Adenoiditis overview: Difference between revisions
Jump to navigation
Jump to search
Usama Talib (talk | contribs) No edit summary |
m (Bot: Removing from Primary care) |
||
| (5 intermediate revisions by 3 users not shown) | |||
| Line 3: | Line 3: | ||
{{CMG}}{{AE}}{{MIR}} | {{CMG}}{{AE}}{{MIR}} | ||
==Overview== | ==Overview== | ||
[[Adenoid]] is a [[lymphoid tissue]] that forms the [[Waldeyer's ring|Waldeyer]] ring | [[Adenoid]] is a [[lymphoid tissue]] that forms the [[Waldeyer's ring|Waldeyer]] ring. [[Adenoiditis]] is the inflammation of [[Adenoid|adenoid tissue]]. [[Adenoid]] infection is mostly due to [[viral]] [[Infection|infections]]. Some [[bacterial]] [[pathogens]] including [[Haemophilus influenzae|H. influenzae]], [[Streptococcus|group A β-hemolytic streptococcus]], and [[Staphylococcus aureus|S. aureus]] can cause the disease as well. [[Adenoid|Adenoids]] can cause [[Sinusitis|recurrent sinusitis]] and [[Chronic otitis media|chronic persistent]] or [[Recurrent otitis media|recurrent otitis]] if left untreated and can lead to [[Adenoiditis|chronic adenoiditis]]. [[Medications]] ([[antibiotics]] or [[steroids]]) or [[surgical]] approach may be required for the management of [[adenoiditis]], depending on the causative agent. | ||
==Historical perspective== | ==Historical perspective== | ||
[[Adenoid]] was | [[Adenoid]] was thought to be a part of [[tonsils]] and responsible for the symptoms of [[Nasal congestion|nasal congestion and obstruction]]. As a result [[Tonsilectomy|adenotonsilectomy]] was performed for at least 2000 years. In the early beginning of 19th century, [[adenoid]] and [[tonsil]] tissue were known as remnants of an unknown [[infectious disease]], and so they were removed with adenotonsilectomy. Willhelm Meyer of Copenhagen, Denmark in 1800 firstly describe [[adenoiditis]] due to adenoid vegetations responsible for nasal symptoms and impaired hearing. He probably was the first one who performed an [[adenoidectomy]] separately. | ||
==Classification== | ==Classification== | ||
Adenoiditis can be classified | Adenoiditis can be classified into the following types including [[acute]] adenoiditis, recurrent acute adenoiditis, and [[chronic]]/persistant adenoiditis.<ref name="urlHead & Neck Surgery--otolaryngology - Google Books">{{cite web |url=https://books.google.com/books/about/Head_Neck_Surgery_otolaryngology.html?id=mFlV1-v_eVwC |title=Head & Neck Surgery--otolaryngology - Google Books |format= |work= |accessdate=}}</ref> | ||
== Pathophysiology == | == Pathophysiology == | ||
[[Adenoid|Adenoids]] are involved in the production of mostly secretory [[IgA]] | [[Adenoid|Adenoids]] are involved in the production of mostly secretory [[IgA]]. [[IgA]] is transported to the surface providing local [[immune]] protection. Studies suggest that a reduction in [[IgA]] will occur after an [[adenoidectomy]].<ref name="pmid12117336">{{cite journal |vauthors=Havas T, Lowinger D |title=Obstructive adenoid tissue: an indication for powered-shaver adenoidectomy |journal=Arch. Otolaryngol. Head Neck Surg. |volume=128 |issue=7 |pages=789–91 |year=2002 |pmid=12117336 |doi= |url=}}</ref> [[bacteria]] in the normal [[flora]] of the oral cavity, are found in adenoid tissue as well. These include [[Streptococcus|alpha-hemolytic streptococci]], [[Enterococcus|enterococci]], [[Corynebacterium]] species, [[Coagulase-negative staphylococci]], [[Neisseria species]], [[Haemophilus|haemophilus species]], [[Micrococcus|micrococcus species]], stomatococcus species. [[Adenoiditis]] can occur as a result of infection. They can harbor [[pathogenic]] bacteria, which may lead to the development of disease of the ears, nose, and sinuses. Adenoiditis can progress to chronic disease if it remains untreated for a long period of time. | ||
[[Adenoiditis]] can | |||
==Causes== | ==Causes== | ||
