Tonsil Hypertrophy Research Articles

Prevalence of obstructive sleep apnea hypopnea syndrome in professional drivers and the relationship with traffic accidents

Objective: To study the prevalence of obstructive sleep apnea hypopnea syndrome (OSAHS) and its relationship with traffic accidents in the professional drivers. Methods: Questionnaires of OSAHS were sent to 950 professional drivers who had annual physical examination at the Central Hospital of Jiading District in Shanghai from October 2014 to September 2015. Those with moderate to severe snoring and/or Epworth Sleepiness Scale (ESS)≥9 performed the home sleep testing. All drivers were divided into OSAHS and non-OSAHS according to the survey and monitoring. The following parameters were compared such as driving ages, neck circumference, body mass index (BMI), average night sleep time, ESS, hypertension, diabetes, hypertrophy of tonsil and the incidence of traffic accidents. The risk factors of traffic accidents were analyzed by multivariate Logistic regression. Results: Totally 826 responses were eligible, including 578 (70.0%) with self-reported snoring. There was measurement failure involving 3 of 233 the home sleep testing due to sensor off, 823 subjects were included in the study. The prevalence of OSAHS was 13.5% (111/823). The mild, moderate and severe OSAHS were 47, 38 and 26 cases respectively. There were 712 drives without OSAHS. The neck circumference[(39.8±3.8) vs (39.0±3.0) cm]and BMI[(26.7±4.2) vs (24.4±3.8) kg/m2]were significantly higher in the drivers suffering from OSAHS (all P<0.05). The percentage of ESS≥ 9 (57.7% vs 12.6%), hypertension (27.9% vs 5.9%), diabetes (4.5% vs 1.1%), hypertrophy of tonsil (7.2% vs 2.3%) were higher in the drivers with OSAHS (all P<0.05). There were no significant difference in driving ages and average night sleep time between two groups (all P>0.05). The overall incidence of traffic accidents was 5.8% (48/823) in a year. The percentage was respectively 17.1% (19/111) in OSAHS and 4.1% (29/712) in non-OSAHS (P<0.001). Multiple logistic regression analysis showed that sleepiness (OR=30.578, 95%CI: 10.699-87.394; P<0.001), OSAHS (OR=14.062, 95%CI: 4.791-41.269; P<0.001) and vehicle years (OR=2.345, 95%CI: 1.183-4.646; P<0.05)were the risk factors, while the average night sleep time (OR=0.037, 95%CI: 0.014-0.098; P<0.001) was the protective factor. Conclusion: Professional drivers have higher prevalence of OSAHS, which contributes to the increased risk of traffic accidents.

Adenoid and tonsils hypertrophy − symptoms and treatment

adenoid and tonsils hypertrophy − symptoms and treatment

Specified data for tonsil surgery in Germany.

