Adenoid surgery and 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...

The adenoid is a part of Waldeyer's ring, the basic function of which is antibody formation, they react later against a great variety of antigens. Pediatric adenoidal obstruction of the nasal airway is associated with significant morbidity and is a frequent indication for surgery, but its relationship to allergy has not been often studied. To examine the influence of atopy on the adenoid hypertrophy we studied 9 children ages 4 to 8 years, who had hypersensitivity to birch pollen and the seasonal allergic rhinitis...

This study examined 71 pediatric tonsillectomy patients through accurate case history and clinical examination, placing particular emphasis on pathologies concomitant to tonsillopathy. In an attempt to find anatomo-clinical correlations, these data were processed together with the results of a histomorphological study of thetonsil epithelium, performed on all tonsillectomy samples. The majority of these patients were females and none more than 13 years of age. Numerous pathologies were found associated with the tonsillopathy and in varying combinations, first and foremost of which was adenoid hypertrophy...

The inclusion of a query concerning the presence of snoring in a questionnaires used by the Allergy Service of Childrens Hospital Los Angeles (CHLA) uncovered a significant number of patients who were experiencing prolonged and discomforting symptoms owing to previously undiagnosed obstructive sleep apnea (OSA) caused by adenotonsillar hypertrophy. Of 352 patients who were discharged with a diagnosis of OSA and tonsillectomy and/or adenoidectomy at CHLA in 1996-1997, a retrospective study of the first 45 randomly selected patients who agreed to participate in a telephone interview was performed...

OBJECTIVE: To determine the prevalence of allergy in children with severe adenotonsillar disease and to determine if the persistence of symptoms following tonsillectomy may be related to the allergic state. DESIGN: A prospective study of a cohort of 108 patients. SETTING: Academic tertiary referral medical center. PARTICIPANTS: Consecutive children scheduled to undergo tonsillectomy for obstructive hypertrophy or recurrent infection were eligible to enroll in this study...

A total of 83 children and teenagers underwent endoscopic nasal and sinus surgery. Six patients had surgery for choanal atresia (4) and adenoid hypertrophy (2) and will only be briefly mentioned. Seventy-seven children and teenagers underwent endoscopic sinus surgery for acute and chronic sinusitis, choanal polyposis, and nasal polyposis with a minimum 2-year follow-up. One hundred thirty-three ethmoidectomies, 37 sphenoidotomies, and 119 maxillary antrostomies were performed. Subjective evaluation of the sinus surgery patients indicated that 38% of patients were cured and 55% improved during an average of 3...

The tonsils are immune organs. The necessity for T & A should have a more rational approach for selected cases. The tonsils have a large immune function. The defense function of the tonsils is much greater in children than in adults. The children develop their resistance to infection by the time they are 7-8 years old. Tonsils and adenoids should not be removed below the age of eight unless there are absolute indications. Tonsillectomy has little or no effect on allergy. It is being done on account of tonsillar sepsis, and no other results are to be expected...

Carbon dioxide laser surgery was performed on children aged 5 to 11 years, on whom either adenoidectomy or tonsilloadenoidectomy had been performed to restore their hearing. We examined 177 ears 18 to 24 months after surgery. Thirty ears (17%) were diagnosed as having otitis media with effusion. Analysis of the endoscopic findings revealed 51% marked tubal tonsil hypertrophy and 33% adenoid tissue hypertrophy. Subjects were operated upon in the dorsal position for a duration of point one second at an amplitude of 15 watts...

This combination orthopedic traction appliance offers a new dimension in treating long faced, mouth breathing patients, who generally exhibit pre-maxillary gingival excess and lip incompetency or a short upper lip. The dynamics of excessive clockwise growth can be reversed if the physical pressures placed on the craniofacial skeletal tissues are reversed. In many instances extraction therapy or orthognatic surgery may be unnecessary to achieve acceptable occlusion and facial esthetics. Dr. Ullrich Teuscher, M...

Obstructive sleep apnea syndrome (OSAS) in children is commonly caused by adenotonsillar hypertrophy. The diagnostic criteria of OSAS in children are not so well delineated as in adults. We report the first case of antral choanal polyp presenting as OSAS in a 10-year-old boy that initially presented to the child psychiatry service for behavior disturbance, enuresis, and daytime somnolence. Overnight electroencephalogram sleep study revealed events consistent with OSAS. Multiple inhalant allergies, chronic maxillary sinusitis, and obstructive adenoid hypertrophy were diagnosed by the allergy and otolaryngology services...

Tonsillectomy and adenoidectomy are currently the most common pediatric surgical procedures performed in the United States. Tonsillectomy may be effective in recurrent acute throat infection (acute tonsillitis), chronic tonsillitis, tonsillar hypertrophy, and peritonsillar abscess. Antimicrobial therapy may also be beneficial. Clinical trials evaluating children with obstructive adenoids are currently being evaluated; anecdotal evidence points to improvement in development and quality of life after surgery...