Acute adenoiditis is mainly due to [[viral]] infection but [[bacterial]] infections can cause the disease as well | Acute adenoiditis is mainly due to [[viral]] infection but [[bacterial]] infections can cause the disease as well. [[Bacterial infections]] have a more important role in recurrent and chronic adenoiditis. The most important viral causes of adenoiditis include [[EBV]], [[CMV]] and [[RSV|RSV]]. The most important bacterial causes adenoiditis include [[Haemophilus influenzae]], [[Streptococcus|group A β-hemolytic streptococcus]], and [[Staphylococcus aureus|staphylococcus aureus]].<ref name="pmid121173362">{{cite journal |vauthors=Havas T, Lowinger D |title=Obstructive adenoid tissue: an indication for powered-shaver adenoidectomy |journal=Arch. Otolaryngol. Head Neck Surg. |volume=128 |issue=7 |pages=789–91 |year=2002 |pmid=12117336 |doi= |url=}}</ref> | ||
==Differentiating tonsillitis from other diseases== | ==Differentiating tonsillitis from other diseases== | ||
Diagnosis of adenoiditis can be challenging as majority of [[Upper respiratory tract infection|upper respiratory tract infections]] | Diagnosis of adenoiditis can be challenging as majority of [[Upper respiratory tract infection|upper respiratory tract infections]] present in the same pattern. The most important differential diagnosis of adenoiditis includes [[Tonsillitis|tonsilitis]], viral [[upper respiratory tract infection]], [[sinusitis]] and [[pharyngitis]]. | ||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
The prevalence of adenoiditis is not completely known. Research indicates that 15-30% of sore throats in children and 5-10% sore throats in adults are [[bacterial]] adenotonsillitis. The prevalence of adenoiditis decreases with age. Adenoid tissue | The prevalence of adenoiditis is not completely known. Research indicates that 15-30% of sore throats in children and 5-10% sore throats in adults are due to [[bacterial]] adenotonsillitis. The prevalence of adenoiditis decreases with age. Adenoid tissue undergoes atrophy after 10 years of age, so adenoiditis is rarely seen after 15 years.<ref name="pmid3534166">{{cite journal |vauthors=Komaroff AL, Pass TM, Aronson MD, Ervin CT, Cretin S, Winickoff RN, Branch WT |title=The prediction of streptococcal pharyngitis in adults |journal=J Gen Intern Med |volume=1 |issue=1 |pages=1–7 |year=1986 |pmid=3534166 |doi= |url=}}</ref><ref name="pmid5115179">{{cite journal |vauthors=Kaplan EL, Top FH, Dudding BA, Wannamaker LW |title=Diagnosis of streptococcal pharyngitis: differentiation of active infection from the carrier state in the symptomatic child |journal=J. Infect. Dis. |volume=123 |issue=5 |pages=490–501 |year=1971 |pmid=5115179 |doi= |url=}}</ref><ref name="pmid12613739">{{cite journal |vauthors=Schroeder BM |title=Diagnosis and management of group A streptococcal pharyngitis |journal=Am Fam Physician |volume=67 |issue=4 |pages=880, 883–4 |year=2003 |pmid=12613739 |doi= |url=}}</ref><ref name="Oroface">{{cite book |last1=Sharav |first1=Yair |last2=Benoliel |first2=Rafael |date=2008 |title=Orofacial Pain and Headache |url= |location= |publisher=Elsevier |page= |isbn=0723434123}}</ref><ref name="pmid26478108">{{cite journal |vauthors=Pagella F, De Amici M, Pusateri A, Tinelli G, Matti E, Benazzo M, Licari A, Nigrisoli S, Quaglini S, Ciprandi G, Marseglia GL |title=Adenoids and clinical symptoms: Epidemiology of a cohort of 795 pediatric patients |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=79 |issue=12 |pages=2137–41 |year=2015 |pmid=26478108 |doi=10.1016/j.ijporl.2015.09.035 |url=}}</ref> | ||
==Risk Factors== | ==Risk Factors== | ||
The most potent risk factor in the development of adenoiditis is being a young child. Other risk factors include | The most potent risk factor in the development of adenoiditis is being a young child. Other risk factors include [[immunodeficiencies]], living in an urban environment with more exposure to [[viruses]] or [[bacteria]] and usage of [[Immunosuppressant drug|immunosuppressant drugs]]. | ||