Background: Tonsillectomy rates vary considerably among different states, regions, and times. This study was conducted to identify the prevalence of “chronic” tonsillitis, peritonsillar abscess, hypertrophy of the tonsils with and without adenoids in absolute and relative numbers in an 80 million people nation. Moreover, the number and rates of different surgical procedures to resolve either “chronic” tonsillitis, peritonsillar abscess, or upper airway obstruction due to (adeno)tonsillar hypertrophy over several years was evaluated in this study (tonsillectomy, adenotonsillectomy, tonsillotomy, abscess tonsillectomy, transoral incision and drainage). Finally, the post-tonsillectomy hemorrhage rate was calculated and analyzed in relation to age and gender.Material and methods: Calculations were based on data as published by the Federal Institute of Statistics or on request, if needed. The latest data were provided for 2013.Results: The total number of the aforementioned diseases (stratified by ICD-10) decreased from 142,574 (in 2000) to 87,624 in 2013 (38.5%). Tonsillectomy, with or without adenoidectomy, was performed in a total of 833,896 patients between 2006 and 2013 in Germany. The yearly number decreased continually from 120,993 in 2006 to 84,332 procedures in 2013 (30.3%). The most significant decrease was registered in patients younger than 20 years of age for this time period: 70.92 per 10,000 in 2010 to 58.68 per 10,000 in 2013. If all age groups were included, the rate decreased from 13.34 per 10,000 to 10.90 per 10,000. In contrast, an increasing number of tonsillotomies was observed between 2007 (4,659 procedures) and 2013 (11,493). The cumulated number of procedures was 59,049. A constant number of 15,000 cases with peritonsillar abscess were diagnosed per year in Germany (19 patients per 100,000). The prevalence increased significantly at an age of 15 years and there was a preponderance of female patients below that age. Compared to the transoral incision and drainage, a 2.8-fold greater number of abscess tonsillectomies were performed annually. Post-tonsillectomy hemorrhage was experienced in 5.98% of all patients after 245,721 procedures in 2010 and 2013 (all indications, except tonsillotomy). Bleeding complications had occurred less frequently in female patients (5.06% vs. 7.02%). Finally, a considerable increase of post-tonsillectomy hemorrhage in patients older than 10 years of age was registered in male patients only.Conclusion: Chronic tonsillitis was less frequently diagnosed and surgically treated in terms of tonsillectomy (with or without adenoidectomy), particularly in female patients. In contrast, the number of tonsillotomies increased continually, particularly in male patients. Peritonsillar abscess was diagnosed and surgically treated in a constant number of patients in the yearly comparison. Most of these patients were scheduled for abscess tonsillectomy, and only a 2.8-fold smaller number for transoral incision and drainage. Independent from the indication for surgery, post-tonsillectomy hemorrhage was clearly associated with male gender and age (>10 years). The study reveals a dramatic change mandating further surveillance in insurance companies and authorities in the national health system of an 80 million people nation. (Tab. 1)

COMPLICAÇÕES DA SÍNDROME FALCIFORME

O presente artigo de revisão integrativa aborda e ressalta as principais complicações da anemia falciforme da criança ao adulto. A Síndrome Falciforme é uma importante hemoglobinopatia genética, um tipo de patologia peculiar pela produção de eritrócitos com deformidades falcêmicas, que ocasiona complicações como litíase biliar, crise álgica, crise do sequestro esplênico, acidente vascular cerebral isquêmico, alterações oculares, alterações retinianas. Objetivo: Destacar as principais complicações da anemia falciforme na criança, no adolescente e adultos auxiliando os profissionais de saúde na assistência ao paciente que apresenta essa patologia. Metodologia do estudo: Com a utilização do meio de informação acadêmico via internet de artigos encontrados na (BVS) Biblioteca Virtual em Saúde, foram utilizados os seguintes descritores: Anemia falciforme AND complicações, Doença Falciforme, Anemia Falciforme e Complicações. Pesquisados 7.544 artigos relacionados às complicações da anemia falciforme, na qual 11 são abordados no presente trabalho, com a utilização bibliográfica do Manual de Hematologia, autor Hamerschlak, Nelson e no Manejo das complicações agudas da doença falciforme conforme Brunetta et al. Resultados: As complicações que predominaram em crianças no presente estudo foi a hipertrofia adenotonsilar obstrutiva acometendo mais de 55% e em adolescentes e adultos foram as alterações oculares com mais de 73% dos clientes. Conclusão: Embora a patologia falciforme seja pouco discutida e de grande prevalência no Brasil devido a miscigenação racial, o presente estudo ressalta as principais complicações causadas pela mesma, tendo as crianças que apresentam uma prevalência de hipertrofia adenotonsilar obstrutiva acima de 55% mostrado no seguinte estudo, na qual o profissional de saúde deve estar atento a sintomatologia para que haja o tratamento adequado e as informações fornecidas aos pais ou responsáveis sejam adequadas para cada cliente. O adulto portador da anemia falciforme tem como principal complicação alterações oculares 73%, na qual o cuidador deve ter atenção a essas ocorrências.

Polysomnographic outcomes following lingual tonsillectomy for persistent obstructive sleep apnea in down syndrome.

