Int J Pediatr Otorhinolaryngol. 2016 Nov;90:128-132. doi: 10.1016/j.ijporl.2016.09.006. Epub 2016 Sep 14.
The ubiquity of asymptomatic respiratory viral infections in the tonsils and adenoids of children and their impact on airway obstruction.
Faden H1, Callanan V2, Pizzuto M3, Nagy M4, Wilby M5, Lamson D6, Wrotniak B7, Juretschko S8, St George K9.
Abstract
BACKGROUND:
Airway
obstruction due to enlargement of tonsils and adenoids is a common
pediatric problem resulting in sleep disordered breathing. The cause for
the relatively abnormal growth of tonsils and adenoids is poorly
understood.
METHODS:
Non-acutely ill children undergoing tonsillectomy and adenoidectomy (T&A) for various reasons were enrolled prospectively in a study to determine the frequency of asymptomatic respiratory viral infections in each lymphoid tissue and to relate the number and types of virus to the degree of airway obstruction. Molecular techniques were used to detect 9 respiratory viruses while Brodsky scores and measurements of percentages airway obstruction were used to estimate the degree of airway compromise due to the tonsil and adenoid, respectively.
RESULTS:
Viruses were detected in 70.9% of tonsils and 94.7% of adenoids, p < 0.001.
Adenovirus was the most common virus detected at 71.1%.
Adenoids had an average of 2.4 viruses compared to 0.92 for tonsils, p < 0.001. Higher Brodsky scores were only associated with EBV in tonsils, p = 0.03, while greater percentages of airway obstruction in the adenoids were associated with adenovirus, EBV, corona virus, parainfluenza virus and rhinovirus, p ≤ 0.005.
CONCLUSIONS:
Asymptomatic viral infections are common and directly related to the degree of airway obstruction significantly more often in adenoids than tonsils.
METHODS:
Non-acutely ill children undergoing tonsillectomy and adenoidectomy (T&A) for various reasons were enrolled prospectively in a study to determine the frequency of asymptomatic respiratory viral infections in each lymphoid tissue and to relate the number and types of virus to the degree of airway obstruction. Molecular techniques were used to detect 9 respiratory viruses while Brodsky scores and measurements of percentages airway obstruction were used to estimate the degree of airway compromise due to the tonsil and adenoid, respectively.
RESULTS:
Viruses were detected in 70.9% of tonsils and 94.7% of adenoids, p < 0.001.
Adenovirus was the most common virus detected at 71.1%.
Adenoids had an average of 2.4 viruses compared to 0.92 for tonsils, p < 0.001. Higher Brodsky scores were only associated with EBV in tonsils, p = 0.03, while greater percentages of airway obstruction in the adenoids were associated with adenovirus, EBV, corona virus, parainfluenza virus and rhinovirus, p ≤ 0.005.
CONCLUSIONS:
Asymptomatic viral infections are common and directly related to the degree of airway obstruction significantly more often in adenoids than tonsils.
Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
KEYWORDS:
Adenoid; Airway obstruction; Obstructive sleep apnea; Recombinant adenovirus; Respiratory virus; Sleep-disordered breathing; Tonsil; Tonsil and adenoid hypertrophy
- PMID:
- 27729119
- DOI:
- 10.1016/j.ijporl.2016.09.006
- [Indexed for MEDLINE]
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