== Screening == | == Screening == | ||
There is insufficient evidence to recommend routine screening for | There is insufficient evidence to recommend routine screening for adenoiditis. | ||
==Natural history, complications and prognosis== | ==Natural history, complications and prognosis== | ||
===Natural History=== | ===Natural History=== | ||
Acute adenoiditis will usually present with [[erythema]] and [[edema]] of the adenoids rapidly upon infiltration of the pathogen.<ref name="urlTonsillitis - NHS Choices">{{cite web |url=http://www.nhs.uk/conditions/Tonsillitis/Pages/Introduction.aspx |title=Tonsillitis - NHS Choices |format= |work= |accessdate=}}</ref> | Acute adenoiditis will usually present with [[erythema]] and [[edema]] of the adenoids. This occurs rapidly upon infiltration of the adenoids by the pathogen.<ref name="urlTonsillitis - NHS Choices">{{cite web |url=http://www.nhs.uk/conditions/Tonsillitis/Pages/Introduction.aspx |title=Tonsillitis - NHS Choices |format= |work= |accessdate=}}</ref> Symptoms including [[fever]] and [[sore throat]] will usually manifest within 24 hours of infection. Adenoiditis is usually combined with [[Tonsillitis|tonsillitis]] due to close anatomical location. | ||
===Complications=== | ===Complications=== | ||
Complications of adenoiditis are caused by persistence and/or spread of the responsible pathogen - usually [[bacterial]] | Complications of adenoiditis are caused by persistence and/or spread of the responsible pathogen - usually [[bacterial]]. The complications of adenoiditis include speech abnormalities, [[otitis media]], acute [[sinusitis]], [[pneumonia]], adenoid [[hyperplasia]], [[peritonsillar abscess]], [[sleep apnea|and sleep apnea]]. | ||
===Prognosis=== | ===Prognosis=== | ||
The prognosis for acute adenoiditis without treatment is usually good | The [[prognosis]] for acute adenoiditis without treatment is usually good. Adenoiditis is usually a self-limiting disease and resolves by itself within 3-4 days.<ref name="urlTonsillitis - NHS Choices3">{{cite web |url=http://www.nhs.uk/conditions/Tonsillitis/Pages/Introduction.aspx |title=Tonsillitis - NHS Choices |format= |work= |accessdate=}}</ref> | ||
==Diagnosis== | ==Diagnosis== | ||
=== Diagnostic criteria === | === Diagnostic criteria === | ||
There | There is no criteria for the diagnosis of adenoiditis. However, seeing inflamed and [[Adenoid hypertrophy|hypertrophied adenoid]] tissue with flexible or rigid nasopharyngoscopy can be used as a criteria for [[adenoidectomy]] in patients suspected of chronic adenoiditis. | ||
===History and Symptoms=== | ===History and Symptoms=== | ||
A positive history of fever | A positive history of fever, nasal obstruction, and [[snoring]] is suggestive of adenoiditis. The most common symptoms of adenoiditis include purulent [[nasal discharge]], mouth breathing, nasal pain and [[sore throat]].<ref name="pmid259506862">{{cite journal |vauthors=Kosikowska U, Korona-Głowniak I, Niedzielski A, Malm A |title=Nasopharyngeal and Adenoid Colonization by Haemophilus influenzae and Haemophilus parainfluenzae in Children Undergoing Adenoidectomy and the Ability of Bacterial Isolates to Biofilm Production |journal=Medicine (Baltimore) |volume=94 |issue=18 |pages=e799 |year=2015 |pmid=25950686 |pmc=4602522 |doi=10.1097/MD.0000000000000799 |url=}}</ref><ref name="pmid276059882">{{cite journal |vauthors=Kajan ZD, Sigaroudi AK, Mohebbi M |title=Prevalence and patterns of palatine and adenoid tonsilloliths in cone-beam computed tomography images of an Iranian population |journal=Dent Res J (Isfahan) |volume=13 |issue=4 |pages=315–21 |year=2016 |pmid=27605988 |pmc=4993058 |doi= |url=}}</ref><ref name="pmid178831913">{{cite journal |vauthors=Galli J, Calò L, Ardito F, Imperiali M, Bassotti E, Fadda G, Paludetti G |title=Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis |journal=Acta Otorhinolaryngol Ital |volume=27 |issue=3 |pages=134–8 |year=2007 |pmid=17883191 |pmc=2640046 |doi= |url=}}</ref> | ||
