Treatment of hypertrophy of adenoids. Balancing between adenotomy and medication

##plugins.themes.bootstrap3.article.main##

Ф. Б. Юрочко

Abstract

The key symptoms of adenoidal hypertrophy, diagnostic tool for this pathology and adenoidectomy indications are described in this article. The negative outcomes of adenoidectomy are also described (surgery complications and long-term influence on adult health). Treatment by intranasal corticosteroids, a new method of non-surgical treatment of adenoid hypertrophy, is described in details.

##plugins.themes.bootstrap3.article.details##

How to Cite
Юрочко, Ф. Б. (2018). Treatment of hypertrophy of adenoids. Balancing between adenotomy and medication. Family Medicine, (3), 100–106. https://doi.org/10.30841/2307-5112.3.2018.146896
Section
Otolaryngology
Author Biography

Ф. Б. Юрочко, Lviv Regional Children's Clinical Hospital «OKHMATDYT»

Fedir B. Yurochko,

Otolaryngology Division

References

Alexopoulos EI, Kaditis AG, Kalampouka E, Kostadima E, Angelopoulos NV, Mikraki V, et al. 2004 Nasal corticosteroids for children with snoring. Pediatr Pulmonol;38:161–167. https://doi.org/10.1002/ppul.20079

Au CT, Li AM. 2009 Obstructive sleep breathing disorders. Pediatr Clin North Am.; 56(1):243–259. https://doi.org/10.1016/j.pcl.2008.10.012

Baugh RF, Archer SM, Mitchell RB, et al. 2011 American Academy of Otolaryngology – Head and Neck Surgery Foundation. Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg.; 144(1 Suppl):S1–30. https://doi.org/10.1177/0194599810389949

Berlucchi M, Salsi D, Valetti L, Parrinello G, Nicolai P. 2007 The role of mometasone furoate aqueous nasal spray in the treatment of adenoidal hypertrophy in the pediatric age group: preliminary results of a prospective, randomized study. Pediatrics;119:e1392–7. https://doi.org/10.1542/peds.2006-1769

Berlucchi M, Sessa M. 2010 Can adenoidal hypertrophy be treated with intranasal steroids? Rev Recent Clin Trials; 5(2):123–127. https://doi.org/10.2174/157488710791233590

Berlucchi M, Valetti L, Parrinello G, et al. 2008 Long-term followup of children undergoing topical intranasal steroid therapy for adenoidal hypertrophy. Int J Pediatr Otorhinolaryngol;72(8):1171–1175. https://doi.org/10.1016/j.ijporl.2008.04.001

Bhargava R, Chakravarti A. 2014 Role of mometasone furoate aqueous nasal spray for management of adenoidal hypertrophy in children. J Laryngol Otol. Dec;128(12):1060–6. https://doi.org/10.1017/S0022215114002503 Epub 2014 Nov 18.

Bitar, M. A., Mahfoud, L., Nassar, J., Dana, R. 2013 Exploring the characteristics of children with obstructive adenoid responding to mometasone fuorate monohydrate: preliminary results. Eur Arch Otorhinolaryngol 270, 931–937. https://doi.org/10.1007/s00405-012-2155-8

Boner A. L. 2001 Effects of intranasal corticosteroids on the hypothalamic pituitary-adrenal axis in children. J Allergy Clin Immunol 108, S32–9. https://doi.org/10.1067/mai.2001.115564

Boonacker CW, Rovers MM, Browning GG, et al 2014 Adenoidectomy with or without grommets for children with otitis media: an individual patient data meta-analysis. Health Technol Assess.; 18(5):1–118. https://doi.org/10.3310/hta18050

Brandtzaeg P. 2003 Immunology of tonsils and adenoids: everything the ENT surgeon needs to know. Int J Pediatr Otorhinolaryngol. 2003;67(suppl 1):S69–S76. http://dx.doi.org/10.1016/S0531-5131(03)00964-6

Brodsky L. 1989 Modern assessment of tonsils and adenoids. Pediatr Clin North Am.;36:1551–1569. https://doi.org/10.1016/S0031-3955(16)36806-7

Brodsky L., Poje Ch. 2006 Tonsillitis, Tonsillectomy, and Adenoidectomy, Byron J. Bailey and Jonas T. Johnson, Head and Neck Surgery-Otolaryngology, 4th edition, Lippincott Williams & Wilkins.,84:1194.

