Adenoidectomy: current approaches and review of the literature

Abstract

Adenoid is a secondary lymphoid organ located in the nasopharynx. Due to its location, it plays an important role in the host defense of the upper respiratory tract. Immunoglobulin G3 and immunoglobulin A1 antibodies are prevalent antibodies in the adenoid tissue. Adenoidal hypertrophy is a common condition in children causing symptoms such as mouth breathing, nasal discharge, snoring, sleep apnea, and hyponasal speech. It also plays a role in the pathogenesis of rhinosinusitis, recurrent otitis media, and otitis media with effusion. Currently, adenoidectomy is one of the most commonly performed pediatric surgical procedures worldwide. Although there is still poor evidence in the literature, recurrent upper respiratory infections, otitis media with effusion, and obstructive sleep apnea syndrome are considered to be the main indications of adenoidectomy. Adenoidectomy can be carried out with several techniques and instruments. Although rare, surgery possesses some risks and may cause emotional distress both for the patient and the family. Nonsurgical treatments such as intranasal steroids are also used in the treatment of adenoid hypertrophy. In this review, we discuss the current literature on the adenoid function, adenoidectomy indications, and treatment of adenoid hypertrophy.Keywords: Adenoidectomy; adenoidectomy indication; adenoidectomy technique; function of adenoid; immunology of adenoid. ÖZAdenoid, nazofarenkste yer alan sekonder lenfoid organdır. Yerleşim yeri nedeniyle, üst solunum yolundaki konak savunmasında önemli bir rol oynar. Immünglobulin G3 ve immünglobulin A1 antikorları, adenoid dokusunda yaygın bulunan antikorlardır. Adenoid hipertrofisi çocuklarda ağız solunumu, burun akıntısı, horlama, uyku apnesi ve hiponazal konuşma gibi semptomlara neden olan yaygın bir durumdur. Bununla birlikte, rinosinüzit, tekrarlayan otitis media ve efüzyonlu otitis media patogenezinde rol oynar. Günümüzde adenoidektomi tüm dünyada en sık uygulanan pediatrik cerrahilerden biridir. Literatürde henüz yeterli kanıt mevcut olmamasına rağmen, tekrarlayan üst solunum yolu enfeksiyonları, efüzyonlu otitis media ve tıkayıcı uyku apnesi sendromunun adenoidektominin başlıca endikasyonları olduğu düşünülmektedir. Adenoidektomi birçok teknik ve araç ile uygulanabilmektedir. Nadir olmasına karşın, cerrahi bazı riskler taşımakta ve hem hasta hem de aile için duygusal stres yaratabilmektedir. Adenoid hipertrofisinin tedavisinde intranazal steroid gibi cerrahi dışı tedaviler de kullanılmaktadır. Bu derlemede adenoid fonksiyonu, adenoidektomi endikasyonları ve adenoid hipertrofisinin tedavisine ilişkin mevcut literatür tartışıldı.Anahtar Sözcükler: Adenoidektomi; adenoidektomi endikasyonu; adenoidektomi tekniği; adenoid fonksiyonu; adenoid immünolojisi.Adenoidectomy is one of the most commonly performed pediatric surgical procedures all over the world today, either alone or in conjunction with tonsillectomy and/or insertion of ventilating tubes.[1] Annual adenoidectomy rates differ between countries.

Adenoidectomy Before Or After Myringotomy In A Single Stage Procedure: Does The Sequence Matter?

“…Kocyigit 9 claims a female, while Khayat 10 documents a male predominance, consistent with our study. The main complaints in our study are also consistent with other similar studies [11][12][13][14] . The Otoscopic findings in our study i.e.…”

The Effect of Adenoid Hypertrophy on Middle Ear Resonance Frequency

“…In some studies, age and gender-related changes were reported, while in other studies it was reported that age and gender did not change RFvalues. 10,11 In recent studies RF value of middle ear for healty children was reported between 650 to 1400 Hz. Ferekidis et al showed that mean RF value of the ears with acute otitis media on the day of the diagnosis was 380 Hz which increased 680 Hz on 10 th day and 749 Hz after 1 month period.…”

“…It is well known that children with adenoid hypertropy are more likely to have OME and beneficial effects of adenoidectomy on OME is also demonstrated. 10,11 The role of adenoid vegetation in OME is complex. Mechanical obstruction of the Eustachian tube with large adenoids is thought to be associated with OME, although small adenoids may also lead to OME by serving as reserve of pathogens causing tube edema and dysfunction.…”

Clinical Outcomes of Montelukast Sodium in Children with Adenoid Hypertrophy

“…Significant expenses, nonattendance of child from school, risk of anesthesia and other surgical procedure related morbidities have additionally featured the need of medicinal treatment for adenoid hypertrophy. Levels of serum immunoglobulins have been seen to be lower in patients who have experienced adenotonsillectomy than in healthy control group [4]. Also, AH may create fundamental irritation in kids and grown-ups as shows by an expansion in C-reactive protein and this is connected with psychological and cardiovascular morbidity which diminishes following adeno-tonsillectomy.…”