===Physical Examination=== | ===Physical Examination=== | ||
Patients with adenoiditis are usually | Patients with adenoiditis are usually well-appearing. Physical examination of patients with adenoiditis is usually remarkable for [[Fever|fever,]] and purulent nasal discharge.<ref name="pmid25950686">{{cite journal |vauthors=Kosikowska U, Korona-Głowniak I, Niedzielski A, Malm A |title=Nasopharyngeal and Adenoid Colonization by Haemophilus influenzae and Haemophilus parainfluenzae in Children Undergoing Adenoidectomy and the Ability of Bacterial Isolates to Biofilm Production |journal=Medicine (Baltimore) |volume=94 |issue=18 |pages=e799 |year=2015 |pmid=25950686 |pmc=4602522 |doi=10.1097/MD.0000000000000799 |url=}}</ref><ref name="pmid27605988">{{cite journal |vauthors=Kajan ZD, Sigaroudi AK, Mohebbi M |title=Prevalence and patterns of palatine and adenoid tonsilloliths in cone-beam computed tomography images of an Iranian population |journal=Dent Res J (Isfahan) |volume=13 |issue=4 |pages=315–21 |year=2016 |pmid=27605988 |pmc=4993058 |doi= |url=}}</ref><ref name="pmid178831912">{{cite journal |vauthors=Galli J, Calò L, Ardito F, Imperiali M, Bassotti E, Fadda G, Paludetti G |title=Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis |journal=Acta Otorhinolaryngol Ital |volume=27 |issue=3 |pages=134–8 |year=2007 |pmid=17883191 |pmc=2640046 |doi= |url=}}</ref> | ||
===Laboratory Findings=== | ===Laboratory Findings=== | ||
Laboratory findings consistent with the diagnosis of adenoiditis include [[neutrophilia]], positive [[Culture collection|culture]] for organism | Laboratory findings consistent with the diagnosis of adenoiditis include [[neutrophilia]], positive [[Culture collection|culture]] for organism from throat exam sampling, and positive [[blood culture]] for the organism in severe cases.<ref name="pmid17883191">{{cite journal |vauthors=Galli J, Calò L, Ardito F, Imperiali M, Bassotti E, Fadda G, Paludetti G |title=Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis |journal=Acta Otorhinolaryngol Ital |volume=27 |issue=3 |pages=134–8 |year=2007 |pmid=17883191 |pmc=2640046 |doi= |url=}}</ref> | ||
=== Imaging Findings === | === Imaging Findings === | ||
On lateral neck x-ray, adenoiditis is characterized by enlargement of adenoids and narrowing of airways. | On lateral neck x-ray, adenoiditis is characterized by enlargement of adenoids and narrowing of airways. [[Adenoiditis]] diagnosis can be confirmed if during flexible or rigid nasopharyngoscopy inflamed adenoid tissue is seen. Flexible or rigid nasopharyngoscopy can provide a direct visualization of [[Nasopharyngeal carcinoma|nasopharynx]] and [[Waldeyer's ring|Waldeyer]] ring so that the inflamed adenoid tissue can be seen too.<ref name="pmid24919758">{{cite journal |vauthors=Ramji M, Biron VL, Jeffery CC, Côté DW, El-Hakim H |title=Validation of pharyngeal findings on sleep nasopharyngoscopy in children with snoring/sleep disordered breathing |journal=J Otolaryngol Head Neck Surg |volume=43 |issue= |pages=13 |year=2014 |pmid=24919758 |pmc=4092353 |doi=10.1186/1916-0216-43-13 |url=}}</ref> | ||
[[Adenoiditis]] diagnosis can be confirmed if during flexible or rigid nasopharyngoscopy inflamed adenoid tissue is seen. Flexible or rigid nasopharyngoscopy can provide a direct visualization of [[Nasopharyngeal carcinoma|nasopharynx]] and [[Waldeyer's ring|Waldeyer]] ring so the inflamed adenoid tissue can be seen too.<ref name="pmid24919758">{{cite journal |vauthors=Ramji M, Biron VL, Jeffery CC, Côté DW, El-Hakim H |title=Validation of pharyngeal findings on sleep nasopharyngoscopy in children with snoring/sleep disordered breathing |journal=J Otolaryngol Head Neck Surg |volume=43 |issue= |pages=13 |year=2014 |pmid=24919758 |pmc=4092353 |doi=10.1186/1916-0216-43-13 |url=}}</ref> | |||