Brouillette R. T. et al. 2001 Efficacy of fluticasone nasal spray for pediatric obstructive sleep apnea. J Pediatr 138, 838–844. https://doi.org/10.1067/mpd.2001.114474

Brouillette RT, Fernbach SK, Hunt CE. 1982 Obstructive sleep apnea in infants and children. Journal of Pediatrics; 100(1):31–40. https://doi.org/10.1016/S0022-3476(82)80231-X

Buchinsky, F.J., Lawry, M.A., Isaacson, G. 2000 Do adenoids regrow after excision? Otolaryngol Head Neck Surg 123, 576–581. https://doi.org/10.1067/mhn.2000.110727

Burns, JJ. Griffen G, Smith T, et al. 2017 Chapter 339: Tonsillectomy and Adenoidectomy. In: American Academy of Pediatrics Textbook of Pediatric Care, 2nd Edition. McInerny TK, Adam HM, Cambell DE, et al, Eds.. Available at: https://pediatriccare.solutions.aap.org/chapter.aspx?sectionid=124826257&bookid=1626 Accessed on April 28, 2017.

Byars S.G., Steams S.C., Boomsma J.J. 2018 Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases With Removal of Adenoids and Tonsils in Childhood JAMA Otolaryngol Head Neck Surg. 2018 Jul 1;144(7):594-603 https://doi.org/10.1001/jamaoto.2018.0614

Casselbrant ML. 1999 What is wrong in chronic adenoiditis/tonsillitis anatomical considerations. Int J Pediatr Otorhinolaryngol. 1999;49 (suppl 1):S133-S135. https://doi.org/10.1016/S0165-5876(99)00147-0

Cengel S., Akyol M. U. 2006 The role of topical nasal steroids in the treatment of children with otitis media with effusion and/or adenoid hypertrophy. Int J Pediatr Otorhinolaryngol 70, 639–645. https://doi.org/10.1016/j.ijporl.2005.08.013

Chadha NK, Zhang L, Mendoza-Sassi RA, Cesar JA. 2009 Using nasal steroids to treat nasal obstruction caused by adenoid hypertrophy: does it work? Otolaryngol Head Neck Surg;140:139–147. https://doi.org/10.1016/j.otohns.2008.11.008

Chan J, Edman JC, Koltai PJ. 2004 Obstructive sleep apnea in children. Am Fam Physician.; 69(5):1147–1154. PDF

Chisholm EJ, Lew-Gor S, Hajioff D, Caulfield H. 2005 Adenoid size assessment: a comparison of palpation, nasendoscopy and mirror examination. Clinical Otolaryngology; 30: 39–41. https://doi.org/10.1111/j.1365-2273.2004.00903.x

Chohan A, Lal A, Chohan K, Chakravarti A, Gomber S. 2015 Systematic review and meta-analysis of randomized controlled trials on the role of mometasone in adenoid hypertrophy in children. Int J Pediatr Otorhinolaryngol. Oct;79(10):1599-608. https://doi.org/10.1016/j.ijporl.2015.07.009 Epub 2015 Jul 13.

