Pediatric adenoid surgery in Sweden 20042013: Incidence, indications and concomitant

surgical procedures.
Gerhardsson H1, Stalfors J2, Odhagen E3, Sunnergren O4.

Author information
Abstract
OBJECTIVES:
To describe the incidence and indications of adenoid surgery and concomitantly performed ENT
surgical procedures in a nationwide cohort covering several years of practice.
METHODS:
A retrospective study based on data from the National patient registry in Sweden. All children
born from 1st of January 2004 to December 31st, 2013 who underwent adenoidectomy for the
first time in Sweden during 2004-2013 were included in the study. Patient characteristics (age
and gender), indications for surgery and performed ENT surgery were evaluated.
RESULTS:
40,829 children underwent adenoid surgery during the studied period. Of these, 24,537 (60%)
were boys. Mean and median age at surgery in the studied population was 4 years and 3.5 years
respectively for both boys and girls. The most frequently performed surgical procedure was
adenotonsillar surgery 43% (n = 17,434) followed by solitary adenoid surgery 26% (n = 10,749).
The most frequent registered indication was hypertrophy 60% (n = 24,422) followed by
hypertrophy and otitis media 21% (n = 8425). The highest age related incidence for all types of
adenoid surgery taken together was 2-4 years of age for both genders. Boys had higher incidence
rates than girls for all ages and all types of surgery except at eight years of age.
CONCLUSIONS:
The main findings were that adenoidectomy most commonly was performed together with
surgery of the tonsils on the indication hypertrophy, that adenoid- and adenoid related ENT
surgery were most commonly performed between 2 and 5 years of age and that the incidence in
surgical rates was higher for boys than girls. There seem to be large unwarranted variations
between countries regarding incidence rates and we believe that there is a need for further studies
in order to establish recommendations for best practice regarding adenoid and related ENT
surgeries.

Copyright 2016 Elsevier Ireland Ltd. All rights reserved.

KEYWORDS:
Adenoidectomy; Adenoids; Epidemiology; Health services research

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Int J Pediatr Otorhinolaryngol. 2016 Sep;88:233-8. doi: 10.1016/j.ijporl.2016.07.018. Epub 2016

Jul 19.

The association of residential mold exposure

and adenotonsillar hypertrophy in children
living in damp environments.
Atan Sahin O1, Kececioglu N2, Serdar M3, Ozpinar A3.

Author information
Abstract
BACKGROUND:
There are many consequences of mold exposure related to respiratory system health of children
This retrospective cohort study aims to find the association between adenoid hypertrophy and
mold exposure in children living in damp environments.
METHODS:

Children with history of recurrent respiratory tract infections were enrolled in the study between
June 2012 and June 2013 and were followed up for adenoid hypertrophy from June 2013 to June
2016. One hundred and forty two children were residents of moldy houses and 242 were living in
normal houses. Skin prick test results for 60 common allergens, vitamin D levels, IgE levels, age,
presence of comorbidities such as urticaria, atopic dermatitis, allergic conjunctivitis, allergic
rhinitis, asthma, frequency of upper respiratory tract infections and lower respiratory tract
infections, were evaluated in both groups.
RESULTS:
A total of 384 children (mean age standard deviation = 53.37 36 months; 198 males and 186
females) were included. The children were classified into 2 groups (1)Children living normal
houses (n = 242) (2); Children living in damp houses (n = 142) according to mold exposure.
Children with adenoid hypertrophy (p < 0,001) and higher IgE levels (p < 0,001) were more
common in mold exposed group. Lower respiratory tract infections were more common in
children with mold exposure (p < 0,05). Bivariate correlation analysis showed no significant
association between IgE levels and adenoid hypertrophy. Multiple linear regression analysis was
performed to evaluate IgE levels, vitamin D levels, and presence of adenoid as independent
variables; age as dependent variable among two groups and was found statistically significant
(p < 0,001). Dermatophagoid sensitive group living in damp houses had a significant increase in
adenoid hypertrophy (p = 0,01). Housedustmite sensitive children with recurrent lower
respiratory tract infection and upper respiratory tract infection were mainly residents of damp
houses (p < 0,001). Allergic comorbidities were significantly more in damp environment group
(p < 0,001), but there was no significant increase in any of the subgroups.
CONCLUSIONS:
Children with mold exposure had significantly increased adenoid hypertrophy regardless of their
atopic nature, however, they may have become more sensitized due to other environmental
triggers and genetic factors. In damp environments, sensitization to dermatophagoids, was
significantly increased in children with adenoid hypertrophy. During the period of infancy, when
children were mostly vitamin D supplemented, they were not sensitized and had normal
adenoids. As children with recurrent respiratory tract infections grow, they tend to have lower
vitamin D levels, become more atopic and tend to have adenoid hypertrophy.
Copyright 2016 Elsevier Ireland Ltd. All rights reserved.
KEYWORDS:
Adenoid; Allergy; Dermatphagoid; Mold; Respiratory

..

Adenoid hypertrophy and chronic

rhinosinusitis: Helicobacter pylori on antral
lavages, adenoid tissue and salival
inmunoglobuline A on paediatric patients.
Cedeo EE1, Ortiz-Princz D2, Figueredo SA3, Porro ME2.

Author information
Abstract
OBJECTIVE:
To determine Helicobacter pylori presence on antral lavages, adenoids and salival
inmunoglobuline A on paediatric patients with chronic rhinosinusitis without nasal polyps
(CRSsNP) and adenoid hypertrophy.
METHODS:
Adenoid tissue, liquid obtained from antral lavages and saliva from 28 children diagnosed with
CRSsNP, from the paediatric otorhinolaryngology practice of "Dr. Domingo Luciani" Hospital
was taken and processed by means of polymerase chain reaction (PCR) using cagA, vacA and
babA primers, also anatomopathological examination using Giemsa stain of the adenoids,
determination of salivary specific secretory inmunoglobuline A (sIgA), socio-economic condition
using the Graffar scale and associated gastrointestinal symptoms were assessed.
RESULTS:
No evidence of Helicobacter pylori neither in antral lavages liquid nor adenoid tissue was found
using PCR and Giemsa stain. sIgA was present in 28.6% of the subjects. The most frequently
found symptoms were, diarrhea in 17.9%, distension and abdominal pain in 10.7%, 64.3% of the
patients were in working (28.6%) and low middle (35.7%) classes.
CONCLUSIONS:
Helicobacter pylori is not present neither in maxillary sinuses nor adenoid tissue of the evaluated
patients, sIgA it is a non-invasive method for assessment of immunologic challenge with the
bacteria, not the presence of acute or chronic infection.
Copyright 2015 Elsevier Ireland Ltd. All rights reserved.
KEYWORDS:

Adenoid hypertrophy; Antral lavages; Chronic rhinosinusitis; Helicobacter pylori;

Inmunoglobuline A