Carotid artery dissection following adenoidectomy

Garg, Arun; Singh, Yeeshu; Singh, Pankaj Kumar; Goel, Gaurav; Bhuyan, Susant

doi:10.1016/j.ijporl.2015.12.017

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…In addition to the most common adenoidectomy complications, several rare complications have been recently described in the literature. In 2016, a case was published where a young girl suffered an internal carotid artery (ICA) dissection and subsequent cerebral infarction resulting in hemiplegia and global aphasia found to be due to an ICA loop later confirmed on angiogram [60]. Other very rare events described in the literature include temporomandibular joint dysfunction, vertebral osteomyelitis [58,61,62], and cerebrospinal fluid (CSF) leak from the use of a microdebrider leading to pneumocephalus and meningitis [63].…”

Section: Adenoidectomy Complicationsmentioning

confidence: 99%

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Schüpper

Nation

Pransky

2018

Curr Otorhinolaryngol Rep

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Purpose of Review Review the current state of the adenoidectomy procedure in the pediatric population with up-to-date indications for surgery, operative techniques, adverse events, non-surgical management of adenoid hypertrophy, and future directions. Recent Findings Adenoidectomy is indicated in children for the treatment of sleep-disordered breathing, nasal airway obstruction, recurrent acute otitis media, and chronic rhinosinusitis. A new recommendation was released in 2016, not supporting adenoidectomy for a primary indication of otitis media in children under 4 years old, including those with prior tympanostomy tubes, unless a distinct indication exists such as nasal obstruction or chronic adenoiditis. Although adenotonsillectomy is the mainstay of treatment for obstructive sleep apnea (OSA), recent studies have identified that non-obese patients with moderate OSA and small tonsils have comparable benefits with adenoidectomy alone with less complications. While conventional approaches such as indirect mirror-assisted curette and suction coagulation are still utilized, direct transnasal endoscopeassisted removal of the adenoids has proven to be a safe technique, with good short-and long-term outcomes. Novel nonsurgical therapies including immunotherapy have been evaluated. Summary Adenoidectomy is a safe procedure in the pediatric population and leads to excellent outcomes. Adverse events are rare, and hospitalization is uncommon. Children with sleep disturbance from nasal airway obstruction, ear disease, or chronic rhinosinusitis are the best operative candidates for this procedure.

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Section: Adenoidectomy Complicationsmentioning

confidence: 99%

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Schüpper

Nation

Pransky

2018

Curr Otorhinolaryngol Rep

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“…Garg et al 43 stated that “carotid dissection and cerebral infarction” have extremely rare complications of adenoidectomy. They reported a case of a 7-year-old girl who underwent left ICA dissection after adenoidectomy and led to global aphasia and right hemiplegia.…”

Section: Discussionmentioning

confidence: 99%

“…31,41 Suture ligatures can penetrate and occlude torn veins, used instruments can tear the vessels, and electric cauterization can conduct indirectly and burn the tissues. 42 Garg et al 43 stated that "carotid dissection and cerebral infarction" have extremely rare complications of adenoidectomy. They reported a case of a 7-year-old girl who underwent left ICA dissection after adenoidectomy and led to global aphasia and right hemiplegia.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging Evaluation of Distance Between Adenoid Tissue and Internal Carotid Artery in Children With Adenoid Hypertrophy