Ciprandi G, Varricchio A, Capasso M, Varricchio AM, De Lucia A, Ascione E, et al. 2007 Intranasal flunisolide treatment in children with adenoidal hypertrophy. International Journal of Immunopathology and Pharmacology;20(4):833–6. https://doi.org/10.1177/039463200702000420

Clinical UM Guideline. 2017 Adenoidectomy. Guideline #: CGSURG-36 Publish Date 06/28/2017 https://www.unicare.com/medicalpolicies/guidelines/gl_pw_c166613.htm

Cohen D, Konak S. 1985 The evaluation of radiographs of the nasopharynx. Clinical Otolaryngology and Allied Sciences;10:73–8. https://doi.org/10.1111/j.1365-2273.1985.tb01170.x

Criscuoli G, D’Amora S, Ripa G, Cinquegrana G,Mansi N, Impagliazzo N, et al. 2003 Frequency of surgery among children who have adenotonsillar hypertrophy and improve after treatment with nasal beclomethasone. Pediatrics;111: e236–8. http://dx.doi.org/10.1542/peds.111.3.e236

Cummings CW, Flint PW, Harker LA, et al. 2005 Otolaryngology Head and Neck Surgery. San Francisco: Mosby

Demain J. G., Goetz D. W. 1995 Pediatric adenoidal hypertrophy and nasal airway obstruction: reduction with aqueous nasal beclomethasone. Pediatrics 95, 355–364. PDF 10.1542/peds.95.3.355

Demirhan H, Aksoy F, Ozturan O, Yildirim YS, Veyseller B. 2010 Medical treatment of adenoid hypertrophy with “fluticasone propionate nasal drops”. International Journal of Pediatric Otorhinolaryngology; 74(7):773–6. https://doi.org/10.1016/j.ijporl.2010.03.051

Derenforf H., Meltzer E.O. 2008 Molecular and clinical pharmacology of intranasal corticosteroids: clinical and therapeutic implications. Allergy 63, 1292–300. https://doi.org/10.1111/j.1398-9995.2008.01750.x

Donaldson GP, Lee SM, Mazmanian SK. 2016 Gut biogeography of the bacterial microbiota. Nat Rev Microbiol; (1)14:32–20. https://doi.org/10.1038/nrmicro3552

Dowling DJ, Levy O. 2014 Ontogeny of early life immunity. Trends Immunol; 35(7): 299–310. https://doi.org/10.1016/j.it.2014.04.007

Fujioka M, Young LW, Girdany BR. 1979 Radiographic evaluation of adenoidal size in children: adenoidalnasopharyngeal ratio. American Journal of Radiology; 173:401–4. https://doi.org/10.2214/ajr.133.3.401

Garetz SL, Mitchell RB, Parker PD, et al. 2015 Quality of life and obstructive sleep apnea symptoms after pediatric adenotonsillectomy. Pediatrics;135:e477–e486. https://doi.org/10.1542/peds.2014-0620

Gates GA, Muntz HR, Gaylis B. 1992 Adenoidectomy and otitis media. Annals of Otology, Rhinology and Laryngology; 101:24–32. https://doi.org/10.1177%2F00034894921010S106

Gluckman PD, Hanson MA. 2006 Developmental origins of health and disease. Cambridge, England: Cambridge University Press. https://doi.org/10.1017/CBO9780511544699

Goenka A, Kollmann TR. 2015 Development of immunity in early life. J Infect. 2015;71(suppl 1):S112–S120. https://doi.org/10.1016/j.jinf.2015.04.027

Goldbart AD, Veling MC, Goldman JL, et al. 2005 Glucocorticoid receptor subunit expression in adenotonsillar tissue of children with obstructive sleep apnea. Pediatr Res; 57(2):232–236. https://doi.org/10.1203/01.PDR.0000150722.34561.E6

Gozal D. 1998 Sleep-disordered breathing and school performance in children. Pediatrics; 102:616–20. PDF

Grimmer JF, Poe DS. 2005 Update on Eustachian tube dysfunction and the patulous Eustachian tube. Current Opinion in Otolaryngology and Head and Neck Surgery; 13:277–82. https://doi.org/10.1097/01.moo.0000176465.68128.45

