Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper discusses the personal criteria followed in indicating tonsillectomy and/or adenotonsillectomy in treating a group of 150 children between the ages of 2 and 12 in the ENT Department of the Crobu Hospital of Iglesias where a follow-up was carried out from May 1989 to March 1991. The study analyzes when and under what conditions these surgical procedures are indicated in young patients without recurrent tonsillitis but with obstructive sleep apnea (OSA). The utility of traditional laboratory investigations (such as surface pharyngeal swabbing) in indicating surgical therapy is also evaluated. In concluding, the Authors affirm that recurrent tonsillitis no longer controllable with medical therapy is still the most frequent indication for surgery. In fact, 64% of the children studied belonged to either class TR or ITR in which recurring infection was the primary indication factor. However, respiratory obstruction has recently emerged as a increasingly important factor in indicating tonsillectomy and/or adenotonsillectomy. In fact, 54 children (35.9%) of the 150 studied belonged to class IT or OSA in which tonsillar and/or adeno-tonsillar hypertrophy with obstruction of various degrees was the determining factor in indicating surgical treatment. It appears that in the near future with fewer tonsillectomies being indicated in the case of recurrent tonsillitis, a progressive increase in the number of indications of surgical treatment in cases of obstruction may be expected. The Authors stress, however, the importance of identifying OSA patients because of the cardiorespiratory risks they may encounter during surgery (intubation difficulty found by the anaesthesiologist, tendency towards laryngeal spasms and pharyngeal obstruction in the post-operatory period).
 ...
PMID:[Tonsillectomy in childhood: personal considerations]. 181 87

One hundred and twenty-six patients who underwent tonsillectomy because of recurrent acute tonsillitis, tonsillar hypertrophy or sleep apnoea were evaluated by tonsillar core culturing. The sleep apnoea patients served as controls, since none of them had tonsillar hypertrophy at ENT examination or any history of recurrent acute tonsillitis, and thus their tonsillar core flora could be regarded as normal. The isolation rate of H. influenzae was much lower among sleep apnoea controls (2.7 per cent) than among either the patients with recurrent acute tonsillitis (20.3 per cent) or those with tonsillar hypertrophy (36.7 per cent) (p less than 0.05), as was that of group A streptococci, 5.4 per cent versus 16.9 and 20 per cent, respectively (though the latter differences were not statistically significant). The isolation frequencies of B. catarrhalis, pneumococci, group C and G streptococci did not differ between the three groups. The high tonsillar core recovery rates of H. influenzae and group A streptococci both in patients with recurrent acute tonsillitis and in those with tonsillar hypertrophy, as compared with normal controls, suggests the possible involvement of these bacteria in both conditions.
 ...
PMID:High recovery of Haemophilus influenzae and group A streptococci in recurrent tonsillar infection or hypertrophy as compared with normal tonsils. 207 11

Nearly 70 per cent of contemporary ENT consultants perform adenoidectomy as a routine when removing the tonsils. It has been stated in the literature that adenoid and tonsillar hypertrophy tend to co-exist and so a study was set up to investigate this hypothesis, with the possibility that it may be of diagnostic importance. A series of 45 children admitted for the operations of tonsillectomy and adenoidectomy was investigated. No correlation was found between adenoid weight and tonsil weight. In view of this, it was concluded that tonsil and adenoid hypertrophy do not necessarily co-exist and that tonsil size cannot be used to predict adenoid size.
 ...
PMID:The relationship of adenoid weight to tonsillar weight. 686 90

Adeno-tonsillar hypertrophy is the most common cause of obstructive sleep apnea syndrome (OSAS) in childhood and may also play a role in the development of craniofacial abnormalities. The mode of breathing and the morphology of the dental arch are very closely connected. Most of the children who came to the ENT clinic had malocclusions. The early performance of surgical treatment on hypertrophied tonsils and/or adenoids influenced greatly the state of health and morphology of the dental arch. In the process of diagnosis and treatment of children with OSAS it is necessary to have multidisciplinary cooperation, especially between the otolaryngologist and the orthodontist.
 ...
PMID:The influence of tonsillectomy on obstructive sleep apnea children with malocclusion. 766 97

A case is reported of a HIV-positive patient with severe von Willebrand's disease describing the bleeding complications during and after tonsillectomy. This patient underwent surgery for asymmetrical tonsillar hypertrophy. The tonsils were spontaneously haemorrhaging and there therefore was a suspicion of neoplasia. Despite close cooperation between the ENT Department and the Haemophilia Centre, involving per-operative Factor VIII monitoring and replacement, the patient suffered both protracted primary and secondary haemorrhages. We report this as a cautionary tale as our previous experience with mild to moderate haemophilia has been uncomplicated, but on this occasion there was massive haemorrhage. We feel that tonsillectomy should not be undertaken in a patient with a severe bleeding disorder without an absolute indicate.
 ...
PMID:Bleeding after tonsillectomy in severe von Willebrand's disease. 779 3

