Radiographic evaluation of adenoidal size in children: adenoidal-nasopharyngeal ratio

Fujioka, Masashi; Young, Lorrie; Girdany, Bertram R.

doi:10.2214/ajr.133.3.401

Cited by 399 publications

(325 citation statements)

References 5 publications

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“…The neck was extended and the patient was instructed to breathe through the nose. The adenoidal/nasopharyngeal ratio was measured according to the method of Fujioka and colleagues (30) by two of the present investigators (A.D.G. and D.G.…”

Section: Lateral Neck X-raysmentioning

confidence: 99%

Leukotriene Modifier Therapy for Mild Sleep-disordered Breathing in Children

Goldbart

Goldman

Veling

et al. 2005

Am J Respir Crit Care Med

283

157

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Background: Children with mild sleep-disordered breathing (SDB), who may not be recommended for adenotonsillectomy, frequently exhibit neurocognitive and behavioral morbidity, and may benefit from alternative therapeutic interventions, such as leukotriene modifier therapy. Methods: Twenty-four children with SDB completed an open-label intervention study for 16 weeks with daily montelukast therapy. Sleep studies and adenoid size estimates from lateral X-ray films of the neck were obtained before and after treatment. In a parallel study, adenoid and tonsillar tissues from children with obstructive sleep apnea or recurrent throat infections were subjected to quantitative polymerase chain reaction, immunohistochemistry, and Western blotting for gene and protein expression of leukotriene receptors LT1-R and LT2-R, and for concentrations of LTB4 and LTC4/D4/E4. Results: Montelukast treatment induced significant reductions in adenoid size and respiratory-related sleep disturbances, which were absent in 16 children with SDB who did not receive treatment. LT1-R and LT2-R mRNA was similarly abundant in adenoid tissues, but increased LT1-R and LT2-R protein expression and higher levels of LTB4 and LTC4/D4/E4 emerged in children with obstructive sleep apnea. Conclusions: Oral therapy with a leukotriene modifier appears to be associated with improved breathing during sleep. Double-blind, placebo-controlled trials will be needed to corroborate current findings and solidly establish antiinflammatory strategies, such as leukotriene modifiers, as therapeutic alternatives in children with SDB too mild to justify referral for adenotonsillectomy.

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Section: Lateral Neck X-raysmentioning

confidence: 99%

Leukotriene Modifier Therapy for Mild Sleep-disordered Breathing in Children

Goldbart

Goldman

Veling

et al. 2005

Am J Respir Crit Care Med

283

157

View full text Add to dashboard Cite

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“…Adenoidectomy and/or tonsillectomy are surgical approaches frequently adopted in Otolaryngology, and are among the oldest surgeries to which human beings have been submitted in the past years. Recently, emphasis over careful selection of prospects for these procedures emerged from a consensus on the immunological role played by palatine and pharyngeal tonsils, as well as the potential complications of these types of surgery 3 . Lateral x-ray of facial sinuses, including soft tissues for paranasal sinuses visualization, is an accessible procedure for the physician and relatively comfortable for the child 4 , consisting of a simple way to determine adenoids' size, shape and position 3 .…”

Section: Introductionmentioning

confidence: 99%

Estudo comparativo radiológico e nasofibroscópico do volume adenoideano em crianças respiradoras orais

Lourenço

Lopes

Pontes

et al. 2005

Rev. Bras. Otorrinolaringol.

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A tonsila faríngea ou adenóides é a extensão superior do anel linfático de Waldeyer e está localizada na porção alta da cavidade nasofaríngea, próxima à tuba auditiva e à coana. Ela desempenha um papel relevante nas otites médias recorrentes e freqüentemente sua hipertrofia é responsável pela obstrução das vias aéreas superiores. A tonsilectomia é um tratamento comumente realizado para doenças crônicas das tonsilas e ainda é o procedimento cirúrgico mais freqüente e mais antigo realizado em crianças e adultos jovens. Os critérios para a realização da tonsilectomia, o efeito da mesma na integridade imunológica do paciente e seus riscos inerentes à cirurgia são muito discutíveis e controversos em todo o mundo. Estudos de imagem utilizando-se o raio-X do cavo é um método simples, fácil e confortável para avaliar o tamanho das adenóides e o grau de obstrução das vias aéreas superiores. Um estudo nasofibroscópico da nasofaringe pode fornecer uma informação melhor sobre essa região, tendo em vista que ele mostra todas as estruturas presentes na nasofaringe e o grau de obstrução das vias aéreas superiores de forma dinâmica. FORMA DE ESTUDO: Clínico não randomizado. MATERIAL E MÉTODO: Este estudo comparou o grau de hipertrofia e de obstrução das vias aéreas superiores, usando os dois métodos acima, em crianças de 3 a 10 anos de idade, constatando que a nasofibroscopia flexível é um método diagnóstico excepcionalmente mais fidedigno do que o raio-x do cavo, na avaliação volumétrica da adenóide.

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“…According to ErolEgeli et al mean age was 7.7 in 64 children aged between 6-9 years; In Karan Sharma et al study the mean age of 300 patients were 5.96. Fujioka 10 et al in their study on randomly selected normal children found that the mean AN ratio increased from 0.55 at the age of 1 year 3 months and reached its highest value of 0.59 at the age of 4 years 6 months and then decreased to 0.52 at the age of 12 years 6 months. Elwany 7 reported that the ANRs of normal children and possible adenoidectomy candidates were 0.58 and 0.71, respectively.…”

Section: Discussionmentioning

confidence: 93%