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Biomed Res Int 2021 2;2021:5550267. Epub 2021 Apr 2.

Department of Pediatric Dentistry, Near East University Faculty of Dentistry, Nicosia/ TRNC, 99138 Mersin 10, Turkey.

We aimed to investigate the oral health of children in terms of the presence of dental caries, periodontal health, halitosis, and dentofacial changes in patients who had adenotonsillar hypertrophy related to mouth breathing and compared these findings with nasal breathing healthy and adenotonsillectomy-operated children. The patient group comprised 40 mouth-breathing children who were diagnosed with adenotonsillar hypertrophy, while the control group consisted of 40 nasal breathing children who had no adenotonsillar hypertrophy. Forty children who had undergone an adenotonsillectomy operation at least 1 year prior to the study were included in the treatment group. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Mar;35(3):193-199

J Craniofac Surg 2021 Mar-Apr 01;32(2):564-568

Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.

Background: Oral breathing (OB) was considered associated with specific craniofacial structures and same for pediatric obstructive sleep apnea (OSA). This study aimed to investigate the differences of craniofacial structures between OB and OSA.

Methods: In this retrospective study, 317 children under age 18 years were recruited and divided into OB group, OSA group, and control group. Read More

Int J Pediatr Otorhinolaryngol 2021 Apr 4;143:110663. Epub 2021 Mar 4.

Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien City, Hualien, Taiwan; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Objectives: The aim of this study was to evaluate the association between different upper respiratory tract disorders and severe dental malocclusion in pediatric patients.

Methods: Newly diagnosed patients (N = 773) with dental malocclusion aged 8-18 years and controls (N = 3865) were identified from the health claim records of the Longitudinal Health Insurance Database 2000 of Taiwan's National Health Insurance Research Database. Controls were frequency matched to the cases by sex, age group, and index year. Read More

Pak J Med Sci 2021 Mar-Apr;37(2):362-366

Dr. Naveed Arshad, M.Phil. (Rehabilitation Sciences). Assistant Professor, Islamabad Medical and Dental College, Islamabad Pakistan.

Background & Objectives: Generally, the blockage of upper respiratory tract in children is seen with the hypertrophy of adenoids and tonsils. Normally for patients with adenoid hypertrophy (AH), Adenoidectomy with or without Tonsillectomy is carried out, however it has its own complications like haemorrhage and recurrence of adenoid tissue. Consequently, therapeutic approach has increased extraordinary consideration rather than surgical procedure. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 01;35(1):42-43

Department of Otorhinolaryngology Head and Neck Surgery，Xuzhou Children's Hospital Affiliated to Xuzhou Medical University，Xuzhou，221000，China.

To investigate the effects of postoperative surgical treatment of infantile adenoidal hypertrophy on children, the recurrence rate, and the changes in immune levels before and after surgery. Low temperature plasma ablation was performed in 11 infants with adenoidal hypertrophy to evaluate the risk of postoperative anesthesia and the effect of surgery on recurrence rate and immunity. During the follow-up period of 3 to 6 months, 2 patients had recurrence（18. Read More

HNO 2021 Jan 22;69(1):3-13. Epub 2020 Dec 22.

Kinder- und Jugendmedizin/Schlafmedizin, Deutsche Gesellschaft für Schlafforschung und Schlafmedizin (DGSM) | Arbeitsgruppe Pädiatrie im Konvent der Deutschen Gesllschaft für Kinder- und Jugendmedizin, Schwalmstadt-Treysa, Deutschland.

Otolaryngologic surgery is one of the most frequent operative interventions performed in children. Tonsil surgery with or without adenoidectomy due to hyperplasia of the tonsils and adenoids with obstruction of the upper airways with or without tympanic ventilation disorder is the most common of these procedures. Children with a history of sleep apnoea (OSA) suffer from a significantly increased risk of perioperative respiratory complications. Read More

J Am Board Fam Med 2020 Nov-Dec;33(6):1025-1030

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This paper reviews current indications for otolaryngology consultation for tonsillectomy and adenoidectomy (T&A). Despite often being performed concurrently, these procedures should be considered separate surgeries done for different indications. The American Academy of Otolaryngology - Head and Neck Surgery published tonsillectomy guidelines for children in 2019. Read More

Clin Exp Otorhinolaryngol 2020 Nov 11. Epub 2020 Nov 11.

Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

Objectives: The paired microbiome of adenoids and tonsils in pediatric patients with snoring has rarely been reported, and its correlation with clinical characteristics has not been evaluated till date. The aim of this study was to identify the adenotonsillar microbiome and determine its correlation with the subjective symptoms of pediatric patients with snoring and with regional mucosal immune molecules.

Methods: Twenty-four children, who underwent tonsillectomy with adenoidectomy owing to snoring, were enrolled in a cross-sectional study conducted between August 2017 and December 2018. Read More

Int J Pediatr Otorhinolaryngol 2020 Nov 11;138:110378. Epub 2020 Sep 11.

Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.

Childhood obstructive sleep apnoea syndrome (OSAS) secondary to adenoid hyperplasia is known to give rise to pulmonary hypertension. However, we present a case of a toddler with pulmonary hypertension (PH) and right heart failure due to OSAS, the cause of which is difficult to identify. After the patient underwent an adenotonsillectomy, OSAS disappeared and the PH eventually resolved. Read More

Front Immunol 2020 30;11:591897. Epub 2020 Sep 30.

Immugen Pharma LLC, South Miami, FL, United States.

Sci Immunol 2020 10;5(52)

Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia.

The nasal-associated lymphoid tissues (NALTs) are mucosal-associated lymphoid organs embedded in the submucosa of the nasal passage. NALTs represent a known site for the deposition of inhaled antigens, but little is known of the mechanisms involved in the induction of immunity within this lymphoid tissue. We find that during the steady state, conventional dendritic cells (cDCs) within the NALTs suppress T cell responses. Read More

JAAPA 2020 Oct;33(10):34-39

At the time this article was written, Alexandra Perez was a student in the PA program at the University of Toledo in Toledo, Ohio. She now practices in neurosurgery at Grant Hospital in Columbus, Ohio. Kimberly Hunter practices and is an assistant professor of psychiatry in the Child and Adolescent Psychiatry Department at the University of Toledo Medical Center. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Sleep-disordered breathing (SDB) and attention deficit hyperactivity disorder (ADHD) are common disorders diagnosed in children. Although these diagnoses were previously considered unrelated, research now is showing that some symptoms of ADHD, specifically oppositional behavior, hyperactivity, and impulsivity, can be related to SDB in children and differs from bona fide ADHD. This article explores the connection between the two disorders and the importance of identifying and screening for SDB in children presenting with similar symptoms related to ADHD. Read More

Otolaryngol Head Neck Surg 2021 05 22;164(5):1100-1107. Epub 2020 Sep 22.

Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Objective: The primary objective was to determine if obstructive sleep apnea (OSA) can improve after adenoidectomy.

Study Design: Case series with chart review.

Setting: Tertiary children's hospital between 2016 and 2018. Read More

Emerg Infect Dis 2020 10;26(10):2518-2520

We investigated palatine tonsil and adenoid specimens excised from otorhinolaryngological patients in a leprosy-endemic region of Brazil. Fite-Faraco staining identified Mycobacterium spp. in 9 of 397 specimen blocks. Read More

Pediatr Emerg Care 2020 Sep 15. Epub 2020 Sep 15.

From the Ann & Robert H. Lurie Children's Hospital of Chicago.

Objectives: The incidence, demographic characteristics, and treatment approaches for pediatric patients who present to the ED with a primary complaint of postoperative pain have not been well described. The purpose of this study was to describe opioid and nonopioid prescribing patterns for pediatric patients evaluated for postoperative pain in the Emergency Department (ED).

Methods: Pediatric Health Information System is an administrative database of encounter-level data from 48 children's hospitals. Read More

Pediatr Investig 2019 Sep 26;3(3):153-158. Epub 2019 Sep 26.

