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Tonsillar hypertrophy

M A DeMarcantonio, E Senser, J Meinzen-Derr, N Roetting, S Shott, S L Ishman
OBJECTIVE: Lingual tonsillar hypertrophy is recognized as a cause of persistent obstructive sleep apnea (OSA) after adenotonsillectomy in children. However, little has been reported regarding the complications, postoperative course and effectiveness of lingual tonsillectomy (LT). Our objective was to review the safety and effectiveness of LT in children. METHODS: Retrospective review of children undergoing LT from January 2009 to December 2015 at a tertiary children's hospital...
December 2016: International Journal of Pediatric Otorhinolaryngology
Corneliu Toader, MioriŢa Toader, Alina Stoica, Gabriel Pop, Alina Oprea, Anca Simona Constantin, Liviu Niculescu, Iolanda Cristina Vivisenco, Mircea Stelian Drăghici, Andrei Osman, Carmen Aurelia Mogoantă
The commonest cause of head and neck malignancy in pediatric patients is lymphoma. A particular case is the tonsillar lymphoma. Even though unilateral tonsillar enlargement represents an ominous sign for neoplasia, clinical manifestations vary and are non-specific. Therefore, a delayed diagnosis is performed which compromises optimal therapy and hinders the prognosis. We present the case of a 5-year-old boy who was initially diagnosed with obstructive sleep apnea, without reported systemic complaints. Asymmetric tonsillar hypertrophy created the premises for performing a tonsillectomy to rule out malignancy...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Taru Ilmarinen, Triin Lont, Jaana Hagström, Taina Tervahartiala, Timo Sorsa, Caj Haglund, Eva Munck-Wickland, Torbjörn Ramqvist, Tina Dalianis, Leena-Maija Aaltonen
The development of several life-long diseases, such as coronary heart disease, is affected by low-grade systemic inflammation. Data on the potential long-term health effects of chronic tonsillitis are limited. Many inflammatory conditions present with enhanced systemic matrix metalloproteinase (MMP)-8 response. In head and neck cancer, high plasma level of tissue inhibitor of metalloproteinase (TIMP)-1 predicts poor prognosis. We analyzed S-MMP-8 with immunofluorometric assay and S-TIMP-1 with an immunosorbent assay in 175 consecutive patients undergoing tonsillectomy for benign tonsillar disease, and in 33 control patients with tonsillar squamous cell carcinoma...
November 2, 2016: Infectious Diseases
M Mahajan, J S Thakur, R K Azad, N K Mohindroo, P C Negi
OBJECTIVE: To assess cardiac functions in adenotonsillar or tonsillar hypertrophy. METHODS: A prospective, interventional, academic centre based study was conducted on 25 children with adenotonsillar or tonsillar hypertrophy. All patients underwent pulsed 2-dimensional Doppler echocardiography, pulse oximetry and 12-lead electrocardiography. These assessments were repeated three months later to determine the impact of adenotonsillectomy. RESULTS: There were significant differences in mean arterial oxygen saturation, pulmonary flow acceleration time and mean pulmonary artery pressure post-operatively...
October 27, 2016: Journal of Laryngology and Otology
Maria Pia Villa, Hanaa Shafiek, Melania Evangelisti, Jole Rabasco, Manuela Cecili, Marilisa Montesano, Mario Barreto
The sleep clinical record (SCR) may be a valid method for detecting children with obstructive sleep apnoea (OSA). This study aimed to evaluate whether there were differences in SCR depending on age and to identify the possible risk factors for OSA development. We enrolled children with sleep disordered breathing between 2013 and 2015, and divided them according to age into preschool- and school-age groups. All patients underwent SCR and polysomnography. OSA was detected in 81.1% and 83.6% of preschool- and school-age groups, respectively...
January 2016: ERJ Open Research
Cláudia Maria de Felício, Franciele Voltarelli da Silva Dias, Gislaine Aparecida Folha, Leila Azevedo de Almeida, Jaqueline Freitas de Souza, Wilma Terezinha Anselmo-Lima, Luciana Vitaliano Voi Trawitzki, Fabiana Cardoso Pereira Valera
OBJECTIVES: The purposes of this study were (1) to identify possible differences in muscular and orofacial functions between children with obstructive sleep apnea (OSA) and with primary snoring (PS); (2) to examine the standardized difference between normal values of myofunctional scores and those of subjects with OSA or PS; and (3) to identify the features associated with OSA. METHODS: Participants were 39 children (mean age 8 ± 1.2 years) of which, 27 had a diagnosis of OSA and 12 had PS...
