Orthodontic treatment after adenoidectomy patients: effect on jaw relations in saggital plane

Adenoid hypertrophy is a normal phenomenon seen in young children. Adenoids may however be of large size or may not reduce in size in adulthood. Large adenoids may cause mouth breathing, overcrowding of teeth or otological symptoms. When adenoids are large and producing these effects, adenoidectomy is necessary. Adenoidectomy immensely benefits such patients but they may still continue to be habitual mouth breathers. This can lead to formation of long narrow face, labially protruded maxillary incisors and class 2 malocclusion. Immediate orthodontic treatment of such patients will improve facial profile and lead to class 1 (Angle) occlusion. We present here a study of 20 patients who were given early orthodontic treatment in postadenoidectomy period as compared to those patients who were not treated by orthodontist.     

Evidence of an association between mannose binding lectin codon 54 polymorphism and adenoidectomy and/or tonsillectomy in children

Mannose binding lectin (MBL) is a calcium-dependent lectin that plays an important role innate immunity by activating the complement pathway. There have been a number of studies describing an association between the MBL genotype and disease susceptibility. MBL deficiency has been described as one of the factors leading to a number of infections in children with recurrent upper respiratory tractus infections (URTI). We hypothesized that MBL deficiency may be associated with recurrent URTI, which requires adenoidectomy and/or adenotonsillectomy. In this study to clarify this hypothesis we investigated whether there may be an association between two low producing MBL variants and adenoidectomy and/or tonsillectomy due to recurrent URTI in children. Blood samples were collected, adenoidectomy and/or tonsillectomy due to recurrent URTI and 50 controls (mean age 80.53 +/- 32.62 months). In all patients and controls codon 54 and codon 57 polymorphisms of the MBL gene were analyzed. None of the subjects from the patient group and control group carried codon 57 polymorphism of the MBL gene. The frequency of low-level MBL genotypes (AB and BB) for codon 54 polymorphism in the patient group was found to be significantly higher compared to the control subjects (55.7% versus 14%) (p<0.001). This study shows that the presence of low-level MBL alleles is associated with adenoidectomy and/or tonsillectomy caused by recurrent URTI in children.     

Trends in otitis media surgery: a decrease in adenoidectomy

OBJECTIVE: Large variability in adenoidectomies and tympanostomy tube insertions between Norway and Finland has been suggested, but not yet confirmed. Objective is to compare trends in paediatric adenoidectomies and tympanostomy tube insertions for Norway and Finland from 1999 to 2005. METHODS: National Finnish and Norwegian databases (STAKES and NPR) provided information on children between 0 and 7 years operated in the years 1999-2005. Surgical rates were viewed in the light of child density, age and gender, and compared bi-nationally. RESULTS: Adenoidectomies were more common in Finland throughout the study period. Adenoidectomies in both countries decreased markedly from 1999 to 2005. The Finnish adenoidectomy rates were reduced from 212 to 133 per 10,000 children, equivalent Norwegian figures were 84 and 44 per 10,000 children. Tympanostomy tube insertions increased from 97 to 147 per 10,000 children in Finland in the same study period. In Norway the rates were more stable, 119 and 123 per 10,000 in 1999 and 2005, respectively. Peak-age for otitis media surgery was the second year of life in Finland, sixth in Norway. Boys were more frequently operated on in both countries. CONCLUSION: Our study confirmed differences in the approach to otitis media surgery and revealed a decreasing trend in adenoidectomies in both countries. Similar data from other countries is needed to confirm the latter.     

鼻内镜下成人腺样体肥大的诊治

目的:总结探讨成人腺样体肥大在鼻内镜下的诊治。方法:鼻内镜检出成人腺样体肥大患者32例,在鼻内镜直视下,完整切除腺样体。结果:术后随访6～36个月,平均13个月,无复发。结论:鼻内镜的普及大大提高成人腺样体肥大的诊治水平。     