Grob GN. 2007 The rise and decline of tonsillectomy in twentieth-century America. J Hist Med Allied Sci; 2007 Oct;62(4):383–421. https://doi.org/10.1093/jhmas/jrm003

Guilleminault C, Korobkin R, Winkle R. 1981 A review of 50 children with obstructive sleep apnea syndrome. Lung;159:275–87. https://link.springer.com/article/10.1007%2FBF02713925

Gupta V, Gupta М, Matreja PS, Singh S. 2014 Efficacy of Mometasone Nasal Spray in Children with Snoring due to Adenoids. Clinical Rhinology: An International Journal, January-April;7(1):1–4. https://doi.org/10.5005/jp-journals-10013-1179

Hanson MA, Gluckman PD. 2008 Developmental origins of health and disease: new insights. Basic Clin Pharmacol Toxicol 2008 Feb;102(2):90–3. https://doi.org/10.1111/j.1742-7843.2007.00186.x

Hassanzadeh N., Majidi M.R., Salehi M. 2014 The Efficacy of Mometasone Furoate Nasal Spray in the Treatment of Adenoidal Hypertrophy in Children. Otolaryngology–Head and Neck Surgery Vol 151, Issue 1_suppl. https://doi.org/10.1177%2F0194599814541627a230

Hong H, Chen F, Zheng X, Liao W, Liao Z, Cao Y, He H, Zhu Z, Fan Y 2017 Decreased frequency of adenoidectomy by a 12-week nasal budesonide treatment Therapeutics and Clinical Risk Management October 2017 Volume:13 Pages 1309–1316. https://doi.org/10.2147/TCRM.S144659

Izu SC, Itamoto CH, Pradella-Hallinan M, Pizarro GU, Tufi k S, Pignatari S, et al. 2010 Obstructive sleep apnea syndrome (OSAS) in mouth breathing children. Braz J Otorhinolaryngol;76:552–556. https://doi.org/10.1590/S1808-86942010000500003

Johanneson S. 1968 Roentgenologic investigation of the nasopharyngeal tonsil in children of different ages. Acta Radiologica: Diagnosis;7:299–304. https://doi.org/10.1177%2F028418516800700402

Joshua B., Bahar G., Sulkes J., Shpitzer T., Raveh E. 2006 Adenoidectomy: long-term follow-up. Otolaryngology, vol. 135, no. 4, pp. 576–580. https://doi.org/10.1016/j.otohns.2006.05.027

Kaditis AG, Alonso AM, Boudewyns A, et al. 2016 Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management. Eur Respir J.;47:69–94. https://doi.org/10.1183/13993003.00385-2015

Kenna MA. 2000 Tonsils and adenoids. In: Behrman RE, Kliegman RM, Jenson HB editor(s). Nelson Textbook of Pediatrics. 16th Edition. Philadelphia: W.B. Saunders,:1267–8.

Kheirandish-Gozal L, Gozal D. 2008 Intranasal budesonide treatment for children with mild obstructive sleep apnea syndrome. Pediatrics.;122:e149–e155. https://doi.org/10.1542/peds.2007-3398

Kheirandish-Gozal L, Serpero LD, Dayyat E, et al. 2009 Corticosteroids suppress in vitro tonsillar proliferation in children with obstructive sleep apnoea. Eur Respir J.;33:1077–1084. https://doi.org/10.1183/09031936.00130608

Lepcha A, Kurien M, Job A, Jeyaseelan L, Thomas K. 2002 Chronic adenoid hypertrophy in children – is steroid nasal spray beneficial? Indian Journal of Otolaryngology and Head and Neck Surgery; 54(4):280–4. https://doi.org/10.1007/BF02993743

Lieberthal AS, Carroll AE, Chonmaitree T, et al 2013 American Academy of Pediatrics Clinical Practice Guideline. The diagnosis and management of acute otitis media. Pediatrics; 131(3):e964-999. PDF Accessed on April 28, 2017.