==Treatment== | ==Treatment== | ||
===Medical Therapy=== | ===Medical Therapy=== | ||
The mainstay of therapy for adenoiditis is symptomatic therapy. | The mainstay of therapy for adenoiditis is symptomatic therapy. Medical therapy is recommended among patients with recurrent and chronic adenoiditis. The best antibiotic therapy regimen include [[amoxicillin]] - [[clavulanic acid]] or [[cephalosporin]]. | ||
===Surgery=== | ===Surgery=== | ||
Surgery is not the first-line treatment option for patients with adenoiditis. [[Adenoidectomy]] is usually reserved for patients with chronic persistent adenoiditis | Surgery is not the first-line treatment option for patients with adenoiditis. [[Adenoidectomy]] is usually reserved for patients with chronic persistent adenoiditis who developed [[adenoid hypertrophy]]. [[Adenoidectomy]] has shown to be effective independent of the size of the adenoids.<ref name="pmid20111586">{{cite journal |vauthors=El-Badrawy A, Abdel-Aziz M |title=Transoral endoscopic adenoidectomy |journal=Int J Otolaryngol |volume=2009 |issue= |pages=949315 |year=2009 |pmid=20111586 |pmc=2809357 |doi=10.1155/2009/949315 |url=}}</ref> | ||
==Prevention== | ==Prevention== | ||
| Line 74: | Line 59: | ||
===Secondary Prevention=== | ===Secondary Prevention=== | ||
[[Secondary prevention]] involves usage of antibiotics to prevent recurrence of adenoiditis. It can be helpful in certain circumstances | [[Secondary prevention]] involves usage of antibiotics to prevent recurrence of adenoiditis. It can be helpful in certain circumstances like history of [[rheumatic fever]], to prevent pharyngitis cause by [[group A beta-hemolytic streptococci]].<ref name="pmid96247642">{{cite journal| author=Dagnelie CF, Bartelink ML, van der Graaf Y, Goessens W, de Melker RA| title=Towards a better diagnosis of throat infections (with group A beta-haemolytic streptococcus) in general practice. | journal=Br J Gen Pract | year= 1998 | volume= 48 | issue= 427 | pages= 959-62 | pmid=9624764 | doi= | pmc=1409991 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9624764 }}</ref> | ||
==Related Chapters== | ==Related Chapters== | ||
*[[Tonsilitis]] | *[[Tonsilitis]] | ||
==References== | ==References== | ||
{{reflist|2}}adenoids can contribute to recurrent sinusitis and chronic persistent or recurrent ear disease because they can harbor a chronic infection.adenoids can contribute to recurrent sinusitis and chronic persistent or recurrent ear disease because they can harbor a chronic infection. | {{reflist|2}}adenoids can contribute to recurrent sinusitis and chronic persistent or recurrent ear disease because they can harbor a chronic infection.adenoids can contribute to recurrent sinusitis and chronic persistent or recurrent ear disease because they can harbor a chronic infection. | ||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Otolaryngology]] | |||
[[Category:Pediatrics]] | |||
[[Category:Pulmonology]] | |||
[[Category:Emergency medicine]] | |||
[[Category:Infectious disease]] | |||
[[Category:Surgery]] | |||
Latest revision as of 20:18, 29 July 2020
|
Adenoiditis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Overview
Adenoid is a lymphoid tissue that forms the Waldeyer ring. Adenoiditis is the inflammation of adenoid tissue. Adenoid infection is mostly due to viral infections. Some bacterial pathogens including H. influenzae, group A β-hemolytic streptococcus, and S. aureus can cause the disease as well. Adenoids can cause recurrent sinusitis and chronic persistent or recurrent otitis if left untreated and can lead to chronic adenoiditis. Medications (antibiotics or steroids) or surgical approach may be required for the management of adenoiditis, depending on the causative agent.
