The Experts below are selected from a list of 2823 Experts worldwide ranked by ideXlab platform
Michael P Major - One of the best experts on this subject based on the ideXlab platform.
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Adenoid Hypertrophy in pediatric sleep disordered breathing and craniofacial growth the emerging role of dentistry
Journal of Dental Sleep Medicine, 2014Co-Authors: Michael P Major, Manisha Witmans, Paul W Major, Hamdy Elhakim, Carlos FloresmirAbstract: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.
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The accuracy of diagnostic tests for Adenoid Hypertrophy: A systematic review
Journal of the American Dental Association, 2014Co-Authors: Michael P Major, Manisha Witmans, Humam Saltaji, Hamdy El-hakim, Paul W Major, Carlos FloresAbstract: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 - One of the best experts on this subject based on the ideXlab platform.
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relative etiological importance of Adenoid Hypertrophy versus sinusitis in children with persistent rhinorrhoea
Indian Journal of Otolaryngology and Head & Neck Surgery, 2015Co-Authors: S Maheswaran, V Rupa, Jareen Ebenezer, Anand Manoharan, Aparna IrodiAbstract: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.
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Relative etiological importance of Adenoid Hypertrophy versus sinusitis in children with persistent rhinorrhoea.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2014Co-Authors: S Maheswaran, V Rupa, Jareen Ebenezer, Anand Manoharan, Aparna IrodiAbstract: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
Manisha Witmans - One of the best experts on this subject based on the ideXlab platform.
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Adenoid Hypertrophy in pediatric sleep disordered breathing and craniofacial growth the emerging role of dentistry
Journal of Dental Sleep Medicine, 2014Co-Authors: Michael P Major, Manisha Witmans, Paul W Major, Hamdy Elhakim, Carlos FloresmirAbstract: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.
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The accuracy of diagnostic tests for Adenoid Hypertrophy: A systematic review
Journal of the American Dental Association, 2014Co-Authors: Michael P Major, Manisha Witmans, Humam Saltaji, Hamdy El-hakim, Paul W Major, Carlos FloresAbstract: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.
Paul W Major - One of the best experts on this subject based on the ideXlab platform.
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Adenoid Hypertrophy in pediatric sleep disordered breathing and craniofacial growth the emerging role of dentistry
Journal of Dental Sleep Medicine, 2014Co-Authors: Michael P Major, Manisha Witmans, Paul W Major, Hamdy Elhakim, Carlos FloresmirAbstract: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.
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The accuracy of diagnostic tests for Adenoid Hypertrophy: A systematic review
Journal of the American Dental Association, 2014Co-Authors: Michael P Major, Manisha Witmans, Humam Saltaji, Hamdy El-hakim, Paul W Major, Carlos FloresAbstract: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.
Tang Yuan-yua - One of the best experts on this subject based on the ideXlab platform.
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Analysis of acoustic rhinometry and modeling of upper airway in children with Adenoid Hypertrophy
Chinese Archives of Otolaryngology-head and Neck Surgery, 2020Co-Authors: Tang Yuan-yuaAbstract:OBJECTIVE To assess the clinical application of acoustic rhinometry in children with Adenoid Hypertrophy and establish the model of upper airway, analyze the morphological and airflow characters in the nasal cavity and nasopharyngeal cavity. METHODS Thirty-five children with Adenoid Hypertrophy were submitted to take lateral X-ray and acoustic rhinometry. Then we measure the ratio of A/N(Adenoid /nasopharyngeal volume). Based on the A/N, all children assigned to three groups(A/N≤0.60, 0.60A/N≤0.70, A/N0.70). The minimal cross-sectional area(MCSA), distance of the minimal cross-sectional area from the nostril(DMCA), nasal airway resistance(NR), nasal volume(NV) and nasopharyngeal volume(NPV), were achieved from the acoustic rhinometry curve. Finally the above parameters were compared by the ANOVA. At the same time, on the basis of CT images of the 9 children with Adenoid Hypertrophy, we build models with threedimensional reconstruction and analyze the character of airf low in upper airway. RESULTS The features of acoustic rhinometry in children with Adenoid Hypertrophy was lower in posterior segment. With the increasing of the size of the Adenoid, NR presented an increasing tendency, while NV and NPV decreasing gradually. No significant difference was observed in MCSA, DMCA, NR and NV among the groups. While the NPV showed a significant difference among the three groups(P =0.000). The shape of the air current in the pharynx was deranged, the change of the pressure was concentrated in the area of limen nasi and the junctional zone of the Adenoid and the tonsil, the high air flow rate of the respiratory passage was concentrated in the limen nasi, middle nasal meatus and nasopharynx. CONCLUSION Acoustic rhinometry can be used to analyze the volume of the nasopharyngeal cavity, and can verify the validity and reliability of the model of upperairway. Using them can reflect the characteristic of upper airway in patients, provide information for clinical therapy and to evaluate the therapeutic effect.