Şahan

Muluk

2021

J Comput Assist Tomogr

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Objectives: In the present study, we investigated the distance between adenoid tissue and internal carotid artery (ICA) in children with adenoid hypertrophy by magnetic resonance imaging.Methods: Cranial magnetic resonance images of 200 children with adenoid hypertrophy between the ages of 5 and 15 were included. In group 1 (5-9 years of age), there were 100 children, and in group 2 (10-15 years of age), there were 100 children. In both groups, adenoid thickness, adenoid/nasopharynx) ratio, and superior, middle, and inferior adenoid-ICA distances were measured.Results: Adenoid thickness is significantly higher in the 10-to-15 years age group than in the 5-to-9 years age group (P < 0.05). Adenoid-ICA distance got lower from the superior to the inferior part in both age groups and in both sexes: inferior < middle < superior adenoid-ICA distance. In the 5-to-9 years age group, the minimum adenoid-ICA distances were 2.40 mm superior , 0.90 mm middle , and 1.20 mm inferior . In 10-to-15 years age group, the minimum adenoid-ICA distances were 2.50 mm superior , 1.00 mm middle , and 0.90 mm inferior . As adenoid thickness increased, the inferior adenoid-ICA distance decreased bilaterally (P < 0.05). As the age got older, adenoid thickness increased, and the left superior and middle adenoid ICA distances and bilateral inferior adenoid-ICA distances decreased (P < 0.05). Conclusion:The distance between adenoid and ICA decreased from superior to inferior. In 10-to 15-year-old children, the distance between adenoid and ICAwas determined as lower than in the 5-to 9-year-old children. The minimum distances between adenoid and ICA were found to be between 0.9 and 2.5 mm in the 10-to-15 age group and between 0.9 and 2.4 mm in the 5-to-9 age group. It should be remembered that ICA can be very close to the adenoid tissue. In addition, because thermal injury can cause deeper damage to the tissue, bipolar cautery should be used with caution in this area and unipolar cautery should not be used.

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“…Although adenoidectomy is the most frequently performed ENT operation in childhood and is a safe and well-established procedure that has been performed for decades, severe bleeding complications can occur in rare cases. In the literature, a number of case reports have been published on fatal bleeding in patients with an underlying coagulation disorder or injuries to major arteries, for example, in the absence of bony coverage or in the case of an atypical course [ 12 , 19 , 57 ]. The risk of bleeding associated with adenoidectomy emphasizes the important role of the coagulation questionnaire, which must always be completed before a surgical procedure is performed on a pediatric patient [ 53 ].…”

Section: Surgical Treatmentmentioning

confidence: 99%

Adenoid hypertrophy—diagnosis and treatment: the new S2k guideline

Ahmad

Krüger

Lautermann

et al. 2023

HNO

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Hyperplasia of the pharyngeal tonsils is to be considered pathologic when nasopharyngeal symptoms of mechanical obstruction and/or chronic inflammation occur. Chronic Eustachian tube dysfunction can result in various middle ear diseases such as conductive hearing loss, cholesteatoma, and recurrent acute otitis media. During examination, attention should be paid to the presence of adenoid facies (long face syndrome), with a permanently open mouth and visible tip of the tongue. In the case of severe symptoms and/or failure of conservative treatment, adenoidectomy is usually performed on an outpatient basis. Conventional curettage remains the established standard treatment in Germany. Histologic evaluation is indicated for clinical evidence of mucopolysaccharidoses. Due to the risk of hemorrhage, the preoperative bleeding questionnaire, which is obligatory before every pediatric surgery, is referred to. Recurrence of adenoids is possible despite correct adenoidectomy. Before discharge home, otorhinolaryngologic inspection of the nasopharynx for secondary bleeding should be performed and anesthesiologic clearance obtained.

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Carotid artery dissection following adenoidectomy

Cited by 5 publications

References 13 publications

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Magnetic Resonance Imaging Evaluation of Distance Between Adenoid Tissue and Internal Carotid Artery in Children With Adenoid Hypertrophy

Adenoid hypertrophy—diagnosis and treatment: the new S2k guideline

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Carotid artery dissection following adenoidectomy

Cited by 5 publications

References 13 publications

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Magnetic Resonance Imaging Evaluation of Distance Between Adenoid Tissue and Internal Carotid Artery in Children With Adenoid Hypertrophy

Adenoid hypertrophy—​diagnosis and treatment: the new S2k guideline

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Adenoid hypertrophy—diagnosis and treatment: the new S2k guideline