Historical perspective
Adenoid was thought to be a part of tonsils and responsible for the symptoms of nasal congestion and obstruction. As a result adenotonsilectomy was performed for at least 2000 years. In the early beginning of 19th century, adenoid and tonsil tissue were known as remnants of an unknown infectious disease, and so they were removed with adenotonsilectomy. Willhelm Meyer of Copenhagen, Denmark in 1800 firstly describe adenoiditis due to adenoid vegetations responsible for nasal symptoms and impaired hearing. He probably was the first one who performed an adenoidectomy separately.
Classification
Adenoiditis can be classified into the following types including acute adenoiditis, recurrent acute adenoiditis, and chronic/persistant adenoiditis.[1]
Pathophysiology
Adenoids are involved in the production of mostly secretory IgA. IgA is transported to the surface providing local immune protection. Studies suggest that a reduction in IgA will occur after an adenoidectomy.[2] bacteria in the normal flora of the oral cavity, are found in adenoid tissue as well. These include alpha-hemolytic streptococci, enterococci, Corynebacterium species, Coagulase-negative staphylococci, Neisseria species, haemophilus species, micrococcus species, stomatococcus species. Adenoiditis can occur as a result of infection. They can harbor pathogenic bacteria, which may lead to the development of disease of the ears, nose, and sinuses. Adenoiditis can progress to chronic disease if it remains untreated for a long period of time.
Causes
Acute adenoiditis is mainly due to viral infection but bacterial infections can cause the disease as well. Bacterial infections have a more important role in recurrent and chronic adenoiditis. The most important viral causes of adenoiditis include EBV, CMV and RSV. The most important bacterial causes adenoiditis include Haemophilus influenzae, group A β-hemolytic streptococcus, and staphylococcus aureus.[3]
Differentiating tonsillitis from other diseases
Diagnosis of adenoiditis can be challenging as majority of upper respiratory tract infections present in the same pattern. The most important differential diagnosis of adenoiditis includes tonsilitis, viral upper respiratory tract infection, sinusitis and pharyngitis.
Epidemiology and Demographics
The prevalence of adenoiditis is not completely known. Research indicates that 15-30% of sore throats in children and 5-10% sore throats in adults are due to bacterial adenotonsillitis. The prevalence of adenoiditis decreases with age. Adenoid tissue undergoes atrophy after 10 years of age, so adenoiditis is rarely seen after 15 years.[4][5][6][7][8]
Risk Factors
The most potent risk factor in the development of adenoiditis is being a young child. Other risk factors include immunodeficiencies, living in an urban environment with more exposure to viruses or bacteria and usage of immunosuppressant drugs.
Screening
There is insufficient evidence to recommend routine screening for adenoiditis.
Natural history, complications and prognosis
Natural History
Acute adenoiditis will usually present with erythema and edema of the adenoids. This occurs rapidly upon infiltration of the adenoids by the pathogen.[9] Symptoms including fever and sore throat will usually manifest within 24 hours of infection. Adenoiditis is usually combined with tonsillitis due to close anatomical location.