Lingual tonsil hypertrophy is a common cause of persistent airway obstruction in patients with Down syndrome (DS) following adenotonsillectomy (T&A); however, little is known about the effect of lingual tonsillectomy (LT) on polysomnographic outcomes in these patients. Our objective was to describe changes in sleep-related respiratory outcomes following LT in children with DS and persistent obstructive sleep apnea (OSA) following T&A. Retrospective case series. We included all children with DS who underwent polysomnography before and after LT at a tertiary care center from 2003 to 2013. Nonparametric analysis of variables was performed. Forty patients with DS underwent LT; 21 met inclusion criteria. The mean age at surgery was 9.3 ± 4.3 years and 47.6% were female. The median apnea-hypopnea index (AHI) was 9.1 events/hour (range, 3.8 to 43.8 events/hour) before surgery and 3.7 events/hour (range, 0.5 to 24.4 events/hour) after surgery. The median improvement in overall AHI and the obstructive AHI (oAHI) were 5.1 events/hour (range, -2.9 to 41) and 5.3 events/hour (range, -2.9 to 41), respectively (P <.0001). The mean oxygen saturation nadir improved from 84% to 89% (P =.004). The mean time with CO2 > 50 mm Hg, central index, and percentage of rapid eye movement sleep were not significantly different. After surgery, the oAHI was <5 events/hour in 61.9% and ≤1 in 19% of patients. In children with DS, persistent OSA after T&A and lingual tonsil hypertrophy, LT significantly improved AHI, oAHI, and O2 saturation nadir. We recommend that children with DS should be evaluated for lingual tonsil hypertrophy if found to have persistent OSA following T&A. 4 Laryngoscope, 2016 127:520-524, 2017.

IMMUNOLOGIC ASPECTS OF PEDIATRIC TONSIL AND ADENOID DISEASE

The mechanisms responsible for adenoids and tonsils hypertrophy still remain a research debate, but lots of published papers show that the proliferative processes in obstructing pharyngeal tonsils are differently regulated versus those in recurrent infectious disease. Studying the immunology of these lymphoid organs allows a better understanding and, eventually, the finding of specific novel targets for the treatment of lymphoid hypertrophy and prevention of complications usually associated with it: cardiovascular, neurological and behavioral.

Distribution and Molecular Characterization of Human Adenovirus and Epstein-Barr Virus Infections in Tonsillar Lymphocytes Isolated from Patients Diagnosed with Tonsillar Diseases.

Surgically removed palatine tonsils provide a conveniently accessible source of T and B lymphocytes to study the interplay between foreign pathogens and the host immune system. In this study we have characterised the distribution of human adenovirus (HAdV), Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) in purified tonsillar T and B cell-enriched fractions isolated from three patient age groups diagnosed with tonsillar hypertrophy and chronic/recurrent tonsillitis. HAdV DNA was detected in 93 out of 111 patients (84%), while EBV DNA was detected in 58 patients (52%). The most abundant adenovirus type was HAdV-5 (68%). None of the patients were positive for HCMV. Furthermore, 43 patients (39%) showed a co-infection of HAdV and EBV. The majority of young patients diagnosed with tonsillar hypertrophy were positive for HAdV, whereas all adult patients diagnosed with chronic/recurrent tonsillitis were positive for either HAdV or EBV. Most of the tonsils from patients diagnosed with either tonsillar hypertrophy or chronic/recurrent tonsillitis showed a higher HAdV DNA copy number in T compared to B cell-enriched fraction. Interestingly, in the majority of the tonsils from patients with chronic/recurrent tonsillitis HAdV DNA was detected in T cells only, whereas hypertrophic tonsils demonstrated HAdV DNA in both T and B cell-enriched fractions. In contrast, the majority of EBV positive tonsils revealed a preference for EBV DNA accumulation in the B cell-enriched fraction compared to T cell fraction irrespective of the patients' age.

The Effect of Tonsillectomy and Adenoidectomy on Right Ventricle Function and Pulmonary Artery Pressure by Using Doppler Echocardiography in Children.

