Radiation Therapy for the Removal of Adenoid Tissue

Abstract

IT IS NOW the carefully considered opinion of many otolaryngologists that infection of nasopharyngeal lymphoid tissue is a factor of the greatest importance in diseases of the respiratory tract and the ear.From the history alone it is apparent that in many patients recurrent infections of ear, nose and throat have their beginning in the nasopharynx. Careful nasopharyngeal examinations and the results observed after elimination of infected adenoids have consistently confirmed this observation. Although this has been especially emphasized in recent years, it has been well recognized for a long time, as demonstrated by the frequency with which repeated surgical attacks onthe nasopharynx have been carried out on children with persistent respiratory or aural diseases.Although radiation therapy for the elimination of adenoids has been used for over twenty years and many thousands of patients have been treated, few reports on the results obtained are in the literature.During the past three years at the Hagerstown Clinic 400 patients have been so treated, and in most of them the results have been observed over long periods. The average period of observation for the total of 400 has been thirteen months to date (June 1946), and most of the more interesting cases have been followed for almost two years. A total of 1,110 radium treatments have been given to the 400 patients so far. There are 211 males and 189 females; 286 of the patients are between 5 and 15 years of age ( fig. 1). As the treatment of many of these patients is not as yet complete, results must not be considered final, either for the bad or for the good. These patients received, in addition to radiation therapy, surgical treatment of the tonsils or the adenoids when indicated (mastoidectomy or nasal operation in some instances) and local treatments to the sinuses, the nose or the ears. RESULTSThe results are best considered under two headings : ( 1 ) changes in the nasopharyngeal lymphoid tissue and (2) changes in the patient's symptoms.

The adenoid: Its history and a cautionary tale

“…There was, however, one person still alive: Dr. Donald F. Proctor (1914–March 28, 2006). Working closely with Dr. Crowe and taking part in the studies with the Johns Hopkins group, Proctor had been an advocate of nasopharyngeal radiation and had authored and coauthored numerous publications concerning the use of nasopharyngeal radiation therapy . As Proctor describes in a historical review article of 1995, “Dr.…”