Complications
Complications of adenoiditis are caused by persistence and/or spread of the responsible pathogen - usually bacterial. The complications of adenoiditis include speech abnormalities, otitis media, acute sinusitis, pneumonia, adenoid hyperplasia, peritonsillar abscess, and sleep apnea.
Prognosis
The prognosis for acute adenoiditis without treatment is usually good. Adenoiditis is usually a self-limiting disease and resolves by itself within 3-4 days.[10]
Diagnosis
Diagnostic criteria
There is no criteria for the diagnosis of adenoiditis. However, seeing inflamed and hypertrophied adenoid tissue with flexible or rigid nasopharyngoscopy can be used as a criteria for adenoidectomy in patients suspected of chronic adenoiditis.
History and Symptoms
A positive history of fever, nasal obstruction, and snoring is suggestive of adenoiditis. The most common symptoms of adenoiditis include purulent nasal discharge, mouth breathing, nasal pain and sore throat.[11][12][13]
Physical Examination
Patients with adenoiditis are usually well-appearing. Physical examination of patients with adenoiditis is usually remarkable for fever, and purulent nasal discharge.[14][15][16]
Laboratory Findings
Laboratory findings consistent with the diagnosis of adenoiditis include neutrophilia, positive culture for organism from throat exam sampling, and positive blood culture for the organism in severe cases.[17]
Imaging Findings
On lateral neck x-ray, adenoiditis is characterized by enlargement of adenoids and narrowing of airways. Adenoiditis diagnosis can be confirmed if during flexible or rigid nasopharyngoscopy inflamed adenoid tissue is seen. Flexible or rigid nasopharyngoscopy can provide a direct visualization of nasopharynx and Waldeyer ring so that the inflamed adenoid tissue can be seen too.[18]
Treatment
Medical Therapy
The mainstay of therapy for adenoiditis is symptomatic therapy. Medical therapy is recommended among patients with recurrent and chronic adenoiditis. The best antibiotic therapy regimen include amoxicillin - clavulanic acid or cephalosporin.
Surgery
Surgery is not the first-line treatment option for patients with adenoiditis. Adenoidectomy is usually reserved for patients with chronic persistent adenoiditis who developed adenoid hypertrophy. Adenoidectomy has shown to be effective independent of the size of the adenoids.[19]
Prevention
Primary Prevention
Primary prevention strategies to prevent adenoiditis include hygienic practices.
Secondary Prevention
Secondary prevention involves usage of antibiotics to prevent recurrence of adenoiditis. It can be helpful in certain circumstances like history of rheumatic fever, to prevent pharyngitis cause by group A beta-hemolytic streptococci.[20]
Related Chapters
References
- ↑ "Head & Neck Surgery--otolaryngology - Google Books".
- ↑ Havas T, Lowinger D (2002). "Obstructive adenoid tissue: an indication for powered-shaver adenoidectomy". Arch. Otolaryngol. Head Neck Surg. 128 (7): 789–91. PMID 12117336.
- ↑ Havas T, Lowinger D (2002). "Obstructive adenoid tissue: an indication for powered-shaver adenoidectomy". Arch. Otolaryngol. Head Neck Surg. 128 (7): 789–91. PMID 12117336.
- ↑ Komaroff AL, Pass TM, Aronson MD, Ervin CT, Cretin S, Winickoff RN, Branch WT (1986). "The prediction of streptococcal pharyngitis in adults". J Gen Intern Med. 1 (1): 1–7. PMID 3534166.
- ↑ Kaplan EL, Top FH, Dudding BA, Wannamaker LW (1971). "Diagnosis of streptococcal pharyngitis: differentiation of active infection from the carrier state in the symptomatic child". J. Infect. Dis. 123 (5): 490–501. PMID 5115179.
- ↑ Schroeder BM (2003). "Diagnosis and management of group A streptococcal pharyngitis". Am Fam Physician. 67 (4): 880, 883–4. PMID 12613739.
- ↑ Sharav, Yair; Benoliel, Rafael (2008). Orofacial Pain and Headache. Elsevier. ISBN 0723434123.