ObjectivesThe purpose of the present study is to emphasize the efficacy of the myocardial performance index and tricuspid annular plane systolic excursion (TAPSE) in the determination of impaired cardiac functions and recovery period following the treatment in children with adenoid and/or tonsillar hypertrophy.MethodsFifty-three healthy children after routine laboratory, imaging and clinical examinations, with adenoid and/or tonsillar hypertrophy were evaluated before and 3 months after adenotonsillectomy for cardiac functions using M mode and Doppler echocardiography.ResultsThe mean age of cases was 6.4±3.0 years, 34 (65%) were male, and 19 (35%) were female. Pulmonary hypertension was observed to be mild in 3 patients and moderate in 1 patient preoperatively. When the preoperative and postoperative echocardiographic measurements of the patients were compared, the tricuspid valve E wave velocity, the E/A ratio (E, early diastolic flow rate; A, late diastolic flow rate), and the TAPSE values were determined to be significantly higher postoperatively (P<0.05). The tricuspid valve deceleration time, the isovolumetric relaxation time and the systolic pulmonary artery pressure were found to be significantly lower compared to the preoperative values (P<0.05).ConclusionAdenoidectomy and/or tonsillectomy may prevent cardiac dysfunctions that can develop in the later periods due to adenoid and/or tonsil hypertrophy in children, before the appearance of the clinical findings of cardiac failure.

Asymptomatic Group A Streptococcus carriage in children with recurrent tonsillitis and tonsillar hypertrophy

BackgroundGroup A Streptococcus (GAS) is the most important bacterial cause of acute tonsillitis in children. Some children are chronic GAS carriers, and this carriage is poorly understood. We determined the frequency of GAS detection using a rapid antigen detection test in pediatric patients with indications for tonsillectomy due to adenotonsillar hypertrophy or recurrent GAS infections. MethodsSeventy-two patients underwent a tonsil swab for a rapid antigen detection test. ResultsThe GAS rapid antigen detection test was positive in 18.1% of children. GAS was not associated with sex, age or previous history of recurrent tonsillitis. Also, the prevalence of GAS was similar between patients with either recurrent tonsillitis or tonsil hypertrophy. ConclusionIn our study, the GAS carriage rate was similar to other reports, and GAS carrier state was not correlated with recurrent tonsillitis.

Extra-Esophageal Pepsin from Stomach Refluxate Promoted Tonsil Hypertrophy.

BackgroundGastroesophageal reflux is associated with numerous pathologic conditions of the upper aerodigestive tract. Gastric pepsin within reflux contributes to immunologic reactions in the tonsil. In this study, we aimed to find the relationships between pepsin and tonsillar hypertrophy.Methods and findingWe explored the notion whether tonsillar hypertrophy was due to pepsin-mediated gastric reflux in tonsil hypertrophy. Fifty-four children with tonsil hypertrophy and 30 adults with tonsillitis were recruited before surgical treatment. Blood and tonsil tissues from each patient were harvested for analysis of changes in lymphocyte and macrophage numbers coupled with histological and biochemical analysis. Pepsin was expressed at different levels in tonsil tissues from each tonsillar hypertrophy. Pepsin-positive cells were found in the crypt epithelium, surrounding the lymphoid follicle with developing fibrosis, and also surrounding the lymphoid follicle that faced the crypt. And also, pepsin staining was well correlated with damaged tonsillar squamous epithelium and TGF-β1 and iNOS expression in the tonsil section. In addition, pepsin and TGF-β1-positive cells were co-localized with CD68-positive cells in the crypt and surrounding germinal centers. In comparison of macrophage responsiveness to pepsin, peripheral blood mononuclear cells (PBMNCs) were noticeably larger in the presence of activated pepsin in the child group. Furthermore, CD11c and CD163-positive cells were significantly increased by activated pepsin. However, this was not seen for the culture of PBMNCs from the adult group.ConclusionsThe lymphocytes and monocytes are in a highly proliferative state in the tonsillar hypertrophy and associated with increased expression of pro-inflammatory factors as a result of exposure to stomach reflux pepsin.

Modified barbed soft palatal posterior pillar webbing flap palatopharyngoplasty.

