Outcomes of adenoidectomy with and without tonsillectomy in patients younger than 2 years with moderate to severe upper airway obstruction

Taniguchi, Kenshiro; Yoshitomi, Ai; Kanemaru, Asako

doi:10.1016/j.ijporl.2021.110841

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…There was highly statistically significant higher length of soft palate among patients with adenoid residual than without. More than half of the studied group had adenoid residual (61.5%) as shown in figure (4).…”

Section: Figure (3): Bar Chart For Groups Of Adenoidectomymentioning

confidence: 89%

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Anatomical Variables as Predictive Factors of Intra-Operative Residual during Adenoidectomy

Saleh¹,

Nasr²,

Elkaseh³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Children with adenoids that have grown too large often have difficulty breathing or get infections among upper respiratory tract because their airways are blocked. In most cases, adenoidectomy can reduce clinical symptoms and boost quality of life.Objectives: This study aimed to determine if there are any factors that can influence the usual procedure of adenoidectomy and its ability to remove all adenoid tissue. Subjects and Methods: Intra-operative variables for assessing demographic and anatomical characteristics, such as age, sex, weight, height, BMI, and soft palate length were observed in a retrospective analysis to determine their impact on adenoidectomy success. Every child had a standard trans-oral curettage adenoidectomy completed under endoscopic control, and if there were any adenoid remnants, a revision adenoidectomy was done at the same time. The total number of patients included was 208. Results: In 43.7% of patients (91/208), complete adenoidectomy was challenging since traditional surgery could not access the most important parts of the nasopharynx. The average soft palate length in this group was 2.8 centimeters, 5 millimeters longer than the sample as a whole, and 1 cm larger than the typical patient who undergoes only standard surgical procedure alone (p < 0.001). Conclusion: Intraoperatively, the soft palate length can be used as a factor for choosing which patients would undergo endoscopic control following standard adenoidectomy.

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Section: Figure (3): Bar Chart For Groups Of Adenoidectomymentioning

confidence: 89%

“…When performed alone, adenoidectomy can alleviate nasal congestion and the symptoms of frequent colds and other respiratory illnesses (4) . However, after surgery, some patients still experience considerable nasal problems.…”

Section: Introductionmentioning

confidence: 99%

Anatomical Variables as Predictive Factors of Intra-Operative Residual during Adenoidectomy

Saleh¹,

Nasr²,

Elkaseh³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…The primary contributor to snoring is adenoid hypertrophy, making adenoidectomy the preferred treatment. Through surgical removal of the adenoids, upper respiratory tract stenosis and obstruction in children is effectively alleviated, leading to improved nocturnal ventilation [13][14][15]. Due to limited space in the nasal cavity and the technical challenges involved, nasal endoscopy is increasingly utilized in adenoidectomy for snoring patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of propofol and remifentanil combination for controlled hypotension during anesthesia in pediatric nasal endoscopic surgery

Li,

Ye,

Wang

2024

Trop. J. Pharm Res

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Purpose: To investigate the safety and efficacy of propofol in combination with remifentanil for controlled hypotension during pediatric nasal endoscopic surgery. Methods: The study involved 30 patients who underwent controlled hypotension measures with remifentanil during the operation (study group), and 30 patients who did not receive controlled hypotension measures (control group). Various parameters including vital signs, operation time, intraoperative bleeding, surgical field quality, anesthesia quality, postoperative recovery time, adverse reaction rate, pain scores, and serum C-reactive protein levels were compared between the two groups. Results: The results revealed a significant decrease in mean arterial pressure and heart rate in the study group during the operation compared to control group. Moreover, study group exhibited improved operation time, reduced intraoperative bleeding, and better surgical field quality compared to control group. Pain scores and serum C-reactive protein levels were also lower in the study group. However, there were no significant differences in recovery time, anesthesia quality, postoperative adverse reaction rate, or cognitive function between the two groups. Conclusion: Propofol in combination with remifentanil for controlled hypotension is a safe and effective anesthesia approach for pediatric nasal endoscopic surgery. Future studies will require larger sample size from different study centers to improve the robustness of the findings of this study.

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“…Taniguchi et al [19 ▪ ] reviewed data of 53 children less than 2 years who were treated with adenoidectomy only (81.1%) or adenotonsillectomy (18.9%) for symptoms of obstructive sleep-disordered breathing. After a median follow-up period of 6.7 months, 7 of 43 patients who were treated with adenoidectomy only required additional tonsillectomy for recurrence of symptoms and all of them had tonsillar size 2+ or 3+ at baseline.…”

Section: The Unknown: Challenges In the Management Of Pediatric Obstr...mentioning

confidence: 99%

Adenotonsillectomy: the good, the bad and the unknown

Kaditis

Gozal

2022

Current Opinion in Pulmonary Medicine

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Purpose of reviewAdenotonsillar hypertrophy is the most common pathogenetic contributor to obstructive sleep apnea syndrome (OSAS) in childhood, and adenotonsillectomy is the standard initial treatment. Here, we summarize the most recent evidence on the efficacy and complications of adenotonsillectomy and explore knowledge gaps in clinical management. Recent findingsFavorable adenotonsillectomy effects have been reported in children with very severe OSAS [apnea-hypopnea index (AHI) >20 episodes/h] and extremely severe OSAS (AHI >100 episodes/h), without postoperative mortality, need for endotracheal intubation, prolonged hospital stay or re-admission after hospital discharge. However, the risk of residual OSAS after adenotonsillectomy, which may reach 30--60%, has not been thoroughly established. Behavior, OSAS-related symptoms and quality of life improve postoperatively even in children with AHI 1--5 episodes/h. Natural history of enuresis resolution is accelerated postadenotonsillectomy and office-based systemic blood pressure is decreased in OSAS and hypertension. However, which children younger than 2 years should undergo adenotonsillectomy instead of adenoidectomy only to prevent recurrence of OSAS symptoms and revision surgery remains unclear. Adenotonsillectomy in children with Prader--Willi syndrome is frequently accompanied by postoperative residual OSAS while complications are not uncommon.

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Outcomes of adenoidectomy with and without tonsillectomy in patients younger than 2 years with moderate to severe upper airway obstruction

Cited by 6 publications

References 9 publications

Anatomical Variables as Predictive Factors of Intra-Operative Residual during Adenoidectomy

Anatomical Variables as Predictive Factors of Intra-Operative Residual during Adenoidectomy

Evaluation of propofol and remifentanil combination for controlled hypotension during anesthesia in pediatric nasal endoscopic surgery

Adenotonsillectomy: the good, the bad and the unknown

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