Role of adenoidectomy in chronic nasal obstruction after nasal steroid therapy failure

Ciolek, Peter J.; Xu, Allen; Anne, Samantha; Geelan-Hansen, Katie

doi:10.1016/j.amjoto.2017.01.031

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…As a result, these areas are routinely assessed by otolaryngologists, either with nasoendoscopic or radiological techniques to facilitate efficacious surgical intervention in the treatment of nasal airway obstruction. 3–5…”

Section: Introductionmentioning

confidence: 99%

Physiological changes in the size of the septal swell body correlate with changes in inferior turbinate size

et al. 2020

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ObjectiveThe nasal septal swell body is a normal anatomical structure located in the superior nasal septum anterior to the middle turbinate. However, the impact of the septal swell body in nasal breathing during normal function and disease remains unclear. This study aimed to establish that the septal swell body varies in size over time and correlates this with the natural variation of the inferior turbinates.MethodConsecutive patients who underwent at least two computed tomography scans were identified. The width and height of the septal swell body and the inferior turbinates was recorded. A correlation between the difference in septal swell body and turbinates between the two scans was performed using a Pearson's coefficient.ResultsA total of 34 patients (53 per cent female with a mean age of 58.3 ± 20.2 years) were included. The mean and mean difference in septal swell body width between scans for the same patient was 1.57 ± 1.00 mm. The mean difference in turbinate width between scans was 2.23 ± 2.52 mm. A statistically significant correlation was identified between the difference in septal swell body and total turbinate width (r = 0.35, p = 0.04).ConclusionThe septal swell body is a dynamic structure that varies in width over time in close correlation to the inferior turbinates. Further research is required to quantify its relevance as a surgical area of interest.

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Section: Introductionmentioning

confidence: 99%

Physiological changes in the size of the septal swell body correlate with changes in inferior turbinate size

et al. 2020

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“…The finding that more than 40% of patients developed refractory symptoms is higher than other estimates ranging from 2% to 30%. 14,15,17,18 Use of preoperative medications and number of preoperative medications were both significantly higher in patients with refractory symptoms. While a higher proportion of patients who used preoperative medications may be expected given that surgical management often follows failed medical management, patients with refractory symptoms also used a significantly higher number of preoperative medications.…”

Section: Discussionmentioning

confidence: 95%

“…The finding that more than 40% of patients developed refractory symptoms is higher than other estimates ranging from 2% to 30%. 14,15,17,18…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…9,12,13 Adenoidectomy has often been used as an initial surgical procedure for symptoms that are refractory to medical therapy, with resolution of symptoms as high as 88% to 98% of patients in two case series focusing on chronic rhinitis, and 69.3% of pediatric patients according to a meta-analysis examining chronic rhinosinusitis. 12,[14][15][16] While several studies have examined the efficacy of adenoidectomy for management of chronic rhinitis, prevalence of refractory rhinitis symptoms after adenoidectomy varies widely and few studies have identified what factors might contribute to responsiveness to adenoidectomy. The objective of this study was to compare patients who experienced refractory rhinitis symptoms following adenoidectomy with those who experienced resolution of their symptoms to identify any factors that might be associated with medication failure.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Refractory Nasal Congestion Following Adenoidectomy

Patel

Brook

Levi

2020

Ann Otol Rhinol Laryngol

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Objective: The objective of this study was to better characterize factors associated with refractory rhinitis in pediatric patients who underwent adenoidectomy compared to those who had symptom resolution. Methods: The authors conducted a case series of patients younger than 18 years old who underwent adenoidectomy at Boston Medical Center from October 2012 to December 2018. Patients who underwent tonsillectomy and adenoidectomy or who underwent adenoidectomy for indications other than rhinitis were excluded. Patients who had refractory rhinitis symptoms postoperatively were compared to those who had resolution of their symptoms using Chi-square analysis and t-tests. Results: One hundred three patients who had refractory symptoms following adenoidectomy were compared to 139 patients who had resolution of symptoms. Patients who had refractory symptoms had significantly higher proportion of use (89.3%, P = .0011) and higher mean number of preoperative (1.50, P = .0226) and postoperative (1.10, P < .0001) medications, including nasal saline, intranasal steroids, antihistamines, and/or antibiotics. They were more likely to receive postoperative allergy evaluations (50%, P = .0068) and repeat surgery (30.1%, P < .0001), and had a higher proportion of reported history of allergies (24.3%, P = .0089). Conclusion: Use and number of preoperative medications, reported history of allergies, and postoperative allergy evaluation were significantly higher in patients with refractory chronic rhinitis following adenoidectomy. This study identified differences in patients who developed refractory symptoms that may help clinical decision making for surgical management.

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Adenoidectomy and chronic nasal obstruction developing after failure of nasal steroid therapy

Lou

2018

American Journal of Otolaryngology

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Role of adenoidectomy in chronic nasal obstruction after nasal steroid therapy failure

Cited by 5 publications

References 15 publications

Physiological changes in the size of the septal swell body correlate with changes in inferior turbinate size

Physiological changes in the size of the septal swell body correlate with changes in inferior turbinate size

Factors Associated with Refractory Nasal Congestion Following Adenoidectomy

Adenoidectomy and chronic nasal obstruction developing after failure of nasal steroid therapy

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