Tonsillectomy and Adenoidectomy and Myringotomy With Tube Insertion

Baum, Eric D.

doi:10.1542/pir.31-10-417

Cited by 6 publications

(4 citation statements)

References 24 publications

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“…Another plausible explanation may be that adenoid tissue is most active in children between age 4 and 10 years before their involution during puberty, possibly attributing more to the pathophysiology of eustachian tube dysfunction in children of that age. 25 However, the inability to stratify the data by surgical indication, the limited number of studies focusing on young children exclusively as well as unknown confounders in the retrospective data may also have produced the age-based finding. Of note, the 4 prospective randomized clinical trials showing no difference between adjuvant adenoidectomy with primary TT and primary TT alone include the study with age range below age 2 years, 11 both studies with age ranges below age 4 years, 13,17 as well as 1 of the 7 studies with age ranges below 9 years.…”

Section: Adenoidectomy At Tympanostomy Tube Placementmentioning

confidence: 99%

Adenoidectomy as an Adjuvant to Primary Tympanostomy Tube Placement

Mikals

Brigger

2014

JAMA Otolaryngol Head Neck Surg

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The current evidence suggests that primary Ad + TT may be superior to TT only in decreasing the risk of r-TT and the risk of RAOM, OME, or otorrhea. Limitations include heterogeneity of the source data, with the predominance of retrospective data as well as studies with older children supporting the superiority of adjuvant adenoidectomy. The practice of Ad + TT may decrease the risk of repeated surgery in children older than 4 years.

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Section: Adenoidectomy At Tympanostomy Tube Placementmentioning

confidence: 99%

Adenoidectomy as an Adjuvant to Primary Tympanostomy Tube Placement

Mikals

Brigger

2014

JAMA Otolaryngol Head Neck Surg

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“…Adenotonsillectomy is one of the most common surgical procedures in children, performed to address upper airway lymphoid hypertrophy, infection, and inflammation (6). Its clinical effect on asthma control has been debated (7).…”

Section: Introductionmentioning

confidence: 99%

Improvement in asthma control and inflammation in children undergoing adenotonsillectomy

Levin

Gagnon

et al. 2013

Pediatr Res

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Background Observational studies suggest that asthma control improves after adenotonsillectomy, but longitudinal studies that correlate the effect of the procedure on the levels of biomarkers associated with airway inflammation are limited. Methods We conducted a longitudinal, observational study on pediatric patients, both with and without asthma, undergoing adenotonsillectomy. Asthma Control Test (ACT) scores and chitinase activity in the circulation were measured at time of surgery and at 6-month follow-up. Results 66 children with asthma and 64 control subjects were enrolled. Mean ACT scores improved by 3 points (p< 0.001) after 6 months. 85% of children with poorly-controlled asthma demonstrated an increase in ACT score of at least 3 points or a decrease in Emergency Department/Urgent Care visits, oral corticosteroid courses, or rescue short acting bronchodilator usage. Chitinase activity decreased significantly in asthmatics who improved (p< 0.01). Higher chitinase activity levels at baseline were associated with improved asthma control following surgery (p< 0.01). Conclusions In children with high pre-operative circulating chitinase activity levels, asthma control and healthcare utilization were significantly improved after adenotonsillecotmy. Chitinase activity decreased after surgery in children with improved control. This suggests that adenotonsillectomy modulates chitinase activity, affecting airway inflammation and improving airway disease.

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“…Several strategies aimed at reducing the burden of co-existing comorbidities show some promise in improving asthma control and may point to more precise treatments for preschool asthma 5,8,9 . Adenotonsillectomy (TA) is one of the most common surgical procedures performed in children to address adenotonsillar hypertrophy, obstructive sleep apnea, and recurrent infection and inflammation [10][11][12] . Studies exploring the effect of TA in asthmatic populations have revealed numerous benefits for symptom control and quality of life 8,9,11,13 .…”

Section: Introductionmentioning

confidence: 99%

Adenotonsillectomy, Bronchoscopy and Bronchoalveolar Lavage in the Management of Preschool Children with Severe Asthma

Campisi

Vargas

Brydges

et al. 2021

Preprint

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Objective: The potential benefit of a combined adenotonsillectomy and bronchoscopy with bronchoalveolar lavage (TA-B-BAL) in preschool children with asthma has been debated in the literature. We aimed to describe the clinical course of preschool children with severe asthma undergoing this combined procedure. Study Design: This is a retrospective case-control study. Patient Selection: Preschool patients diagnosed with severe asthma who underwent TA-B-BAL treatment between 2012 and 2019 were included as cases. Controls were age and sex matched patients receiving standard asthma care. Methodology: A retrospective patient chart review was conducted. Data on demographics, clinical characteristics, medication use, virology and microbiology from bronchoalveolar lavage, and asthma control questionnaires were collected. Cases and controls were compared with t-tests and regression analysis. Results: Eighteen preschool subjects (mean age 3.19±1.13 years) in the case group were matched to eighteen control subjects receiving standard care. A Poisson mixed effects regression analysis revealed reduced risk of oral corticosteroid use (RR 0.39, 95%CI 0.18, 0.83, p=0.014), reduced emergency department visits (RR 0.36, 95%CI 0.17, 0.75, p=0.01) and reduced risk of asthma exacerbations (RR 0.58, 95%CI 0.28, 1.20, p=0.14) in cases compared to controls. Ten patients experienced clinically meaningful improvements in TRACK scores after the procedure (p<0.001). Conclusion: This pilot study provides early evidence that preschool children with severe asthma may benefit from combined adenotonsillectomy and bronchoscopy with bronchoalveolar lavage procedure. The procedure is a useful adjunct for reduction of medication use and hospital visits for preschool age patients with severe asthma.

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Tonsillectomy and Adenoidectomy and Myringotomy With Tube Insertion

Cited by 6 publications

References 24 publications

Adenoidectomy as an Adjuvant to Primary Tympanostomy Tube Placement

Adenoidectomy as an Adjuvant to Primary Tympanostomy Tube Placement

Improvement in asthma control and inflammation in children undergoing adenotonsillectomy

Adenotonsillectomy, Bronchoscopy and Bronchoalveolar Lavage in the Management of Preschool Children with Severe Asthma

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