The soft palate and the lateral pharyngeal walls contribute to the collapse of the upper airway in patients with snoring and obstructive sleep apnea. In this study, the original soft palatal webbing flap palatopharyngoplasty for both soft palatal and oropharyngeal lateral wall collapse has been modified to include all tonsil grades and to apply the barbed suture technique. Twenty-one adults with significant soft palatal webbing, lateral pharyngeal wall collapse, and tonsil hypertrophy of any grade were selected for the study with a minimum follow-up period of 6months. Snoring was improved with snoring scale reduced from 9.4±1.6 to 1.7±3.2 (p<0.005). The preoperative to postoperative apnea-hypopnea index (AHI) statistically improved from 45.7±2.6 to 12.3±3.9 (p<0.005) and lowest O2 saturation from 73.8±3.6 to 89.4±1.9% (p<0.005). Postoperative endoscopic findings showed significant improvement in soft palatal and lateral pharyngeal wall collapse. There were no significant intraoperative or postoperative complications. Modified barbed soft palatal webbing flap palatopharyngoplasty provided objective improvement of obstructive sleep apnea (OSA) in adults with soft palatal, lateral pharyngeal wall collapse and tonsillar hypertrophy, with no significant complications and has the potential to serve as an effective alternative for these cases.

Sequent therapy for adenoidal and tonsillar hypertrophy patients with OSDB

Children suffering from adenoidal and tonsillar hypertrophy are very common, the hypertrophy of adenoid and tonsil could obstruct the upper airway to cause mouth breathing,as a result, some dentofacial deformities are developed. The key reason for these deformities is mouth breathing. For the children with adenoidal and tonsillar hypertrophy, T&A is just the first step for treatment, most patients need a sequent treatment by the doctors from multiple departments, such as ENT doctors,orthodontics doctors,orthognathic surgeon. The earlier the treatment begins, the better the effect is.

Adenoid and Tonsil Hypertrophy in Children and Facial Malformations

The controversy over the effect of nasal breathing in musculoskeletal facial development has continued over the decades. Although today it is better understood how facial bones grow and the hormonal effect on them, further well-controlled studies with larger populations are still needed to establish a direct relationship between obstruction of the upper airway and poor facial development.

Functional state of palatine tonsils in children with diabetes type 1

Actuality. Chronic disease of lymphoepithelial throat structures (CHLTS) in children with diabetes mellitus type 1 (DM-1) are widespread according to our earlier studies. The frequent exacerbations lead to the rise of glycemia profile, worsening of patient life quality and effectiveness of the complex therapy of the main disease.Aim of research: to assess the functional state of palatine tonsils in children and teenagers with DM-1 and chronic tonsillitis.Materials and methods. During the period 2014-2015 years there was carried out clinical and laboratory examination of 51 children with DM-1 6-18 years old. All children were treated in endocrinological department of National child specialized hospital “Ohmatdit”. The main group of observance included 40 children with DM-1 and CT, the control one included 11 children and teenagers with DM-1 without ENT-pathology. All children of the main and control groups underwent cytological examination of the tonsillar crypt lacunas content.Results and discussion. The highest specific weight of the chronic diseases of lymphepithelial throat structures (CDLTS) in the main group of observation was revealed at the presence of chronic tonsillitis. In children with DM-1was diagnosed CT – 17 (33,3 %), CT and nasal septum curvature– 16 (31,3 %), CT and adenoid – 9 (17,7 %), CT and palatine tonsils hypertrophy – 5 (9,8 %), CT and recidivous nasal bleedings – 4 (7,8 %). According to the results of this examination in children with CDLTS and DM-1 were separated the four cytological groups that characterize the functional state of palatine tonsils.I. Good functional power of palatine tonsils.II. High activity of lymphoid tissue of palatine tonsils.III. Compensated functional power of palatine tonsils.IV. Decompensation of palatine tonsils functions.Conclusion. Cytological examination of tonsillar crypt lacunas content in children and teenagers with DM-1 may be the accessible and informative method of assessment of the functional activity of palatine tonsils, for more precise diagnostics of CT in patients with DM-1, the detection of its form, an effectiveness of the treatment

Is the difference in the volume of the pharyngeal space, as measured by acoustic pharyngometry, before and after tonsillectomy proportional to the volume of the excised tonsils?

