Search Our Scientific Publications & Authors

J Craniofac Surg 2022 Jun 28. Epub 2022 Jun 28.

Oxford Craniofacial Unit, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital.

Abstract: Pathogenic variants of the ERF gene were previously associated with craniosynostosis, craniofacial dysmorphism and Chiari malformation. This study investigates cognitive, behavioural, speech, language, and developmental outcomes in the first 5 children identified at the Oxford Craniofacial Unit as having ERF-related craniosynostosis, together with three of their carrier parents.There were no consistent findings related to overall intelligence. Read More

Otolaryngol Head Neck Surg 2022 May 24:1945998221097659. Epub 2022 May 24.

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.

Objective: To compare findings of same-day cine magnetic resonance imaging (MRI) and drug-induced sleep endoscopy (DISE) and examine how each technique uniquely contributes to the evaluation of persistent obstructive sleep apnea following adenotonsillectomy.

Study Design: Retrospective cohort study.

Setting: Quaternary care center. Read More

J Med Virol 2022 Apr 29. Epub 2022 Apr 29.

Department of Pediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, Finland.

Adenoids and tonsils have gained interest as a new in vivo model to study local immune functions and virus reservoirs. Especially herpesviruses are interesting because their prevalence and persistence in local lymphoid tissue are incompletely known. Our aim was to study herpesvirus and common respiratory virus infections in nonacutely ill adenotonsillar surgery patients. Read More

Am J Otolaryngol 2022 May-Jun;43(3):103458. Epub 2022 Apr 7.

Bozyaka Training and Research Hospital, Department of Otolaryngology, Head and Neck Surgery, Izmir, Turkey.

Objectives: COVID-19 has seriously altered physicians' approach to patients and diseases, with a tendency to postpone elective procedures. Tonsillectomy, alone or with adenoidectomy, is one of the most common surgeries performed by otolaryngologists. Although they are generally accepted as elective surgeries, they significantly improve the quality of life, and postponing these surgeries for a long time can have deteriorative effects on the patients. Read More

Sleep Med 2022 04 19;92:96-102. Epub 2022 Feb 19.

Division of Orthodontics, Department of Orofacial Science, School of Dentistry, University of California San Francisco, San Francisco, CA, USA. Electronic address:

Introduction: Adenoid and tonsillar hypertrophy in children often leads to adverse respiratory symptoms and obstructive sleep apnea (OSA). Current clinical guidelines from the American Academy of Pediatrics and American Academy of Otolaryngology-Head and Neck Surgery recommend tonsillectomy as the first line of pediatric OSA treatment for children with tonsillar hypertrophy. Rapid palatal expansion (RPE) performed by orthodontists improves obstructive sleep apnea in children by reducing nasal airway resistance, increasing nasal volume, raising tongue posture, and enlarging pharyngeal airway. Read More

Res Sq 2022 Mar 23. Epub 2022 Mar 23.

SARS-CoV-2 infection triggers adaptive immune responses from both T and B cells. However, most studies focus on peripheral blood, which may not fully reflect immune responses in lymphoid tissues at the site of infection. To evaluate both local and systemic adaptive immune responses to SARS-CoV-2, we collected peripheral blood, tonsils, and adenoids from 110 children undergoing tonsillectomy/adenoidectomy during the COVID-19 pandemic and found 24 with evidence of prior SARS-CoV-2 infection, including detectable neutralizing antibodies against multiple viral variants. Read More

Pediatr Clin North Am 2022 04;69(2):247-259

Pediatric Otolaryngology, Joseph M. Sanzari Children's Hospital, 30 Prospect Ave. WFAN Bldg 3rd Floor, Hackensack, NJ 07601, USA. Electronic address:

Tonsillectomy and adenoidectomy are among the most commonly performed major pediatric operations in the United States, with more than 500,000 procedures performed annually. This procedure can be performed with or without adenoidectomy. These procedures were traditionally performed for recurrent tonsillitis; however, the vast majority of tonsillectomies are currently performed for obstructive symptoms. Read More

Cleft Palate Craniofac J 2022 Mar 21:10556656221088171. Epub 2022 Mar 21.

Department of Oral and Maxillofacial Surgery, University of Pennsylvania, School of Dental Medicine, Philadelphia, PA, USA.