Ophthalmology, Otorhinolaryngology, Head and Neck Surgery Department Botucatu Medical School State University São Paulo UNESP Brazil.

Importance: Hypertrophy of the pharyngeal and palatine tonsils can interfere with breathing, physical and cognitive development, and quality of life, including sleep quality. There are important relationships between the muscles of the airways, the anatomy, and the pattern of breathing and swallowing.

Objective: The aims of the present study were to evaluate the swallowing process in children after adenotonsillectomy undertaken to treat obstructive breathing disorders. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020 Aug;34(8):713-718

Department of Otolaryngology，Shanghai Children's Medical Center Affiliated with Shanghai Jiaotong University School of Medicine，Shanghai，200127，China.

Drug induced sleep endoscopy（DISE） is a useful tool to locate the upper airway obstructions in patients with obstructive sleep apnea syndrome（OSAS）. The goal of our research was to compare the sites, degree and patterns of upper airway obstruction detected by DISE versus endoscopy in awake children. The benefit of DISE-mediated upper airway surgery in pediatric OSAS was evaluated. Read More

Pediatr Hematol Oncol 2021 Feb 17;38(1):25-35. Epub 2020 Aug 17.

Department of Pediatrics, Section of Hematology and Oncology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.

Introduction: Children with low von Willebrand factor (VWF) activity or type 1 von Willebrand disease (VWD) have increased risk of bleeding after adenotonsillar procedures and the optimal perioperative management to minimize bleeding is unknown.

Aim: To report the effectiveness and safety of an institutional protocol in minimizing postoperative bleeding in children with type 1 VWD or low VWF activity.

Methods: We conducted a retrospective chart review in children with type 1 VWD or low VWF activity treated via an institutional protocol that utilizes repeated doses of Desmopressin acetate (DDAVP, 1-deamino 8-D arginine- vasopressin) or VWF concentrate, brief hospitalization for observation and extended use of oral epsilon aminocaproic acid (EACA). Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020 Aug;55(8):760-763

The Sixth Medical center of Chinese PLA General Hospital, College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100048, China.

To study the relationship between adenoid hypertrophy, tonsillar hypertrophy and overweight or even obesity in children. A total of 799 children aged 2 to 12 years with tonsillar and adenoid hypertrophy from January 2015 to December 2019 in the Department of Otolaryngology Head Neck Surgery, the Sixth Medical Center of Chinese PLA General Hospital were selected. The body mass index (BMI) was calculated according to the height and weight measured routinely at the time of admission. Read More

J Clin Sleep Med 2020 12;16(12):2021-2028

Department of Pediatric Dentistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Study Objectives: Obstructive sleep apnea (OSA) is a respiratory disorder caused by the obstruction of the upper airway during sleep. The most common cause of pediatric OSA is adenotonsillar hypertrophy. Adenotonsillectomy is the first-line treatment for pediatric OSA; however, OSA persists in a significant number of patients due, in part, to the method of evaluating enlarged adenoids and tonsil tissue. Read More

Otolaryngol Head Neck Surg 2021 02 11;164(2):414-421. Epub 2020 Aug 11.

Department of Otorhinolaryngology, Hospital Prof Doutor Fernando Fonseca, Lisbon, Portugal.

Objective: To describe drug-induced sleep endoscopy (DISE) findings in children with obstructive sleep apnea and to differentiate them between surgically naïve children and children who had adenotonsillectomy performed.

Study Design: Retrospective case series with chart review.

Setting: Secondary care hospital. Read More

Acta Paediatr 2021 03 21;110(3):977-984. Epub 2020 Aug 21.

Department of Paediatrics, Tampere University Hospital, Tampere, Finland.

Aim: The difficulty of assessing the likelihood of obstructive sleep apnoea (OSA) in children who snore without full-night polysomnography is widely recognised. Our aim was to identify features that were characteristic of two-year-old children with OSA and evaluate whether this information could be used to assess the likelihood of OSA.

