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Adenoid Hypertrophy

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Michael P Major – 1st expert on this subject based on the ideXlab platform

  • Adenoid Hypertrophy in pediatric sleep disordered breathing and craniofacial growth the emerging role of dentistry
    Journal of Dental Sleep Medicine, 2014
    Co-Authors: Michael P Major, Manisha Witmans, Paul W Major, Hamdy Elhakim, Carlos Floresmir

    Abstract:

    sleep disordered breathing (SDB); and can be an etiologic cause of altered craniofacial growth characterized by long face, retrusive chin, and narrow maxilla. Early detection and treatment may mitigate or resolve negative effects of Adenoid Hypertrophy. Adenoidectomy remains a front line treatment for the majority of cases, although alternative treatments must be considered when different SDB etiologies and co-morbidities are present. Best available evidence suggests that rapid maxillary expansion and Adenoidectomy work synergistically to resolve SDB symptoms, and often both treatments are necessary for full treatment effect. Conclusions: Primary care dentists, pediatric dentists, and orthodontists have an important role in early detection of Adenoid Hypertrophy. Emerging evidence continues to demonstrate dental treatments as playing an increasingly important role in multidisciplinary management of pediatric SDB.

  • The accuracy of diagnostic tests for Adenoid Hypertrophy: A systematic review
    Journal of the American Dental Association, 2014
    Co-Authors: Michael P Major, Humam Saltaji, Hamdy El-hakim, Manisha Witmans, Paul W Major, Carlos Flores

    Abstract:

    ABSTRACT Background Adenoid Hypertrophy may cause sleep-disordered breathing and altered craniofacial growth. The authors conducted a study to gauge the accuracy of alternative tests compared with nasoendoscopy (reference standard) for screening Adenoid Hypertrophy. Methods The authors conducted a systematic review that included searches of electronic databases, hand searches of bibliographies of relevant articles and gray literature searches. They included all articles in which an alternative test was compared with nasoendoscopy in children with suspected nasal or nasopharyngeal airway obstruction. Results The authors identified seven articles that were of poor to good quality. They identified the following alternative tests: multirow detector computed tomography (sensitivity, 92 percent; specificity, 97 percent), videofluoroscopy (sensitivity, 100 percent; specificity, 90 percent), rhinomanometry with decongestant (sensitivity, 83 percent; specificity, 83 percent) and clinical examination (sensitivity, 22 percent; specificity, 88 percent). Lateral cephalograms tended to have good to fair sensitivity (typically 61-75 percent) and poor specificity (41-55 percent) when Adenoid size was evaluated but excellent to good specificity when airway patency was evaluated (68-96 percent). Conclusions No ideal tool exists for dentists to screen Adenoid Hypertrophy, owing to access constraints, radiation concerns and suboptimal diagnostic accuracy. Research is needed to identify a low-risk, easily acceptable, highly valid diagnostic screening tool. Practical Implications Although lateral cephalograms (which have good to fair sensitivity) and a thorough medical history (which has good specificity) are imperfect individually, when they are used together, they can compensate for each other’s weaknesses. This combined approach is the best tool available to dentists for screening Adenoid Hypertrophy.

Aparna Irodi – 2nd expert on this subject based on the ideXlab platform

  • relative etiological importance of Adenoid Hypertrophy versus sinusitis in children with persistent rhinorrhoea
    Indian Journal of Otolaryngology and Head & Neck Surgery, 2015
    Co-Authors: S Maheswaran, V Rupa, Jareen Ebenezer, Anand Manoharan, Aparna Irodi

    Abstract:

    Persistent rhinorrhoea is a common, yet often neglected, problem among Indian children. This study was designed to evaluate the relative etiological importance of Adenoid Hypertrophy versus sinusitis in children with persistent rhinorrhea. Additionally, the association between S. pneumoniae colonization and Adenoid Hypertrophy was studied. Children aged 1–14 years with persistent rhinorrhea underwent clinical evaluation, rigid nasal endoscopy and xrays of the nasopharynx and paranasal sinuses to ascertain the presence of Adenoid Hypertrophy and sinusitis using standard criteria. Nasopharyngeal swabbing to ascertain the presence of nasopharyngeal colonization with S. pneumoniae was also performed. Adenoid Hypertrophy was more consistently associated with persistent rhinorrhea than sinusitis (p < 0.0001). Coincident Adenoid Hypertrophy and sinusitis occurred in 57 %. S. pneumoniae was cultured in only 29 % of children. Up to 47 % of patients had features of nasal allergy. There was no association between S. pneumoniae colonization and Adenoid Hypertrophy (p = 0.1). Adenoid Hypertrophy is an important cause of persistent rhinorrhea in children. Measures to evaluate for and treat Adenoid Hypertrophy should be instituted early to alleviate the problem of persistent rhinorrhoea in children. S. pneumoniae colonization of the nasopharynx is not a major etiological factor for persistent rhinorrhoea in these children. Nasal allergy may be a cause of Adenoid Hypertrophy in roughly half the children.