Objective: To determine the risk factors and their respective magnitudes for developing Obstructive Sleep Apnea (OSA) in Down syndrome (DS) patients.

Design: Retrospective cohort study.

Patients: The 2016 Kids' Inpatient Database (KID) was queried to identify all patients diagnosed with DS. Read More

Front Cell Infect Microbiol 2022 28;12:831887. Epub 2022 Feb 28.

Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia.

Background: The underlying pathogenesis of pediatric obstructive sleep disordered breathing (SDB) and recurrent tonsillitis (RT) are poorly understood but need to be elucidated to develop less invasive treatment and prevention strategies.

Methods: Children aged between 1- and 16-years undergoing adenoidectomy, tonsillectomy or adenotonsillectomy for SDB (n=40), RT alone (n=18), or both SDB and RT (SDB+RT) (n=17) were recruited with age-matched healthy controls (n=33). Total bacterial load and species-specific densities of nontypeable (NTHi) and were measured by qPCR in nasopharyngeal swabs, oropharyngeal swabs, adenoid and tonsillar tissue from children with SDB, SDB+RT and RT, and in naso- and oro- pharyngeal swabs from healthy children. Read More

Am J Med Genet A 2022 Jul 12;188(7):1964-1971. Epub 2022 Mar 12.

Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, Paris, France.

The relationship between neurofibromatosis type 1 (NF1) and sleep-disordered breathing (SDB) has not been widely studied. The aim of the study was to analyze SDB in children with NF1 of the respiratory system. All children with NF1 followed between September 2008 and July 2020 who had a respiratory polygraphy (RP) were included. Read More

Vestn Otorinolaringol 2022 ;87(1):4-8

Sechenov First Moscow State Medical University, Moscow, Russia.

Objective: To summarize the results of a study of the clinical and polygrapic features of sleep in children with pathologic conditions of the tonsillar ring and obstructive sleep apnea. Tonsillar hypertrophy is the most common cause of obstructive sleep apnea in children. Using the data of overnight polysomnographic study and/or nocturnal pulse oximetry, groups of patients were distinguished depending on the presence and severity of their sleep breathing disorders. Read More

J Speech Lang Hear Res 2022 04 3;65(4):1282-1293. Epub 2022 Mar 3.

Department of Speech and Hearing Science, University of Illinois Urbana-Champaign.

Purpose: The adenoids, or pharyngeal tonsils, consist of a pad of lymphoid tissue, located on the posterior pharyngeal wall of the nasopharynx. During childhood, the adenoid pad serves as a contact site for the soft palate to assist with velopharyngeal closure during oral speech. During adenoidal involution, most children are able to maintain appropriate velopharyngeal closure necessary for normal speech resonance. Read More

Sleep Sci 2021 Jan-Mar;14(4):370-374

Botucatu Medical School - State University São Paulo, UNESP, Department of Ophthalmology and Otorhinolaryngology - Botucatu - Sao Paulo - Brazil.

Objective: To evaluate the economic and technical viability of the sleep study (type III) in children with adenotonsilar hypertrophy.

Methods: 141 children were submitted to sleep study (type III), aged between three and 11, all with symptoms of OSA. The frequency of failed examinations and a comparison of cost analysis between complete polysomnography were described. Read More

Eur Arch Otorhinolaryngol 2022 Jun 12;279(6):3013-3019. Epub 2022 Jan 12.

Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342 005, India.

Purpose: Chronic upper airway obstruction caused by adenotonsillar hypertrophy is one of the major cause of morbidity in children. It can lead to Obstructive Sleep Apnoea Syndrome, Pulmonary Hypertension, Cor Pulmonale and right heart failure. The study aimed to evaluate and compare various parameters of cardiac function with the help of echocardiography preoperatively and postoperatively in children undergoing adenotonsillectomy. Read More

J Physiol Pharmacol 2021 Aug 31;72(4). Epub 2021 Dec 31.

Department of Pediatrics, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania.

