vincent Cheung, Gunjan Goel, J Scott Pannell, Javan Nation, Alexander Khalessi
Although there have been reports of carotid artery pseudoaneurysm formation after adenoidectomy and/or tonsillectomy secondary to iatrogenic injury, there are no case reports of successful endovascular reconstruction of the injured artery in the pediatric population. In most pediatric cases, the internal carotid artery (ICA) is sacrificed. The authors report on a 6-year-old girl who presented with odynophagia, left-sided Horner's syndrome, hematemesis, and severe anemia 6 months after a tonsillectomy. On examination she was found to have a pulsatile mass along the left posterior lateral oropharynx, and imaging demonstrated a dissection of the extracranial left ICA and an associated pseudoaneurysm...
September 30, 2016: Journal of Neurosurgery. Pediatrics
Yanfei Zhu, Jiaying Li, Yanmei Tang, Xiaoling Wang, Xiaochen Xue, Huijun Sun, Ping Nie, Xinhua Qu, Min Zhu
BACKGROUND: Children with severe airway obstruction tend to have a vertical direction of growth, class II malocclusion, and narrow arches. Adenoidectomy and tonsillectomy were recommended for the promotion of balanced dentition growth in these children.The aim of this study was to determine the effect of adenoidectomy and tonsillectomy on the growth of dental morphology in children with airway obstruction. METHODS: A comprehensive search of the Medline, Embase, Web of science, and OVID databases for studies published through to January 17, 2016 was conducted...
September 2016: Medicine (Baltimore)
Changlong Hu, Demin Han, Bing Zhou, Luo Zhang, Yunchuan Li, HongRui Zang, LiFeng Li
CONCLUSION: From aspect of fluid dynamics, expanding patients' nasopharyngeal coronal-sectional area to 48.3-54.7% of normal area will bring the airflow velocity back to normal in adenoidal hypertrophy children. It might provide a suggestion for adenoidectomy range selection and whether total resection is necessary. OBJECTIVES: To evaluate the nasopharyngeal airflow characteristics in pediatric OSA patients with adenoidal hypertrophy, and to explore the proper resection range for adenoidectomy Method: Nine OSA patients and four normal children were recruited...
August 9, 2016: Acta Oto-laryngologica
David F Smith, Ting Sa, Matthew Fenchel, Aliza P Cohen, Christine Heubi, Sally R Shott, Christine G Gourin, Stacey L Ishman
OBJECTIVES/HYPOTHESIS: We sought to characterize changes in the patterns of inpatient surgical sleep care over time and ascertain if these changes were consistent with previously reported trends in adult surgical sleep care. STUDY DESIGN: Repeated cross-sectional study. METHODS: Discharge data from the U.S. Nationwide Inpatient Sample for 125,691 nasal, palatal, or hypopharyngeal procedures in children for sleep-disordered breathing or obstructive sleep apnea (OSA) from 1993 to 2010 were analyzed using cross-tabulations and multivariate regression modeling...
September 19, 2016: Laryngoscope
Zorik Spektor, David J Kay, David L Mandell
PURPOSE: To compare post-operative pain severity, analgesic intake, and complications in children undergoing tonsillectomy and adenoidectomy with bipolar radiofrequency ablation (Coblation) vs. pulsed-electron avalanche knife (PEAK) technology. MATERIALS AND METHODS: This was a prospective, non-randomized, non-blinded comparative cohort study in a private practice setting with three fellowship-trained pediatric otolaryngologists. Patients aged 3 to 12years undergoing tonsillectomy and adenoidectomy were assigned to surgery with either bipolar radiofrequency ablation or pulsed electron avalanche knife instrumentation...
August 5, 2016: American Journal of Otolaryngology
Svetlana Diacova, Thomas J McDonald, Ion Ababii
We conducted a prospective, observational study over a 3-year period to compare the clinical, functional, and surgical findings in children with chronic bilateral otitis media with effusion who underwent one of three different types of treatment. Our study population was made up of 150 patients-79 boys and 71 girls aged 24 to 84 months-who were randomly assigned to one of the three treatment groups of 50 patients each. One group was treated with myringotomy, tympanostomy tube insertion, and adenoidectomy (T+A group); another with a combination of physical conservative treatment and adenoidectomy (P+A group); and the third with physical conservative treatment alone (P-only group)...
August 2016: Ear, Nose, & Throat Journal
David Kasle, Jordan Virbalas, John P Bent, Jeffrey Cheng
OBJECTIVE: To identify predictors of post-operative respiratory complications in children undergoing tonsillectomy. METHODS: Consecutive case series with chart review of children who underwent polysomnography (PSG) and subsequent tonsillectomy with or without adenoidectomy for obstructive sleep apnea (OSA). Patients with craniofacial anomalies or significant cardiopulmonary comorbidities were excluded. Rates of post-surgical respiratory complication were reviewed and compared to patient specific factors and PSG findings to identify possible risk factors...
September 2016: International Journal of Pediatric Otorhinolaryngology
Jennifer C Lane, James Dworkin-Valenti, Lisa Chiodo, Michael Haupert
OBJECTIVE & HYPOTHESIS: Stated in the Null form: There will be no difference in primary or secondary hemorrhage rate in children undergoing tonsillectomy or adenotonsillectomy across three surgical techniques: PEAK Plasmablade, electric monopolar cautery, coblation. STUDY DESIGN: Retrospective chart analysis. SETTING: Academic Medical Center: Children's Hospital. SUBJECTS & METHODS: Electronic chart data were collected from patient's age 2-18 years who underwent tonsillectomy, with or without adenoidectomy, at a tertiary pediatric hospital between June 2011 to May 2013 by electric monopolar cautery, coblation, or PEAK PlasmaBlade...