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Clinical research of acoustic rhinometry in children with Adenoid Hypertrophy
Journal of Dalian Medical University, 2020Co-Authors: Tang Yuan-yuaAbstract:Objective To assess the clinical application of acoustic rhinometry(AR) in children with Adenoid Hypertrophy. From the present study we would like to show that AR is a valid method to analyze nasal and nasopharyngeal volume of children suffering from Adenoid Hypertrophy in quantity. And then we can predict how the disorder of Adenoid Hypertrophy contributes to the growth of nose. Methods Thirty- five children with Adenoid Hypertrophy were examined with lateral X-ray and AR. Based on the Adenoid /nasopharyngeal(A /N) volume,all children were assigned to three groups: 1) A /N≤0. 60(total 8,boy 6,girl 2);2) 0. 6 A /N≤0. 70( total 8,boy 5,girl 3);3) A /N 0. 70( total 19,boy 13,girl 6). The parameters,including minimal cross- sectional area(MCSA),distance of the minimal cross- sectional area from the nostril(DMCA),nasal airway resistance( NR),nasal volume( NV),and nasopharyngeal volume( NPV),were achieved from the AR curve. Finally the above parameters were compared by the ANOVA. Results The characteristic feature of the AR curve in children with Adenoid Hypertrophy was flat in the posterior segment. In association with the degree of Adenoid Hypertrophy,NR increased gradually,while NV and NPV had a tendency to decrease. There was significant difference observed among the groups with respect to MCSA,DMCA,NR and NV. While comparison of NPV among the three groups showed a significant difference(P = 0. 000). Conclusion Acoustic rhinometry is a rapid,harmless,noninvasive method,and has a high reproducibility. Adenoid Hypertrophy can affect the growth of the nose,which can be assessed by AR. Thus AR can be used to screen the children with OSAHS and provides information for individualized clinical treatment options.
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Analysis of nasopharyngeal bacterial culture in children with Adenoid Hypertrophy
Chinese Journal of Microecology, 2020Co-Authors: Tang Yuan-yuaAbstract:Objective To study the nasopharyngeal bacteria in children with Adenoid Hypertrophy. Methods Nasopharyngeal bacterial culture was conducted in 127 children( 3-14 years old from March 2013 to March 2014)with Adenoid Hypertrophy,hospitalized for surgery. They were divided into two groups,with the first group including 34 cases of simple Adenoid Hypertrophy with OSAHS( obstructive sleep apnea hypo-ventilation syndrome),and the second group consisting of 93 cases of Adenoid Hypertrophy and OSAHS merged with sinusitis and otitis media,the results were compared. Results The detection rate of bacteria from nasopharyngeal swabs in 127 cases of Adenoid Hypertrophy was 84. 3%,among which the first group accounted for 76. 5%,and the second group was87. 1%. Correlation existed between the detection rate of bacteria and patients' clinical symptoms,with much higher detection rate of bacteria found in children with otitis media and chronic sinusitis. Through χ2rest,significant difference of positive rates was revealed in bacterial culture of nasopharyngeal Adenoids in both groups( χ2= 127,P 0. 05). Conclusion Nasopharyngeal pathogenic bacterial carrying rate is higher in children aged 3-14 with Adenoid Hypertrophy,particularly in children with chronic sinusitis or otitis media. The research results may provide etiological basis for late treatment course of children,and play a positive role in prevention and control of Adenoid Hypertrophy as well as infectious diseases at adjacent organs.