The study aims to explore the inflammatory cytokines and oxidative stress in children with obstructive sleep apnea syndrome (OSAS) triggered by adenoids and/or tonsillar hypertrophy and their changes after adenotonsillectomy (AT) and to investigate the associated behavioral disorders in OSAS, before and after AT. Thirty patients with OSAS and 20 healthy children, aged 3 - 13 years were included in the study. According to apnea-hypopnea index (AHI), OSAS children were classified into 3 groups: mild (n = 19), moderate (n = 5), and severe OSAS (n = 6). Read More

Pediatr Res 2022 04 24;91(5):1099-1105. Epub 2021 Dec 24.

Department of Otorhinolaryngology, The First Affiliated Hospital of Fujian Medical University, 350000, Fuzhou, Fujian, China.

Background: The typical characteristic of pediatric obstructive sleep apnea syndrome (OSAS) is systemic inflammation and adenotonsillar hypertrophy (ATH), but the inflammatory markers and mechanism of adenotonsillar proliferation are unclear.

Methods: IHC, qPCR, and western blotting were used to identify the expression of CHI3L1 in the tonsils of children with OSAS. The primary tonsil lymphocytes (PTLCs) from children with OSAS were cultured and recombinant human CHI3L1 protein was added to culture media. Read More

J Clin Med 2021 Nov 28;10(23). Epub 2021 Nov 28.

Department of Otolaryngology, Phoniatrics and Audiology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, 85-168 Bydgoszcz, Poland.

Background: The purpose of this study is to analyze seasonal differences in adenoid size and related mucus levels via endoscopy, as well as to estimate changes in middle ear effusion via tympanometry.

Methods: In 205 children with adenoid hypertrophy, endoscopic choanal assessment, adenoid hypertrophy assessment using the Bolesławska scale, and mucus coverage assessment using the MASNA scale were performed in two different thermal seasons, summer and winter. The study was conducted in two sequences of examination, summer to winter and winter to summer, constituting two separate groups. Read More

Medicine (Baltimore) 2021 Nov;100(44):e27616

Department of Mother and Child Medicine - Pediatrics, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.

Rationale: Tuberculosis is an entity that usually affects the lungs, although extrapulmonary sites can also be involved. Tonsils are rarely affected, especially in the absence of pulmonary disease, primary tonsillar tuberculosis being a diagnostic challenge for the clinician.

Patient Concerns: We present the case of a 14-year-old female teenager, presented to our Pediatric Service with a 14-day history of dysphagia, odynophagia and left reflex otalgia associated with a 5 kg weight loss. Read More

J Clin Sleep Med 2022 04;18(4):1211-1214

Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, UK.

Sleep-related breathing disorders are a common problem in infancy and childhood. The most common type of sleep-related breathing disorder in this age group is obstructive sleep apnea syndrome (OSAS), generally caused by factors affecting airway patency, such as tonsillar hypertrophy or obesity. However, in adults OSAS can also be caused by processes affecting the brainstem, such as central nervous system tumors. Read More

Arkh Patol 2021 ;83(6):27-34

National Medical Research Center of Otorhinolaryngology of the Federal Biomedical Agency of Russia, Moscow, Russia.

Along with central immune organs, the peripheral lymphoepithelial organs of the pharynx are actively involved in protecting the body from infections. Adaptive, or induced, immunity occurs during the postnatal ontogenesis of immunocompetent lymphocytes, which includes the secondary somatic recombination of the V genes with the participation of recombination-activating gene (RAG) and terminal deoxynucleotidyl transferase (Tdt) proteins. This publication discusses the results of detection of Tdt-positive cells in the pharyngeal and palatine tonsils of children of different ages, who had been operated on for adenoid vegetations and chronic tonsillitis. Read More

Vestn Otorinolaringol 2021 ;86(5):58-62

National Medical Research Center for Otorhinolaryngology of the Federal Medical and Biological Agency of Russia, Moscow, Russia.

Objective: To describe the technique and determine the indications for sleep endoscopy in children.

Material And Methods: This study included 35 children, the average age of 5 years 1 month ± 3 years 4 months (from 1 year 6 months to 14 years 5 months). All children underwent standard polysomnography and sleep endoscopy. Read More

J Clin Med 2021 Oct 26;10(21). Epub 2021 Oct 26.

Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8504, Japan.

The adenoid (Ad) and tonsil (Ts), located in the upper airway, play an important role in immunological protection. These lymphoid tissues grow rapidly, reach a peak of growth at the age of 6-8 years, and decrease in their size thereafter. However, little information is available on the longitudinal growth patterns of Ad and Ts in the general population. Read More

Adv Drug Deliv Rev 2022 01 6;180:114037. Epub 2021 Nov 6.