OBJECTIVE:Adenotonsillectomy is recognized as an effective therapy for snoring and sleep disorders in children. It is important to understand whether adenotonsillectomy significantly increases the volume of the pharyngeal space. The goal of this study was to evaluate the change in oropharyngeal volume after adenotonsillectomy and the correlation of this change with the objective volume of the tonsils and body mass index.METHODS:We included 27 subjects (14 males) with snoring caused by tonsil and adenoid hypertrophy. The mean age of the subjects was 7.92 (±2.52) years. Children with craniofacial malformations or neuromuscular diseases or syndromes were excluded. The parents/caregivers answered an adapted questionnaire regarding sleep-disordered breathing. All patients were subjected to weight and height measurements and body mass index was calculated. The subjects underwent pharyngometry before and after adenotonsillectomy and the volume of both excised tonsils together was measured in cm3 in the operating room.RESULTS:Pharyngometric analysis showed that the mean pharyngeal volume was 28.63 (±5.57) cm3 before surgery and 31.23 (±6.76) cm3 after surgery; the volume of the oropharynx was significantly increased post-surgery (p=0.015, Wilcoxon test). No correlation was found between the objective tonsil volume and the post-surgical volume increase (p=0.6885). There was a fair correlation between the oropharyngeal volume and body mass index (p=0.0224).CONCLUSION:Adenotonsillectomy increases the volume of the pharyngeal space, but this increase does not correlate with the objective tonsil size. Furthermore, greater BMI was associated with a smaller increase in the pharyngeal volume. Oropharyngeal structures and craniofacial morphology may also play a role in the increase in oropharyngeal volume.

Evaluation of the Role of Palatal Tonsil Hypertrophy in Sleep Apnea Patients: Cephalometric Analysis

The purpose of this research was to elucidate the relationship between tonsillar hypertrophy and Obstructive Sleep Apnea Syndrome (OSAS) in terms of cephalometric analysis, as well as to determine factors that affect OSAS severity. 25 patients were enrolled in this study. Lateral cephalograms of the subjects were taken. Disease severity was evaluated by the Apnea Hypopnea Index (AHI). Cephalometric measurements (angle between line S-N and line N-A (SNA), angle between line S-N and line N-B (SNB), distance between the Mandibular Plane and the Hyoid (MPH), posterior airway space, the width of the airway behind the base of tongue along the B-Go line (PAS), upper airway space, the distance parallel to long axis of the airway, between a horizontal plane tangent to the superior aspect of the hyoid and a horizontal plane tangent to the posterior palate (UAL), multiplication of PAS and UAL (PAS × UAL)) were analyzed and compared between the groups with and without tonsillar hypertrophy. PAS and PAS × UAL were lower in the no hypertrophy group. SNB was significantly lower in the severe apnea group than mild to moderate group in no hypertrophy group (p = 0.035). In conclusion, patients with tonsillar hypertrophy had severe obstruction, but they had a relatively larger pharyngeal space on cephalometric analysis. After exclusion of the tonsillar hypertrophy group, cephalometric analysis could be more effective for analyzing OSAS severity.

Rehabilitation of children with nasal obstruction syndrome

The objective of the study: To increase the efficacy of treatment the children suffering with the nasopharynx lymphoid tissue hypertrophy. The article provides the results of application of isotonic aerosol Mometasone Furoate in combination with the herbal preparation Tonsilgon and inhalations with Interferon solution in children with the degree 1 and 2 pharyngeal tonsil hypertrophy. The authors studied the microflora of children with the degree 1 and 2 pharyngeal tonsil hypertrophy.