Methods: The study was carried out as part of the Child-Sleep Project, a longitudinal birth cohort study of children born at Tampere University Hospital, Finland. Read More

Laryngorhinootologie 2020 08 30;99(8):568-582. Epub 2020 Jul 30.

What is right? Tonsillotomy or tonsillectomy? Moreover, when and what has to be preferred? Is the discussion never ending? No, and this is good. Tonsil surgery is and will remain a frequent surgical procedure for the otolaryngologist. Especially, because many children are operated, and because - also rare - significant complications can occur, a quality-controlled benefit-risk-analysis is important. Read More

Int J Pediatr Otorhinolaryngol 2020 Nov 10;138:110231. Epub 2020 Jul 10.

Department of Otolaryngology-Head & Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230000, PR China. Electronic address:

Objective: To evaluate the levels of vitamin D and the frequencies of regulatory T cells (%Tregs) in children undergoing adenotonsillectomies (T&As) and their controls.

Methods: We prospectively collected data from 130 children aged from 2 to 14 years old undergoing T&As and 60 undergoing unrelated elective procedures from November 1, 2015 to December 20, 2017 at the First Affiliated Hospital of Anhui Medical University. Demographic and disease specific data was obtained in addition to blood samples for the measurement of 25-hydroxy (OH)-vitamin D, interleukin-10 and %Tregs. Read More

Pediatr Blood Cancer 2020 09 16;67(9):e28361. Epub 2020 Jul 16.

Division of Haematology/Oncology, Department of Paediatrics, SickKids Hospital and University of Toronto, Toronto, Canada.

Waldeyer's ring (WR) involvement in pediatric Hodgkin lymphoma (HL) is extremely rare and criteria for determining involvement and response to treatment are unclear. The international Staging, Evaluation, and Response Criteria Harmonization for Childhood, Adolescent and Young Adult Hodgkin Lymphoma (SEARCH for CAYAHL) Group performed a systematic review of the literature in search of involvement or response criteria, or evidence to support specific criteria. Only 166 cases of HL with WR involvement were reported in the literature, 7 of which were pediatric. Read More

Am J Respir Crit Care Med 2020 12;202(11):1560-1566

Department of Respiratory and Sleep Medicine and.

Sleep-disordered breathing (SDB) is associated with increased vascular resistance in children and adults. Persistent increased vascular resistance damages vascular endothelial cells-a marker of which is increased platelet activation. This study compared whole-blood impedance platelet aggregation in children with clinically diagnosed SDB warranting adenotonsillectomy and healthy control subjects. Read More

Auris Nasus Larynx 2020 Aug 15;47(4):559-564. Epub 2020 Jun 15.

Assistant professor of Otorhinolaryngology, Head and Neck Surgery, Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Egypt.

Objective: to detect, analyze and discuss the different ear nose throat (ENT) manifestations those were reported in COVID19 positive patients in the reviewed and published literatures.

Methods: We performed a search in the PubMed databases, Web of Science, LILACS, MEDLINE, SciELO, and Cochrane Library using the keywords; COVID-19, Novel coronavirus, corona, 2019-nCoV, SARS-CoV-2, ENT, ear, nose, throat, otorhinolaryngology, ORL, pharynx, ORL, smell, larynx, different ENT related symptoms. We reviewed published and peer reviewed studies that reported the ENT manifestations in COVID-19 laboratory-confirmed positive patients. Read More

Biotech Histochem 2020 Nov 18;95(8):634-640. Epub 2020 Jun 18.

Department of Advance Diagnostics, Institute for Maternal and Child Health IRCCS Burlo Garofolo , Trieste, Italy.

Both bacterial infections and innate oral immunity response participate in development of adeno-tonsillar hypertrophy (ATH). ATH can lead to obstructive sleep apnea. We investigated the beta-defensin 2 (hBD-2) encoding gene, , by analyzing the copy number variations (CNVs) of the defensin gene cluster in patients with ATH and by correlating CNV with gene expression. Read More