  • Relative etiological importance of Adenoid Hypertrophy versus sinusitis in children with persistent rhinorrhoea.
    Indian Journal of Otolaryngology and Head & Neck Surgery, 2014
    Co-Authors: S Maheswaran, V Rupa, Jareen Ebenezer, Anand Manoharan, Aparna Irodi

    Abstract:

    Persistent rhinorrhoea is a common, yet often neglected, problem among Indian children. This study was designed to evaluate the relative etiological importance of Adenoid Hypertrophy versus sinusitis in children with persistent rhinorrhea. Additionally, the association between S. pneumoniae colonization and Adenoid Hypertrophy was studied. Children aged 1–14 years with persistent rhinorrhea underwent clinical evaluation, rigid nasal endoscopy and xrays of the nasopharynx and paranasal sinuses to ascertain the presence of Adenoid Hypertrophy and sinusitis using standard criteria. Nasopharyngeal swabbing to ascertain the presence of nasopharyngeal colonization with S. pneumoniae was also performed. Adenoid Hypertrophy was more consistently associated with persistent rhinorrhea than sinusitis (p 

Paul W Major – 3rd expert on this subject based on the ideXlab platform

  • Adenoid Hypertrophy in pediatric sleep disordered breathing and craniofacial growth the emerging role of dentistry
    Journal of Dental Sleep Medicine, 2014
    Co-Authors: Michael P Major, Manisha Witmans, Paul W Major, Hamdy Elhakim, Carlos Floresmir

    Abstract:

    sleep disordered breathing (SDB); and can be an etiologic cause of altered craniofacial growth characterized by long face, retrusive chin, and narrow maxilla. Early detection and treatment may mitigate or resolve negative effects of Adenoid Hypertrophy. Adenoidectomy remains a front line treatment for the majority of cases, although alternative treatments must be considered when different SDB etiologies and co-morbidities are present. Best available evidence suggests that rapid maxillary expansion and Adenoidectomy work synergistically to resolve SDB symptoms, and often both treatments are necessary for full treatment effect. Conclusions: Primary care dentists, pediatric dentists, and orthodontists have an important role in early detection of Adenoid Hypertrophy. Emerging evidence continues to demonstrate dental treatments as playing an increasingly important role in multidisciplinary management of pediatric SDB.

  • The accuracy of diagnostic tests for Adenoid Hypertrophy: A systematic review
    Journal of the American Dental Association, 2014
    Co-Authors: Michael P Major, Humam Saltaji, Hamdy El-hakim, Manisha Witmans, Paul W Major, Carlos Flores

    Abstract:

    ABSTRACT Background Adenoid Hypertrophy may cause sleep-disordered breathing and altered craniofacial growth. The authors conducted a study to gauge the accuracy of alternative tests compared with nasoendoscopy (reference standard) for screening Adenoid Hypertrophy. Methods The authors conducted a systematic review that included searches of electronic databases, hand searches of bibliographies of relevant articles and gray literature searches. They included all articles in which an alternative test was compared with nasoendoscopy in children with suspected nasal or nasopharyngeal airway obstruction. Results The authors identified seven articles that were of poor to good quality. They identified the following alternative tests: multirow detector computed tomography (sensitivity, 92 percent; specificity, 97 percent), videofluoroscopy (sensitivity, 100 percent; specificity, 90 percent), rhinomanometry with decongestant (sensitivity, 83 percent; specificity, 83 percent) and clinical examination (sensitivity, 22 percent; specificity, 88 percent). Lateral cephalograms tended to have good to fair sensitivity (typically 61-75 percent) and poor specificity (41-55 percent) when Adenoid size was evaluated but excellent to good specificity when airway patency was evaluated (68-96 percent). Conclusions No ideal tool exists for dentists to screen Adenoid Hypertrophy, owing to access constraints, radiation concerns and suboptimal diagnostic accuracy. Research is needed to identify a low-risk, easily acceptable, highly valid diagnostic screening tool. Practical Implications Although lateral cephalograms (which have good to fair sensitivity) and a thorough medical history (which has good specificity) are imperfect individually, when they are used together, they can compensate for each other’s weaknesses. This combined approach is the best tool available to dentists for screening Adenoid Hypertrophy.