Lim J, McKean M. 2006 Adenotonsillectomy for obstructive sleep apnoea in children. Cochrane Database of Systematic Reviews, Issue 2. https://doi.org/10.1002/14651858.CD003136.pub2

Liu, W. et al. 2017 Combination of mometasone furoate and oxymetazoline for the treatment of adenoid hypertrophy concomitant with allergic rhinitis: A randomized controlled trial. Sci. Rep. 7,40425. https://dx.doi.org/10.1038%2Fsrep40425

Lofstrand-Tidestrom B., Hultcrantz E. 2007 The development of snoring and sleep related breathing distress from 4 to 6 years in a cohort of Swedish children. Int J Pediatr Otorhinolaryngol 71, 1025–33. https://doi.org/10.1016/j.ijporl.2007.03.005

Madisetti S, Muppidi V, Jadi L, et al. 2017 Does intranasal steroids reduce the need of adenoidectomy in adenoid hypertrophy. J. Evid. Based Med. Healthc.; 4(47), 2871–2875. https://doi.org/10.18410/jebmh/2017/570

Marcus CL, Brooks LJ, Draper, KA, et al. 2012 American Academy of Pediatrics Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics; 130(3):576–584. https://doi.org/10.1542/peds.2012-1671

Mary K, Anjali L, John M, Arif A, Jeyaseelan L. 2005 X-rays in the evaluation of adenoid hypertrophy: its role in the endoscopic era. Journal of Indian Association of Pediatric Surgeons;57:45–7. https://dx.doi.org/10.1007%2FBF02907627

Menashe V, Farrehi F, Miller M. 1965 Hypoventilation and cor pulmonale due to chronic upper airway obstruction. Journal of Pediatrics;67:198–203. https://doi.org/10.1016/S0022-3476(65)80242-6

Mikals SJ, Brigger MT. 2014 Adenoidectomy as an adjuvant to primary tympanostomy tube placement: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg.; 140(2):95–101. https://doi.org/10.1001/jamaoto.2013.5842

Mira JGS, Pasinato RC, Mocellin M, Ferreira Neto O, Capasso R, Catam GSA, et al. 1998 Efeitos da adenoamigdalectomia no sistema imune humoral. Rev Bras Otorhinolaryngol; 64:437–440. Full text

Modrzynski M, Potyra F, Zawisza E. 2005 Radiographic evaluation of adenoidal size in children with allergic perennial rhinitis: still the current method. Polish Journal of Radiology;70:13–7. PDF

National Comprehensive Cancer Network® (NCCN). 2014 NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancer (V.2.2014). May 30. For additional information visit the NCCN website: http://www.nccn.org/. Accessed on August 20, 2014.

Nave H, Gebert A, Pabst R. 2001 Morphology and immunology of the human palatine tonsil. Anat Embryol (Berl);204:367–373. https://doi.org/10.1007/s004290100210

Neri G, Mennucci E, Ortore R, Leone O, Croce A. 2004 Rhinopharynx endoscopy in the diagnosis of chronic otitis media with effusion in infancy. Acta Otorhinolaryngologica Italica;24:63–7. PDF

Nico Jonas. 2018 Adenoidectomy surgery technique. Open access atlas of otolaryngology, head and neck operative surgery. https://vula.uct.ac.za/access/content/group/ba5fb1bd-be95-48e5-81be-586fbaeba29d/Paediatric%20Adenoidectomy.pdf Доступ 25 травня 2018.

Pagella F, Colombo A, Gatti O, Giourgos G, Matti E. 2010 Rhinosinusitis and otitis media: the link with adenoids. Int J Immunopathol Pharmacol; 23(Suppl 1):38–40.