September 2016: International Journal of Pediatric Otorhinolaryngology
Alex Labby, Jess C Mace, Michelle Buncke, Carol J MacArthur
OBJECTIVE: To evaluate quality-of-life changes after bilateral pressure equalization tube placement with or without adenoidectomy for the treatment of chronic otitis media with effusion or recurrent acute otitis media in a pediatric Down syndrome population compared to controls. STUDY DESIGN: Prospective case-control observational study. METHODS: The OM Outcome Survey (OMO-22) was administered to both patients with Down syndrome and controls before bilateral tube placement with or without adenoidectomy and at an average of 6-7 months postoperatively...
September 2016: International Journal of Pediatric Otorhinolaryngology
Oshri Wasserzug, Gadi Fishman, Dan Sternbach, Efrat Reindorf-Kfir, Eran Averbuch, Dan M Fliss, Yael Oestreicher-Kedem, Ari Derowe
OBJECTIVE: Informed consent is an important part of the surgical process. Based on our clinical experience, we hypothesized that parents providing consent for their children's tonsillectomy do not comprehend all the information that is given to them by the operating surgeon at the time of a conventional consent process. MATERIALS AND METHODS: Parents whose children were scheduled for tonsillectomy with or without adenoidectomy and/or tympanostomy tubes insertion were enrolled...
September 2016: International Journal of Pediatric Otorhinolaryngology
Mehmet Emre Dinc, Aytug Altundag, Denizhan Dizdar, Mehmet Ozgur Avincsal, Ethem Sahin, Seckin Ulusoy, Ceki Paltura
OBJECTIVES: Although most specialists in otorhinolaryngology and pediatrics find halitosis to be a common problem in children with adenoid hypertrophy, there are no objective data on this topic in the literature. Whether adenoid hypertrophy is a risk factor for halitosis or whether halitosis is a sign of adenoid hypertrophy remains unclear. Thus, the aim of this study was to investigate whether children diagnosed with adenoid hypertrophy have a higher probability of halitosis than do children in the normal population and whether adenoidectomy can decrease oral malodor...
September 2016: International Journal of Pediatric Otorhinolaryngology
Mieke Maris, Stijn Verhulst, Marek Wojciechowski, Paul Van de Heyning, An Boudewyns
OBJECTIVE: To evaluate the outcome of adenotonsillectomy (AT) in a cohort of children with Down syndrome (DS) and obstructive sleep apnoea (OSA). DESIGN: Retrospective, cross-sectional study. SETTING: Tertiary care centre. PATIENTS: Children with DS and OSA, without previous upper airway (UA) surgery. INTERVENTIONS: AT and full overnight polysomnography. MAIN OUTCOME RESULTS: A significant improvement of the obstructive apnoea-hypopnoea index (oAHI) after AT was obtained...
August 2, 2016: Archives of Disease in Childhood
Ramón Moreno-Luna, Eugenio Cárdenas Ruiz-Valdepeñas, José Ignacio Tato, Monica Rivero-Garvia, Javier Márquez-Rivas, Antonio Mochón Martín
BACKGROUND: Adenoidectomy is one of the most common procedures in the field of pediatric otolaryngology. Postoperative bleeding is one of the most frequent complications (0.4%). In turn, cerebrospinal fluid fistula is a very uncommon but critical complication in this type of surgery. METHODS: We report the case of a 3-year-old patient who underwent adenoidectomy and presented a cerebrospinal fluid leak associated with pneumocephalus and meningitis. RESULTS: The solution provided was a suture in layers of the fistula tract, reinforced with basipharyngeal vascularized and rotation random flap of mucosa, and a free graft of muscle, through a transoral endoscopic approach...
September 2016: World Neurosurgery
Keren Armoni Domany, Elad Dana, Riva Tauman, Guy Gut, Michal Greenfeld, Bat-El Yakir, Yakov Sivan
STUDY OBJECTIVE: Adenotonsillectomy is the recommended treatment for children with obstructive sleep apnea (OSA). Since adenoidectomy alone may be associated with significantly lower morbidity, mortality, and cost, we aimed to investigate whether adenoidectomy alone is a reasonable and appropriate treatment for children with OSA. METHODS: Five-hundred fifteen consecutive children diagnosed with moderate-to-severe OSA (apnea-hypopnea index > 5) based on polysomnography and who underwent adenoidectomy or adenotonsillectomy were reevaluated after 17-73 months (mean 41) for residual or recurrent OSA using a validated questionnaire (Pediatric Sleep Questionnaire, PSQ)...
2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Marina Davcheva-Chakar, Ana Kaftandzhieva, Beti Zafirovska
INTRODUCTION: Otitis media and rhinosinusitis are commonly encountered illnesses in pediatric population. Literature reports have documented the association between the occurrence of these two conditions and even their almost identical microbiological findings. Until recently, the key factor in the association of these two conditions was considered to be the hypertrophic adenoid tissue, but within the past few years there have been evidences in the literature about the presence of bacterial biofilms on the adenoids suggesting biofilms to be also responsible for both conditions, chronic otitis media with effusion and chronic rhinosinusitis...
2015: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
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