- ↑ Pagella F, De Amici M, Pusateri A, Tinelli G, Matti E, Benazzo M, Licari A, Nigrisoli S, Quaglini S, Ciprandi G, Marseglia GL (2015). "Adenoids and clinical symptoms: Epidemiology of a cohort of 795 pediatric patients". Int. J. Pediatr. Otorhinolaryngol. 79 (12): 2137–41. doi:10.1016/j.ijporl.2015.09.035. PMID 26478108.
- ↑ "Tonsillitis - NHS Choices".
- ↑ "Tonsillitis - NHS Choices".
- ↑ Kosikowska U, Korona-Głowniak I, Niedzielski A, Malm A (2015). "Nasopharyngeal and Adenoid Colonization by Haemophilus influenzae and Haemophilus parainfluenzae in Children Undergoing Adenoidectomy and the Ability of Bacterial Isolates to Biofilm Production". Medicine (Baltimore). 94 (18): e799. doi:10.1097/MD.0000000000000799. PMC 4602522. PMID 25950686.
- ↑ Kajan ZD, Sigaroudi AK, Mohebbi M (2016). "Prevalence and patterns of palatine and adenoid tonsilloliths in cone-beam computed tomography images of an Iranian population". Dent Res J (Isfahan). 13 (4): 315–21. PMC 4993058. PMID 27605988.
- ↑ Galli J, Calò L, Ardito F, Imperiali M, Bassotti E, Fadda G, Paludetti G (2007). "Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis". Acta Otorhinolaryngol Ital. 27 (3): 134–8. PMC 2640046. PMID 17883191.
- ↑ Kosikowska U, Korona-Głowniak I, Niedzielski A, Malm A (2015). "Nasopharyngeal and Adenoid Colonization by Haemophilus influenzae and Haemophilus parainfluenzae in Children Undergoing Adenoidectomy and the Ability of Bacterial Isolates to Biofilm Production". Medicine (Baltimore). 94 (18): e799. doi:10.1097/MD.0000000000000799. PMC 4602522. PMID 25950686.
- ↑ Kajan ZD, Sigaroudi AK, Mohebbi M (2016). "Prevalence and patterns of palatine and adenoid tonsilloliths in cone-beam computed tomography images of an Iranian population". Dent Res J (Isfahan). 13 (4): 315–21. PMC 4993058. PMID 27605988.
- ↑ Galli J, Calò L, Ardito F, Imperiali M, Bassotti E, Fadda G, Paludetti G (2007). "Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis". Acta Otorhinolaryngol Ital. 27 (3): 134–8. PMC 2640046. PMID 17883191.
- ↑ Galli J, Calò L, Ardito F, Imperiali M, Bassotti E, Fadda G, Paludetti G (2007). "Biofilm formation by Haemophilus influenzae isolated from adeno-tonsil tissue samples, and its role in recurrent adenotonsillitis". Acta Otorhinolaryngol Ital. 27 (3): 134–8. PMC 2640046. PMID 17883191.
- ↑ Ramji M, Biron VL, Jeffery CC, Côté DW, El-Hakim H (2014). "Validation of pharyngeal findings on sleep nasopharyngoscopy in children with snoring/sleep disordered breathing". J Otolaryngol Head Neck Surg. 43: 13. doi:10.1186/1916-0216-43-13. PMC 4092353. PMID 24919758.
- ↑ El-Badrawy A, Abdel-Aziz M (2009). "Transoral endoscopic adenoidectomy". Int J Otolaryngol. 2009: 949315. doi:10.1155/2009/949315. PMC 2809357. PMID 20111586.
- ↑ Dagnelie CF, Bartelink ML, van der Graaf Y, Goessens W, de Melker RA (1998). "Towards a better diagnosis of throat infections (with group A beta-haemolytic streptococcus) in general practice". Br J Gen Pract. 48 (427): 959–62. PMC 1409991. PMID 9624764.
adenoids can contribute to recurrent sinusitis and chronic persistent or recurrent ear disease because they can harbor a chronic infection.adenoids can contribute to recurrent sinusitis and chronic persistent or recurrent ear disease because they can harbor a chronic infection.