Science Medical Center, Saratov State University, Saratov 410012, Russian Federation.

This review presents principles and novelties in the field of tissue optical clearing (TOC) technology, as well as application for optical monitoring of drug delivery and effective antimicrobial phototherapy. TOC is based on altering the optical properties of tissue through the introduction of immersion optical cleaning agents (OCA), which impregnate the tissue of interest. We also analyze various methods and kinetics of delivery of photodynamic agents, nanoantibiotics and their mixtures with OCAs into the tissue depth in the context of antimicrobial and antifungal phototherapy. Read More

Acta Otorhinolaryngol Ital 2021 Oct;41(5):436-442

Dentistry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Objectives: To evaluate the association between upper airway obstruction and occlusal anomalies in mouth-breathing children.

Methods: 356 mouth-breathing children were evaluated by ENT physicians and specialists in orthodontics. ENT examination included nasal endoscopy to assess the adenoidal hypertrophy, tonsillar grading and presence of nasal septum deviation. Read More

J Periodontol 2022 05 19;93(5):721-731. Epub 2022 Jan 19.

Graduate Institute of Integrated Medicine, China Medical University Hospital, Taichung, Taiwan.

Background: To determine whether patients who had undergone tonsillectomy would have higher risks of postoperative periodontitis.

Methods: Data were collected from the Taiwan Longitudinal Health Insurance Dataset from 1999 to 2013, a population-based cohort study consisting of cases of newly-onset sleep apnoea, chronic diseases of tonsils and adenoids, peritonsillar abscess, and periodontal diseases. A total of 1482 tonsillectomy cases and 14,796 non-tonsillectomy controls were selected. Read More

Clin Exp Metastasis 2022 02 15;39(1):139-157. Epub 2021 Oct 15.

Ronald O. Perelman Department of Dermatology, Department of Pathology, and NYU Langone Laura and Isaac Perlmutter Cancer Center, NYU Grossman School of Medicine, New York, NY, 10016, USA.

The lymphatic system is a complicated system consisting of the lymphatic vessels and lymph nodes draining the extracellular fluid containing cellular debris, excess water and toxins to the circulatory system. The lymph nodes serve as a filter, thus, when the lymph fluid returns to the heart, it is completely sterile. In addition, the lymphatic system includes the mucosa-associated lymphoid tissue, such as tonsils, adenoids, Peyers patches in the small bowel and even the appendix. Read More

Trials 2021 Oct 10;22(1):690. Epub 2021 Oct 10.

Developmental Neurosciences Unit and Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.

Background: Young children with sickle cell anaemia (SCA) often have slowed processing speed associated with reduced brain white matter integrity, low oxygen saturation, and sleep-disordered breathing (SDB), related in part to enlarged adenoids and tonsils. Common treatments for SDB include adenotonsillectomy and nocturnal continuous positive airway pressure (CPAP), but adenotonsillectomy is an invasive surgical procedure, and CPAP is rarely well-tolerated. Further, there is no current consensus on the ability of these treatments to improve cognitive function. Read More

J Laryngol Otol 2021 Sep 29:1-6. Epub 2021 Sep 29.

Busamed Hillcrest Private Hospital, Durban, South Africa.

Objective: Post-tonsillectomy haemorrhage remains a significant complication despite modifications of technique and instrumentation. Intracapsular tonsillectomy spares the capsule as a protective barrier for underlying blood vessels and musculature. Its efficacy in children with sleep-disordered breathing has been established, along with lowered rates of haemorrhage and pain, but research pertaining to adults and for recurrent infections has been limited. Read More

J Otolaryngol Head Neck Surg 2021 Sep 20;50(1):55. Epub 2021 Sep 20.

Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.

Objectives: Analysis of frequency and reasons for planned and unplanned 30-day readmission in hospitalized pediatric otorhinolaryngology patients using German Diagnosis Related Group (G-DRG) system data.

Methods: A retrospective population-based cohort study in Thuringia, Germany, was performed for the year 2015 with 2440 cases under 18 years (55.6% male) out of a total number of 15. Read More