Tonsillar microbial flora was studied in cultures of tonsillar core specimens from 34 patients tonsillectomized due to recurrent group A streptococcal pharyngotonsillitis (n = 17) or sleep apnoea (n = 17). Patients in the sleep apnoea subgroup, who had no history of recurrent tonsillitis and manifested no tonsillar hypertrophy at ENT examination, served as controls. Tonsillar core specimens were cultured for semi-quantitative estimation of growth of aerobic, anaerobic and facultative organisms. The recurrent tonsillitis and apnoea subgroups did not differ significantly in the mean number of isolates per patient, either of aerobic spp. (3.8 vs. 4.3) or anaerobic spp. (5.2 vs. 4.7). Nor did the two subgroups differ significantly in the proportion of patients whose specimens manifested beta-lactamase producers (71% vs. 59%), in the isolation frequency of viridans (alpha) streptococci, or in the occurrence of semi-quantitative growth estimates of 3-4+ for aerobic, anaerobic or beta-lactamase-producing spp. Thus, the study provided no support for the hypothesis that inactivation of penicillin V by beta-lactamase-producing bacteria in oral or throat flora, or the eradication of viridans streptococci with their GAS-inhibitory capacity, is an important factor with regard to recurrent group A streptococcal tonsillitis. Other possible explanations, such as poor antibiotic penetration at the site of infection, are discussed.
 ...
PMID:Tonsillar microbial flora: comparison of recurrent tonsillitis and normal tonsils. 1021 95

Adeno-tonsillar hypertrophy, with signs of upper airway obstruction is a common presentation in ENT clinics. Recently it is identified as a major cause of sleep apnea syndrome. Several isolated case reports of pulmonary hypertension and corpulmonale appeared in the literature. The authors report two such children aged less than 2 years with cardio-pulmonary changes occurring secondary to chronic adeno-tonsillar hypertrophy that were successfully treated with the surgical removal.
 ...
PMID:Reversible cardio-pulmonary changes due to adeno-tonsilar hypertrophy. 1103 78

In order to investigate the effect of oxidative damage due to free radicals on ENT infectious diseases, levels of superoxide dismutase (SOD), glutathione-peroxidase (GPx) and reductase (GRt) and the total antioxidant status (TAS) were measured by spectrophotometry on tonsillar tissue obtained from tonsillectomy in 538 patients, who were divided in three groups according to their surgical indication: tonsillar hypertrophy (n = 235), recurrent tonsillitis (n = 280) or peritonsillar abscess (n = 23). SOD concentration were also measured on adenoid tissue and middle ear exudate in 75 patients from the first two groups. Erythrocyte and tonsillar SOD levels were significantly greater in the abscess group, and lower in the hypertrophic one. These differences were similar for GPx and TAS. For GRt, its level in abscess were lower than in the other two groups in a statistically significant way. There were strong correlations between erythrocyte and tonsillar SOD, tonsillar SOD and GPx, tonsillar SOD and TAS, and tonsillar GPx and TAS. SOD concentrations from adenoid tissue and middle ear exudate did not affect its blood level. So, we can conclude that tonsillar oxidative damage is determined by the frequency or the severity of local infections, and it can be evaluated by measuring the SOD concentration in the tonsillar tissue or in the peripheral blood. So, it can be considered a good marker of tonsillar damage.
 ...
PMID:[Oxidative profile of tonsil infection. Study of antioxidant enzymes in tonsil and blood]. 1240 89

The purpose of this study was to investigate the presence of actinomyces in adenotonsillar disease, recurrent infections, or tonsillar hypertrophy in children. The study included 64 patients, ranging in age from 2 to 16 years, who had elective adenotonsillar surgery to treat either adenotonsillar hypertrophy (36 children) or recurrent adenotonsillitis (28 children). Adenotonsillar Actinomyces was present in 30 children (48%). No statistical significance was found between Actinomyces and recurrent adenotonsillitis or adenotonsillar hypertrophy. However, there was a statistically significant relationship identified between the presence of actinomycosis and age, with a greater occurrence of actinomycosis in children between 5 and 16 years old.
B-ENT 2006
PMID:A correlation between age and Actinomyces in the adenotonsillar tissue of children. 1691 Feb 94

Obstructive sleep apnoea syndrome in a child is characterized by prolonged episodes of obstructive hypopnoea and/or apnoea of upper airway leading to morbidity. The most common risk factor is adeno-tonsillar hypertrophy. Obstructive sleep apnoea syndrome diagnosis is based on clinical ENT evaluation and an instrumental approach, such as pulse oximetry or the gold standard overnight polysomnography. The aim is to establish, in a population of children with suspected obstructive sleep apnoea syndrome, the frequency of this disorder, the effect of adenotonsillectomy and the risk of post-operative complications. A total of 481 patients (297 male, 184 female) with suspected obstructive sleep apnoea syndrome (aged 2-14 years) were evaluated between March 2007 and April 2010 and divided into 3 morphological phenotypes: classic, adult and congenital. All patients underwent ENT assessment and a pulse oximetry with 4 channels cardiopulmonary monitoring. The examination following the Brouillette criteria was defined as negative, positive or inconclusive; when positive, adenotonsillectomy was the first therapeutic approach. At 6 months after surgery, all patients underwent check-up pulse oximetry. Of the overall sample, 96% of the patients had a classical phenotype, 3% an adult type and 1% a congenital type. The monitoring resulted pathological in 19% (17% of them were at increased post-operative risk), negative in 61% and inconclusive in 20%. All 5 patients with congenital phenotype were positive. Of the positive patients, 86% underwent adenotonsillectomy and a control pulse oximetry 6 months thereafter, 96% resulted negative. Pulse oximetry was efficient in order to avoid incorrect surgery indications, improving appropriateness and safety of adenotonsillectomy in children with obstructive sleep apnoea syndrome. Adenotonsillectomy showed a success rate of 96% and there were no episodes of post-surgery complications in particular in those patients at increased risk.
 ...
PMID:Diagnostic and therapeutic iter in paediatric OSAS: personal experience. 2205 92


1 2 Next >>