The effect of adenoids and endoscopic adenoidectomy on nasal patency in children

Czech version

Authors: J. Sojak ^1,3; P. Ďurdík ²; R. Péčová ^3,4
Authors‘ workplace: Slovenská zdravotnícka univerzita v Bratislave, Lekárska fakulta Slovenskej zdravotníckej univerzity Klinika otorinolaryngológie a chirurgie hlavy a krku, Ústredná vojenská nemocnica SNP – Fakultná nemocnica, Ružomberok ¹; Univerzita Komenského v Bratislave, Jesseniova lekárska fakulta v Martine (JLF UK), Klinika detí a dorastu, Univerzitná nemocnica, Martin ²; Ústav patologickej fyziológie JLF UK, Martin ³; Martinské centrum pre biomedicínu JLF UK, Martin ⁴
Published in: Čes-slov Pediat 2017; 72 (3): 170-175.
Category: Original Papers

Overview

Background:
The aim of this study was to clarify changes of nasal obstruction, transnasal airflow and resistance resulting from adenoid hypertrophy and to assess the effect of endoscopic adenoidectomy.

Methods:
Altogether 156 children (average age of 6.7 years, with average high of 123 cm) were submitted to a nasal fiberoptic endoscopy, condition of nasopharynx and the grade of eventual adenoid hypertrophy was determined, according to which the children were divided into groups. We also conducted active anterior rhinomanometry (transnasal pressure 150 Pa) and assessed values of total transnasal inspiratory airflow (Fl.L+R) and total nasal resistance (ResL+R). We compared this values with reference parameters and assessed grade of nasal obstruction for all groups. In group of 50 children we conducted these measurements also after adenoidectomy and assessed the change of nasal patency due to adenoidectomy.

Results:
In a group of 151 children with verified adenoid hypertrophy we measured value of Fl.L+R corresponding to 60% and value of ResL+R corresponding to 233% of reference parameters what correlate with 2nd grade of nasal obstruction. We have noticed statistically significant decrease of Fl.L+R (p=0.01) and increase of ResL+R (p=0.012) due to adenoid hypertrophy. Also we have noticed relationship between increase of adenoid hypertrophy grade and grade of nasal obstruction. The grade of nasal obstruction due to AT statistically changed (p=0.028) and we recorded improvement of 0.58 grade. Value of Fl.L+R after adenoidectomy correlated with 2nd grade of nasal obstruction. We have not observed relevant changes in nasal obstruction after adenoidectomy in children with 2nd grade of adenoid hypertrophy; in children with 3rd grade of adenoid hypertrophy we have observed improvement of 1.11 nasal obstruction grade.

Conclusions:
In our study we have confirmed negative influence of adenoid hypertrophy on nasal obstruction and patency. Higher grade of adenoid hypertrophy relate with higher grade of nasal obstruction. The significant reduction of nasal obstruction symptoms after adenoidectomy might be expected only in group of patients with the 3rd and 4th grade of adenoid hypertrophy respectively 3rd and 4th grade of nasal obstruction.

Key words:
adenoids, adenoidectomy, nasal obstruction, nasal patency, rhinoendoscopy, rhinomanometry

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