手术治疗腺样体肥大儿童阻塞性睡眠呼吸暂停综合征

目的　探讨腺样体切除术、腺样体扁桃体切除术对腺样体肥大儿童阻塞性睡眠呼吸暂停综合征(OSAS)的治疗作用。方法　对 2 0例腺样体肥大合并OSAS(OSAS组 )儿童手术前后的临床表现、多导睡眠图(PSG)检查结果进行前瞻性比较研究 ,并与同期住院的 1 0例单纯性腺样体肥大儿童 (对照组 )进行对照研究。结果　OSAS组的常见症状发生率与对照组差异无显著性 (P >0 .0 5 ) ;两组体块指数分别为 1 5 .4± 2 .5kg/m2 和1 7.6± 3.1kg/m2 ,差异无显著性 (P >0 .0 5 )。OSAS组与对照组的鼻咽侧位片A/n值、总睡眠时间、睡眠效率及S1、S2、慢波睡眠 (SWS)、快速眼动睡眠期 (REM)所占比例差异均无显著性 (P >0 .0 5 )。OSAS患儿术后呼吸暂停指数 (AI)、呼吸暂停低通气指数 (AHI)、阻塞性呼吸暂停指数 (OAI)较术前降低 (P <0 .0 5或 0 .0 1 ) ,REM所占比例较术前增高 (P <0 .0 5 )。结论　腺样体肥大合并OSAS的临床表现、鼻咽侧位片A/n值、睡眠结构与单纯腺样体肥大患儿无差别 ;腺样体肥大合并OSAS儿童手术治疗效果良好。     

儿童腺样体肥大120例临床分析

目的 比较2种不同手术方法治疗儿童腺样体肥大的临床症状及心理行为改善情况.方法 120例患者随机分为对照组、观察组各60例;对照组采用传统腺样体刮除术;观察组采用鼻内镜辅助下经口动力系统腺样体切除术.评估2组术后3个月鼻塞、鼻漏、夜间打鼾及听力等临床症状的改善和2组术前与术后3个月儿童心理行为的改善情况.结果 2组术后3个月临床主要症状均有明显改善,观察组比对照组改善更为显著(P＜0.05);术后3个月2组心理行为总粗分及检出率较术前相比均明显下降,2组间比较差异有统计学意义(P＜0.05).结论 鼻内镜辅助下经口动力系统腺样体切除术为理想的治疗腺样体肥大的手术方式,值得临床推广.     

鼻窦CT评估腺样体切除术对儿童慢性鼻窦炎的影响

目的探索儿童慢性鼻窦炎的严重程度与腺样体大小的关系,分析腺样体切除术后儿童慢性鼻窦炎的预后情况。方法选取2018年8月至2018年12月于山东省立医院东院耳鼻喉科行腺样体切除术的119例患儿作为研究对象,术前通过电子鼻咽喉镜评估腺样体的大小,依据腺样体组织阻塞后鼻孔的面积将所有患者分为3组:A组(阻塞后鼻孔<70%,n=23),B组(阻塞后鼻孔70%~90%,n=42),C组(阻塞后鼻孔>90%,n=54)。分别于术前及术后3个月行鼻窦CT检查,利用Lund-Mackay评分评估鼻窦炎的严重程度,并比较手术前后患儿鼻窦炎的变化情况。结果A、B、C组Lund-Mackay评分分别为(3.91±3.44)分、(4.02±4.07)分、(7.67±6.46)分,C组与A、B组比较差异有统计学意义(P<0.05)。腺样体切除术后患儿的Lund-Mackay评分低于术前,差异具有统计学意义。结论腺样体的大小会影响鼻窦炎的严重程度,腺样体切除手术有助于儿童慢性鼻窦炎的恢复。     

OSAHS患儿扁桃体和腺样体术后免疫功能的变化

目的 阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是耳鼻咽喉科的一种常见病,儿童发病率呈上升趋势,调查显示儿童OSAHS发生率为4%~5%,2~6岁是发病的高峰期。OSAHS不仅严重影响儿童的睡眠质量,还会引起儿童生长发育迟缓、智力缺陷等一系列不良反应,OSAHS患儿的主要病因是扁桃体和/或腺样体肥大,因此最有效的治疗方法是扁桃体切除术和腺样体切除术。而扁桃体和腺样体是儿童淋巴组织系统的重要组成部分,在机体的防御和保护功能中发挥着重要作用。手术治疗OSAHS是否影响儿童的免疫功能目前存在争议。一些学者认为扁桃体切除和腺样体切除后儿童的免疫力降低,而另一些学者认为OSAHS儿童的免疫力在手术后保持不变,甚至比手术前有所提高。本文就儿童OSAHS手术前后免疫指标的变化作一综述。     

The safety and risk factors of revision adenoidectomy in children and adolescents: A nationwide retrospective population-based cohort study

Objective

To investigate the safety of adenoidectomy and risk factors of re-adenoidectomy, and intend to provide evidence-based information to clinicians for further consideration.