The impact of laronidase treatment in otolaryngological manifestations of patients with mucopolysaccharidosis

IntroductionMucopolysaccharidosis (MPS) is a lysosomal storage disease caused by deficiency of α-l-iduronidase. The otolaryngological findings include hearing loss, otorrhea, recurrent otitis, hypertrophy of tonsils and adenoid, recurrent rhinosinusitis, speech disorders, snoring, oral breathing and nasal obstruction. ObjectiveTo evaluate the impact of enzymatic replacement therapy with laronidase (Aldurazyme®) in patients with mucopolysaccharidosis (MPS I), regarding sleep and hearing disorders, and clinical manifestations in the upper respiratory tract (URT). MethodsNine patients with MPS I (8 Hurler-Scheie, and 1 Scheie phenotypes) of both sexes, ages ranging between 3 and 20 years, were included in this study. Patients were evaluated between seven and 11 months before the treatment and between 16 and 22 months after the onset of the enzymatic replacement. They were all submitted to a clinical and otolaryngological evaluation, including nasofibroscopical, polysomnographic and audiologic exams. ResultsThe results’ data showed decreasing of the frequency of ear, nose and throat infections, with improvement of the rhinorrhea and respiratory quality. No remarkable changes were observed regarding macroglossia and tonsil and adenoid hypertrophy. Audiometric and polysomnographic evaluations did not show statistical significance. ConclusionEnzymatic replacement therapy in patients with mucopolysaccharidosis I provides control of recurrent URT infections, rhinorrhea and respiratory quality, however it is does not seem to improve audiologic and polisomnographic parameters, with no effect on adenoid and tonsils hypertrophy and macroglossia.

Impact of adenotonsillectomy on vocal emission in children

IntroductionAdenotonsillectomy is the most common surgery performed by otolaryngologists in pediatric age, and one of the most frequently asked questions about the postoperative period is whether there is a potential for change in vocal pattern of these children. ObjectiveTo evaluate the impact of adenotonsillectomy in the voice emission pattern of children with hypertrophy of palatine and pharyngeal tonsils. MethodsThis is a prospective study in which we carried out perceptual auditory assessments and acoustic analysis of 26 children with adenotonsillar hypertrophy at three time points: before surgery, one month and three months after surgery. The following acoustic parameters were estimated using the Praat software: fundamental frequency, jitter, shimmer, and harmonic–noise ratio. ResultsA statistically significant change was found between shimmer and harmonic–noise ratio during vowel /u/ production between the preoperative and 1st month postoperative time points. No significant differences were detected for acoustic parameters between preoperative analysis and that of the 3rd month post-operation. ConclusionTransient changes in acoustic parameters occur in children with adenotonsillar hypertrophy submitted to adenotonsillectomy, progressing to normalization in the 3rd postoperative month.

Changes of the Immunophenotypic Spectrum and the Enzymatic Profile of Peripheral Blood Lymphocytes in Infants with Hypertrophy of the Pharyngeal Tonsil

to study immunophenotype and NAD- and NAD(P)-dependent dehydrogenase of blood lymphocytes activity indicators in children with hypertrophy of the pharyngeal tonsils (HPT). 57 children aged 1-3 years with HPT were examined. The focus group included 35 healthy children of the similar age. The number of CD₃⁺-, CD₄⁺-, CD₈⁺-, CD₁₆⁺/₅₆⁺-, CD₁₉⁺-cells in the blood was determined by flow cytometry. The activity of NAD(P)-dependent dehydrogenase was studied by the method of A. Savchenko and coauth. (1989). The changes of immunophenotypic spectrum of peripheral blood lymphocytes in infants with HPT have been revealed. The increase of ribose-5-phosphate and NADN-dependent reactions of macromolecular synthesis, the reduction of malataspartat shunt role in cell energy, the reduction of anaerobic lactate dehydrogenase reaction, the compensatory increase in the glycerol-3-phosphate dehydrogenase activity, the high substrate flow of the citric acid cycle and the reduced level of glutathione have been fixed. The correlation analysis has showed increase in the number of correlations between indicators of investigated oxidoreductase activity in blood lymphocytes in children with HPT and the high level of correlation between the metabolic reactions of the mitochondrial compartment. the change of immunophenotype, enzymatic activity, correlation pattern of connection between intracellular enzymes of peripheral blood lymphocytes have been revealed in children aged 1-3 years with HPT.