November 2016: International Journal of Pediatric Otorhinolaryngology
Rogatus Kabyemera, Neema Chami, Neema Kayange, Respicius Bakalemwa, Antke Zuechner, Tumaini Mhada, Gustave Buname, Adolfine Hokororo, Johannes Kataraihya
Upper airway obstruction (UAO) due to adenotonsillar hypertrophy represents one of the rare causes of pulmonary hypertension in children. We report a case of adenotonsillar hypertrophy, managed at pediatric and otorhinolaryngology departments in Bugando Medical Centre (BMC), northwestern Tanzania, with complete remission of symptoms of pulmonary hypertension following adenotonsillectomy. A 17-month-old boy presented with difficulty breathing, dry cough, and noisy breathing since 1 year. He had facial and lower limb oedema with a pan systolic murmur at the tricuspid area, fine crepitations, and tender hepatomegaly...
2016: Case Reports in Pediatrics
Ghassan Idris, Barbara Galland, Christopher J Robertson, Mauro Farella
BACKGROUND: Sleep-Disordered Breathing (SDB) varies from habitual snoring to partial or complete obstruction of the upper airway and can be found in up to 10% of children. SDB can significantly affect children's wellbeing, as it can cause growth disorders, educational and behavioral problems, and even life-threatening conditions, such as cardiorespiratory failure. Adenotonsillectomy represents the primary treatment for pediatric SDB where adeno-tonsillar hypertrophy is indicated. For those with craniofacial anomalies, or for whom adenotonsillectomy or other treatment modalities have failed, or surgery is contra-indicated, mandibular advancement splints (MAS) may represent a viable treatment option...
2016: Frontiers in Physiology
Anshuman J Das, Tulio A Valdez, Jose Arbouin Vargas, Punyapat Saksupapchon, Pushyami Rachapudi, Zhifei Ge, Julio C Estrada, Ramesh Raskar
Three-dimensional (3D) visualization of oral cavity and oropharyngeal anatomy may play an important role in the evaluation for obstructive sleep apnea (OSA). Although computed tomography (CT) and magnetic resonance (MRI) imaging are capable of providing 3D anatomical descriptions, this type of technology is not readily available in a clinic setting. Current imaging of the oropharynx is performed using a light source and tongue depressors. For better assessment of the inferior pole of the tonsils and tongue base flexible laryngoscopes are required which only provide a two dimensional (2D) rendering...
April 1, 2016: Biomedical Optics Express
Brett J Baldwin, Dhananjay Chitale, Kang Mei Chen, Maria J Worsham, Kathleen Yaremchuk
OBJECTIVES/HYPOTHESIS: The human papillomavirus (HPV) is known to infect the tissues of the oropharynx as demonstrated in HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). HPV has also been shown to induce benign lymphoid hypertrophy. We sought to investigate an association between obstructive sleep apnea (OSA) and the presence of HPV in palatine and lingual tonsillar oropharyngeal tissue. STUDY DESIGN: Case series with chart review. METHODS: This retrospective laboratory-based study of oropharyngeal tissue from patients with OSA included patients >18 years old who underwent surgical treatment for OSA at a single institution between January 2012 and May 2014...
July 14, 2016: Laryngoscope
Chang Ho Hwang
Phenytoin induces lymphoid proliferation, resulting in complications that can range from tissue hyperplasia to lymphoma. Some of the complications resolve spontaneously after drug discontinuation. This report describes for the first time a case of dysphagia with lack of velopharyngeal coordination and nasopharyngeal reflux combined with massive palatine tonsillar hypertrophy. The condition did not develop before phenytoin administration, was induced by phenytoin, and spontaneously resolved upon drug discontinuation...
July 6, 2016: American Journal of Physical Medicine & Rehabilitation
Muhsin Balaban, Alper Aktas, Cuneyd Sevinc, Ugur Yucetas
OBJECTIVES: This study was organized to assess the relationship of enuresis nocturna (EN) and upper airway obstruction (UAO) in children. MATERIAL AND METHODS: This study was multi-centrically and prospectively designed including 79 children who presented to a urology clinic with symptoms of EN between January 2013 and February 2014. Sixty-four age-matched children with no history of urological complaints were randomly recruited from children admitted to a pediatric clinic as a control group...
July 4, 2016: Archivio Italiano di Urologia, Andrologia
Isabela P Olivetti Pontin, Daniela Cristina Janolli Sanchez, Renata Di Francesco
BACKGROUND: Group A Streptococcus (GAS) is the most important bacterial cause of acute tonsillitis in children. Some children are chronic GAS carriers, and this carriage is poorly understood. We determined the frequency of GAS detection using a rapid antigen detection test in pediatric patients with indications for tonsillectomy due to adenotonsillar hypertrophy or recurrent GAS infections. METHODS: Seventy-two patients underwent a tonsil swab for a rapid antigen detection test...
