Tonsillectomy and Adenoidectomy - Pediatric Clinics of North America

Nguyen, Brandon; Quraishi, Huma

doi:10.1016/j.pcl.2021.12.008

Cited by 11 publications

(9 citation statements)

References 68 publications

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“…Chemokines, substance P, pro-inflammatory factors, and vasoactive intestinal peptides release during this surgery because of the local trauma of the oropharynx that induces vasodilatation, tissue edema, and pain. [ 24 25 ]…”

Section: Discussionmentioning

confidence: 99%

The Effect of Half Percent Oxymetazoline Nasal Drops on Post-Tonsillectomy Cough, Sore Throat and Bleeding in Children; a Double-Blind Randomized Clinical Trial

Masoudifar,

Rezaeian,

Mosharaf

2023

Advanced Biomedical Research

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Background: Considering the high prevalence of tonsillectomy in children and concerns of postoperative management, this study was conducted with the aim of evaluating the effects of oxymetazoline on bleeding, cough, and sore throat in children undergoing tonsillectomy. Materials and Methods: The current double-blind clinical trial study was conducted on 88 tonsillectomy candidate patients. These patients were randomly divided into two groups. In the first group, oxymetazoline 0.05% nasal spray (OXY group) and in the second group, distilled water spray (Control group) was prescribed as one puff in each nostril immediately after anesthesia induction., the nasal spray was prescribed again in both nostrils at 12 h after tonsillectomy. Then the hemodynamic parameters, post-tonsillectomy hemorrhage (PTH) and sore throat were evaluated. Results: The mean of the sore throat of children was not significantly different between the two groups in any of the follow-up times ( P value >0.05). PTH in recovery and in the ward in the OXY group with the mean of 57.60 ± 71.82 ml and 22.11 ± 22.50 ml, respectively, was significantly lower than the control group (83.50 ± 113.64 ml and 27.52 ± 35.11 ml) ( P value < 0.05). Also, the frequency of cough in the ward in the OXY group with 27.3% was significantly lower than the control group with 56.8% ( P value = 0.005). Conclusion: Regarding the results of the present study, sore throat and hemodynamic parameters did not change significantly with the administration of oxymetazoline. But this drug has played a significant role in reducing PTH and cough in children.

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Section: Discussionmentioning

confidence: 99%

The Effect of Half Percent Oxymetazoline Nasal Drops on Post-Tonsillectomy Cough, Sore Throat and Bleeding in Children; a Double-Blind Randomized Clinical Trial

Masoudifar,

Rezaeian,

Mosharaf

2023

Advanced Biomedical Research

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“…10 Recent studies reveal the prevalence of SDB in the pediatric population as 12%, and surgery is recommended as the primary treatment choice. 11 In terms of tonsillar hypertrophy, though tonsillar size is found to be unrelated to the degree of obstruction 12 it is recommended to use the Brodsky grading scale, 2 which consists of 5 grades from 0 to 5 based on size and anatomic extent of the tonsils 13 and used by clinicians to determine the degree and progression of tonsillar hypertrophy. Our patient was evaluated pre-operatively as grade 1 corresponding to tonsils occupying ≤33% of the oropharyngeal width, and was later intraoperatively found to be grade 2, meaning 34% to 66% occupation.…”

Section: Discussionmentioning

confidence: 99%

“…Tonsillectomy and adenoidectomy, especially in the pediatric age group, are listed among the most performed procedures, exceeding 500,000 per year in the United States. 1,2 When performed with proper indications such as recurrent tonsillitis, obstructive sleep-disordered breathing, chronic or recurrent otitis media with effusion, chronic adenoiditis, etc 2 , tonsillectomy and adenoidectomy, profoundly enhances the patient's quality of life. 3,4 Performing routine pathologic examination of tonsillectomy and/or adenoidectomy specimens is not strongly encouraged by the current literature, as it is not regarded to be cost-effective due to the low rates of malignancy, 5 which is also the reason why referring the resected material to pathology is not commonly applied in the surgical practice of many institutions.…”

