Enlargement of Tonsil or Adenoid
Conditions
Keywords
obstructive sleep apnea, tonsillitis, middle ear effusion, pathophysiology, score
Brief summary
Adenotonsillar hypertrophy is the principal cause of obstructive sleep apnea of childhood, yet little is known with regard to its pathophysiologic and molecular mechanisms. The present trial examines potential bioclinical markers of the disease.
Detailed description
Background: Tonsils and adenoids comprise the main bulk of Waldeyer's ring, which is commonly enlarged in childhood, until the age of 11. Obstructive sleep apnea caused by adenotonsillar hypertrophy is a major contributing factor to cardiorespiratory morbidity in the pediatric population. It is also responsible for otitis media with effusion, the most frequent cause of children's hearing loss. Even so, there is scarce knowledge of its molecular pathogenesis. Objective: Identification of clinical/molecular markers of adenotonsillar enlargement and investigation of their participation in the process of tissue hypertrophy. Methods: A prospective cohort of children with adenotonsillar hypertrophy were recruited starting on 02/01/2017 and ending on 12/22/2017. Demographic and clinical data including age, gender, sleep apnea severity, tonsillar size, presence of middle ear effusion, family history, review of systems as well as tympanometric and complete blood count results were recorded. Blood samples and tissue specimens from the therapeutic adenotonsillectomy procedure were archived for future analyses. Children with chronic tonsillitis and/or adenoiditis, who also underwent excision of tonsils and/or adenoids served as study controls. Informed consent was obtained from parents of all study participants.
Interventions
DIAGNOSTIC_TESTComplete Blood Count
White blood cell subgroups count
DIAGNOSTIC_TESTTympanometry
Conventional and multifrequency tympanometry, documenting middle ear admittance and absorbance
PROCEDURETonsillectomy and/or adenoidectomy
Excision of palatine and/or pharyngeal tonsils.
Sponsors
University of Patras
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
1 Years to 16 Years
Healthy volunteers
No
Inclusion criteria
* Available history and physical exam findings * Available complete blood count and tympanometry at admission
Exclusion criteria
* Previous tonsillectomy and/or adenoidectomy. * Previous ear surgery. * Acute infection during the past month. * Active severe systemic disease.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Bioclinical profile of adenotonsillar hypertrophy | One year post surgical procedure | Clinical, laboratory, and molecular markers of adenotonsillar hypertrophy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical markers of adenotonsillar hypertrophy | One year post surgical procedure | Clinical findings from history (sympoms) and physical exam (signs) suggestive of adenotonsillar hypertrophy. |
| Laboratory markers of adenotonsillar hypertrophy | One year post surgical procedure | Complete blood count (cells/L) |
| Tympanometric findings of middle ear disease resulting from adenotonsillar hypertrophy | One year post surgical procedure | Middle ear pressure (dekaPascals) |
| Wide-Band tympanometric findings of middle ear disease resulting from adenotonsillar hypertrophy | One year post surgical procedure | Resonance frequency of the middle ear (Hz) |
| Molecular determinants of adenotonsillar hypertrophy | One year post surgical procedure | Immunohistochemical expression of molecular factors involved in tissue growth (semiquantitative scale) |
Countries
Greece
Outcome results
None listed