July 2016: International Journal of Pediatric Otorhinolaryngology
Nicholas Hope, Caroline Patricia Smith, Michael Moran, William Primrose
Lingual tonsillar hypertrophy is an unusual presentation of voice change. If managed incorrectly this group of patients has the potential to deteriorate significantly causing airway obstruction and potentially death.
May 2016: Clinical Case Reports
Farzaneh Assadian, Karl Sandström, Kåre Bondeson, Göran Laurell, Adnan Lidian, Catharina Svensson, Göran Akusjärvi, Anders Bergqvist, Tanel Punga
Surgically removed palatine tonsils provide a conveniently accessible source of T and B lymphocytes to study the interplay between foreign pathogens and the host immune system. In this study we have characterised the distribution of human adenovirus (HAdV), Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in purified tonsillar T and B cell-enriched fractions isolated from three patient age groups diagnosed with tonsillar hypertrophy and chronic/recurrent tonsillitis. HAdV DNA was detected in 93 out of 111 patients (84%), while EBV DNA was detected in 58 patients (52%)...
2016: PloS One
J P Windfuhr
BACKGROUND: One of the most significant clinical trials, demonstrating the efficacy of tonsillectomy (TE) for recurrent throat infection in severely affected children, was published in 1984. This systematic review was undertaken to compile various indications for TE as suggested in the literature after 1984 and to stratify the papers according to the current concept of Evidence-based Medicine. MATERIAL AND METHODS: A systematic Medline research was performed using the key word "tonsillectomy" in combination with different filters such as "systematic reviews", "meta-analysis", "English", "German" and "from 1984/01/01 to 2015/05/31"...
April 2016: Laryngo- Rhino- Otologie
Eva Kirkegaard Kiær, Troels Bock, Peter K Tingsgaard
INTRODUCTION: Sleep-disordered breathing in children is often associated with tonsillar hypertrophy. For many years, total tonsillectomy (TE) was the treatment of choice, but performing an intracapsular tonsillotomy (TT) is becoming increasingly widespread. In this Danish study, we have investigated the long-term results on efficacy and parent satisfaction after TT performed on children. METHODS: This was a retrospective study based on a questionnaire that was sent to the parents of 335 children who underwent TT due to sleep-related obstructive symptoms...
May 2016: Danish Medical Journal
Ryuta Kamekura, Ryokichi Imai, Kenichi Takano, Keiji Yamashita, Sumito Jitsukawa, Tomonori Nagaya, Fumie Ito, Motoyasu Hirao, Hiroshi Tsubota, Tetsuo Himi
Defensins are small antimicrobial peptides and effector components of innate immune responses. Recent studies have shed light on their beneficial functions for the prevention of infection and potential for development of new drugs. Here, we showed the expression profiles of human defensins in palatine tonsils with 3 different diseases: tonsillar hypertrophy, recurrent tonsillitis and focal infection of the tonsil. RT-PCR analysis and immunofluorescence revealed that the expression of human α-defensin 4 and β-defensin 3 (β3) in palatine tonsils with tonsillar hypertrophy was lower than that in recurrent tonsillitis and focal infection of the tonsil, suggesting that chronic inflammation induces defensin expression...
2016: Advances in Oto-rhino-laryngology
Oscar L Llanos, Panagis Galiatsatos, Edmarie Guzmán-Vélez, Susheel P Patil, Philip L Smith, Thomas Magnuson, Michael Schweitzer, Kimberley Steele, Vsevolod Y Polotsky, Alan R Schwartz
Insulin resistance is associated with sleep apnoea, leading us to hypothesise that it is also associated with elevations in pharyngeal collapsibility, even in the absence of sleep apnoea.90 bariatric patients were characterised for sleep apnoea, pharyngeal collapsibility and insulin resistance. Patients with a respiratory disturbance index (RDI) >10 events·h(-1), diabetes mellitus, tonsillar hypertrophy and pulmonary disease were excluded. The remaining 14 females underwent collapsibility measurements (passive critical pressure, Pcritp ) during non-rapid eye movement sleep...
June 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Onur Çağlar Acar, Abdurrahman Üner, Mehmet Fatih Garça, İbrahim Ece, Serdar Epçaçan, Mahfuz Turan, Ferhat Kalkan
OBJECTIVES: The purpose of the present study is to emphasize the efficacy of the myocardial performance index and tricuspid annular plane systolic excursion (TAPSE) in the determination of impaired cardiac functions and recovery period following the treatment in children with adenoid and/or tonsillar hypertrophy. METHODS: Fifty-three healthy children after routine laboratory, imaging and clinical examinations, with adenoid and/or tonsillar hypertrophy were evaluated before and 3 months after adenotonsillectomy for cardiac functions using M mode and Doppler echocardiography...
June 2016: Clinical and Experimental Otorhinolaryngology
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