Paradise JL, Bernard BS, Colborn K, Janosky JE. 1998 Assessment of adenoidal obstruction in children: clinical signs versus roentgenographic findings. Pediatrics;101:979–86. http://dx.doi.org/10.1542/peds.101.6.979

Paradise JL. 1995 Tonsillectomy and adenoidectomy. In: Bluestone CD, Stool SE editor(s). Pediatric Otolaryngology. 3rd Edition. Philadelphia: W.B. Saunders,:1054–65.

Passali D., Spinosi M.C., Crisanti A., Bellussi L.M. 2016 Mometasone furoate nasal spray: a systematic review. Multidisciplinary Respiratory Medicine 11:18 https://dx.doi.org/10.1186%2Fs40248-016-0054-3

Paulussen, C., Claes, J., Claes, G. & Jorissen, M. 2000 Adenoids and tonsils, indications for surgery and immunological consequences of surgery. Acta Otorhinolaryngol Belg 54, 403–408.

Pearl A. J., Manoukian J. J., 1994 Adenoidectomy: indirect visualization of choanal adenoids. Journal of Otolaryngology, vol. 23, no. 3, pp. 221–224.

Ramos SD, Mukerji S, Pine HS. 2013 Tonsillectomy and adenoidectomy. Pediatr Clin North Am, 60(4):793–807. https://doi.org/10.1016/j.pcl.2013.04.015

Randall DA, Hoffer ME. 1998 Complications of tonsillectomy and adenoidectomy. Otolaryngol Head Neck Surg 118(1):61–8. https://doi.org/10.1016%2FS0194-5998%2898%2970376-6

Rehman A., Malla R. A., Hamid S., Sangoo M. 2013 The Effect of Mometasone Furoate Nasal Spray on Adenoid Hypertrophy and Its Related Obstructive Sleep Apnea in Pediatric Age Group. Indian Journal of Applied Research Volume : III, Issue : X, October. http://dx.doi.org/10.15373/2249555X/OCT2013/98

Rezende RM, Silveira F, Barbosa AP. 2012 Objective reduction in adenoid tissue after mometasone furoate treatment. Int J Pediatr Otorhinolaryngol; 76:829–831. https://doi.org/10.1016/j.ijporl.2012.02.052

Rosenfeld RM, Shin JJ, Schwartz SR, et al. 2016 Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngol Head Neck Surg; 154(1 Suppl):S1-S41. https://doi.org/10.1177/0194599815623467

Rutkow IM. 1986 Ear, nose, and throat operations in the United States. Archives of Otolaryngology - Head and Neck Surgery;112:873–6. http://dx.doi.org/10.1001/archotol.1986.03780080073017

Samoliński B, Nowicka A, Wojas O, Lipiec A, Krzych-Fałta E, Tomaszewska A. 2014 Intranasal glucocorticosteroids - not only in allergic rhinitis In the 40th anniversary of intranasal glucocorticosteroids’ introduction. Otolaryngol Pol.; 68(2):51–64. https://doi.org/10.1016/j.otpol.2013.12.003

Santos F P, Weber R, Fortes B C, Pignatari Sh Sh N. 2013 Short and long term impact of adenotonsillectomy on the immune system. Braz J Otorhinolaryngol; 79(1):28–34. https://doi.org/10.5935/1808-8694.20130006

Schenkel, E. J. et al. 2000 Absence of growth retardation in children with perennial allergic rhinitis after one year of treatment with mometasone furoate aqueous nasal spray. Pediatrics 105, E22. http://dx.doi.org/10.1542/peds.105.2.e22

Sclafani AP, Ginsburg J, ShahMK, Dolistsky JN. 1998 Treatment of symptomatic chronic adenotonsillar hypertrophy with amoxicillin/clavulanate potassium: short- and long-term results. Pediatrics;101:675–81. https://doi.org/10.1542/peds.101.4.675

Sharma AA, Jen R, Butler A, Lavoie PM. 2012 The developing human preterm neonatal immune system: a case for more research in this area.Clin Immunol 145(1):61–8. https://doi.org/10.1016/j.clim.2012.08.006