Section: Introductionmentioning

confidence: 99%

Pediatric T-cell Lymphoblastic Leukemia/Lymphoma Diagnosed at Routine Adenoidectomy Specimen

et al. 2022

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Postoperative routine pathologic evaluation of tonsillectomy and adenoidectomy specimens rarely reveals a diagnosis of malignancy. The object of this case report is to highlight this rare clinical occurrence. A 4-year-old boy presented with symptoms of sleep-disordered breathing and had a history of recurrent tonsillitis. Physical examination revealed adenoid hypertrophy and Brodsky Grade 1 bilateral tonsillar hypertrophy. The patient underwent adenoidectomy and tonsillectomy. The adenoids were found to be MAGS Grade 4 (Modified Adenoid Grading System) hypertrophic causing 100% obstruction. After the histologic examination, T-cell lymphoblastic leukemia/lymphoma was diagnosed. Proper treatment allowed full recovery. Currently, no consensus has been made about routine pathological evaluation. To achieve a cost-effective and precautionary approach, we recommend pathological follow-up of cases with unusual intraoperative findings with/without clinical malignancy suspicion.

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“…Specialized otolaryngologists should carefully evaluate specific indications before deciding to proceed with adenoidectomy and tonsillectomy surgeries [ 73 ]. It is crucial to thoroughly assess the potential risks and benefits associated with these interventions prior to making recommendations [ 74 ].…”

Section: Diagnosis and Management Of Adenotonsillar Diseasementioning

confidence: 99%

Unveiling the Enigmatic Adenoids and Tonsils: Exploring Immunology, Physiology, Microbiome Dynamics, and the Transformative Power of Surgery

Samara

Athanasopoulos

2023

Microorganisms

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Within the intricate realm of the mucosal immune system resides a captivating duo: the adenoids (or pharyngeal tonsils) and the tonsils (including palatine, tubal, and lingual variations), which harmoniously form the Waldeyer’s ring. As they are strategically positioned at the crossroads of the respiratory and gastrointestinal systems, these exceptional structures fulfill a vital purpose. They function as formidable “gatekeepers” by screening microorganisms—both bacteria and viruses—with the mission to vanquish local pathogens via antibody production. However, under specific circumstances, their function can take an unsettling turn, inadvertently transforming them into reservoirs for pathogen incubation. In this review, we embark on a fascinating journey to illuminate the distinctive role of these entities, focusing on the local immune system inside their tissues. We delve into their behavior during inflammation processes, meticulously scrutinize the indications for surgical intervention, and investigate the metamorphosis of their microbiota in healthy and diseased states. We explore the alterations that occur prior to and following procedures like adenoidectomy, tonsillectomy, or their combined counterparts, particularly in pediatric patients. By comprehending a wealth of data, we may unlock the key to the enhanced management of patients with otorhinolaryngological disorders. Empowered with this knowledge, we can embrace improved therapeutic approaches and targeted interventions/surgeries guided by evidence-based guidelines and indications.

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Tonsillectomy and Adenoidectomy - Pediatric Clinics of North America

Cited by 11 publications

References 68 publications

The Effect of Half Percent Oxymetazoline Nasal Drops on Post-Tonsillectomy Cough, Sore Throat and Bleeding in Children; a Double-Blind Randomized Clinical Trial

The Effect of Half Percent Oxymetazoline Nasal Drops on Post-Tonsillectomy Cough, Sore Throat and Bleeding in Children; a Double-Blind Randomized Clinical Trial

Pediatric T-cell Lymphoblastic Leukemia/Lymphoma Diagnosed at Routine Adenoidectomy Specimen

Unveiling the Enigmatic Adenoids and Tonsils: Exploring Immunology, Physiology, Microbiome Dynamics, and the Transformative Power of Surgery

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