Simon AK, Hollander GA, McMichael A. 2015 Evolution of the immune system in humans from infancy to old age. Proc Biol Scu 282(1821):20143085. https://doi.org/10.1098/rspb.2014.3085

Sobhy T.S. 2013 Role of Intranasal Steroid in the Prevention of Recurrent Nasal Symptoms after Adenoidectomy. International Journal of Otolaryngology Volume 2013, Article ID 603493, 5 pages https://doi.org/10.1155/2013/603493

Spruyt K. 2012 Pediatric Sleep disordered breathing: criteria and spectrum of disease. In: Pediatric Sleep disordered breathing in children: a comprehensive clinical guide to evaluation and treatment. Kheirandish-Gozal L; Gozal D (Eds.). Springer; New York, NY. https://doi.org/10.1007/978-1-60761-725-9

van den Akker EH, Sanders EA, van Staaij BK, Rijkers GT, Rovers MM, Hoes AW, et al. 2006 Long-term effects of pediatric adenotonsillectomy on serum immunoglobulin levels: results of a randomized controlled trial. Ann Allergy Asthma Immunol; 97:251–256. https://doi.org/10.1016/S1081-1206(10)60022-1

Waitrak BJ, Woolley AL. 2005 Pharyngitis and adenotonsilar disease. Em: Cummings CW, Flint PW, editors. Cummings otolaryngology head and neck surgery. 4th ed. Philadelphia: Elsevier Mosby; p.4135–4139.

Wang D, Clement P, Kaufman L, Derde MP. 1992 Fiberoptic examination of the nasal cavity and nasopharynx in children. International Journal of Pediatric Otolaryngology; 24: 35–44. http://dx.doi.org/10.1016/0165-5876(92)90064-V

Welch K.C., Goldberg A.N., 2008 Sleep disorders, Current Diagnosis and Treatment, otolaryngology head and neck surgery, 2nd edition. Anil K. Lalwani, 40:535. PDF

West LJ. 2002 Defining critical windows in the development of the human immune system. Hum Exp Toxicol 21(9-10):499–505. https://doi.org/10.1191/0960327102ht288oa

Wormald PJ, Prescott CA. 1992 Adenoids: comparison of radiological assessment methods with clinical and endoscopic findings. Journal of Laryngology and Otology;106:342–4. http://dx.doi.org/10.1017/S0022215100119449

Yilmaz H. B., Celebi S., Sahin-Yilmaz A., Oysu C. 2013 The role of mometasone furoate nasal spray in the treatment of adenoidal hypertrophy in the adolescents: a prospective, randomized, cross-over study. European Archives of Oto-Rhino-Laryngology September, Volume 270, Issue 10, pp 2657–2661. https://doi.org/10.1007/s00405-013-2364-9

Yong Gi Jung, , Hyo Yeol Kim, Jin-Young Min, Hun-Jong Dhong, Seung-Kyu Chung. 2011 Role of Intranasal Topical Steroid in Pediatric Sleep Disordered Breathing and Influence of Allergy, Sinusitis, and Obesity on Treatment Outcome Clinical and Experimental Otorhinolaryngology; 4(1):27–32. https://dx.doi.org/10.3342%2Fceo.2011.4.1.27

Zhang L, Mendoza-Sassi RA, Cesar JA, Chadha NK. 2008 Intranasal corticosteroids for nasal airway obstruction in children with moderate to severe adenoidal hypertrophy. Cochrane Database of Systematic Reviews, Issue 3. https://doi.org/10.1002/14651858.CD006286.pub2

Zojaji R, Mirzadeh M, Mazloum FBM, Khorashadizadeh M, Sabeti HR. 2014 The effect of adenotonsillectomy on children’s quality of life. Iran J Otorhinolaryngol.;26:199–205. http://dx.doi.org/10.22038/ijorl.2014.2864