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      • Record: found
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      Role of Peak Nasal Inspiratory Flow for Measuring the Effectiveness of Surgery in Children with Adenoidal Hypertrophy

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          Abstract

          Objective

          Nasal airway obstruction in children is a frequent problem in otolaryngology practice. Adenoidal hypertrophy (AH) is the most common pathology in childhood that requires surgery. Nasal patency can be evaluated by subjective and objective methods. Unlike other methods, peak nasal inspiratory flow (PNIF) is portable and easy to perform. The need for patient compliance is the most important disadvantage of this method. We aimed to analyze the significance of PNIF for measuring the effectiveness of adenoidectomy as well as to compare PNIF with other subjective methods.

          Methods

          Two-hundred forty-five (245) patients aged between six and 11 years were evaluated. Seventy-seven (77) of them formed the study group and 168 formed the control group. Pre and post-surgery PNIF measurements, adenoid scores, and simple visual analog scale (sVAS) were recorded.

          Results

          The average PNIF value has significantly increased to 70.65 L/min from 33.02 L/min after adenoidectomy (p<0.01). The average PNIF value was 71.66 L/min in control subjects. High PNIF values were significantly correlated with low sVAS and adenoid scores postoperatively in the study group as compared with those of preoperative data (p<0.01).

          Conclusions

          PNIF has a satisfying correlation with nasal examination findings and other subjective methods to evaluate nasal obstruction and may provide unique and complementary information helpful for evaluating and improving the effects of adenoidectomy in children.

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          Most cited references21

          • Record: found
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          Measurements of nasal airflow and patency: a critical review with emphasis on the use of peak nasal inspiratory flow in daily practice.

          G Ottaviano, W. Fokkens (2016)
          Objective measures can be used to assist the clinician to diagnose and treat nasal obstruction and also to quantify nasal obstruction in research. Objective measurements of nasal obstruction are as important as objective measurements of lung function. peak nasal inspiratory flow (PNIF), acoustic rhinometry (AR) and rhinomanometry (RM), with their specific peculiarity, assess different aspects of nasal obstruction. From the studies available in the literature, it seems that these methods roughly correlate with each other and that all of them can be alternatively utilized very well in research as well as in clinical practice. This review describes the various methods that can be used to measure nasal patency, airflow and resistance, mainly peak nasal inspiratory flow, rhinomanometry and acoustic rhinometry. PNIF has been demonstrated to be reproducible and as good an indication of objective nasal patency as formal rhinomanometry and has the advantage to be cheap, simple and suitable for serial measurements and for home use even in the paediatric population. PNIF normative data are available for children, adults and elderly subjects, and the availability of unilateral PNIF normal values allows evaluation of nasal sides separately. Just as in the lower airways, objective and subjective evaluation gives different information that together optimizes the diagnosis and the treatment of our patients. We argue that PNIF should be used regularly in every outpatient clinic that treats patients with nasal obstruction.
          Article 0 comments Cited 30 times – based on 0 reviews     Review now
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            Systemic and mucosal immune responses in young children and adults after parenteral influenza vaccination.

            L L Haaheim, J Olofsson, C. R. Cox … (1998)
            The effect of natural mucosal priming on systemic and mucosal immune responses was investigated in young children after parenteral influenza vaccination. Eighteen young children and 8 adults were vaccinated with trivalent influenza vaccine at various time intervals before tonsillectomy. The influenza-specific IgG, IgA, and IgM immune responses were examined in tonsillar lymphocytes and frequent samples of peripheral blood and oral fluid. Young children were divided into primed and unprimed groups on the basis of presence of prevaccination serum antibodies. In peripheral blood, adults and primed children had significantly higher IgG and IgA antibody responses than did unprimed children. Irrespective of priming, children elicited weaker IgA responses than adults in both tonsils and oral fluid. While natural priming was essential to elicit strong systemic response in young children after parenteral influenza vaccination, it did not influence the local responses, which were significantly lower in both primed and unprimed children than in adults.
            Article 0 comments Cited 24 times – based on 0 reviews     Review now
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              Assessment of adenoid size in children by fibreoptic examination.

              Howard L. Kaufman, William Wang, P Clement … (1997)
              In order to investigate the relationship between the size of the adenoid and upper respiratory symptoms in children, fibreoptic examination of the nasal cavity and nasopharynx was performed in 817 children. The size of the adenoid was classified into three categories according to the distance between the vomer and the adenoid tissue. There was a significant relation between the size of the adenoid and the complaints of nasal obstruction (P < 0.001) and of snoring (P < 0.001), but not with the presence of purulent sinusitis. In the whole population, the size of the adenoid correlated well with the results of tympanometry (P < 0.001), but this does not hold in all age groups. This study has confirmed adenoid hypertrophy as a common aetiological factor in children with the complaints of nasal obstruction and snoring. The enlargement of the adenoid only partially explains the occurrence of otitis media with effusion. The introduction of the flexible fibrescope in the examination of the nasal cavity and nasopharynx in children is of great clinical value, especially in the selection of children for adenoidectomy. It is a minor invasive examination well tolerated by most children, giving more information than a lateral skull radiograph and avoiding unnecessary radiation.
              Article 0 comments Cited 23 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 30 December 2020
                Publication date (Electronic, collection): December 2020
                Volume: 12
                Issue: 12
                Electronic Location Identifier: e12378
                Affiliations
                [1 ] Otolaryngology - Head and Neck Surgery, Bagcilar Training and Research Hospital, Istanbul, TUR
                [2 ] Otolaryngology - Head and Neck Surgery, Bahcelievler State Hospital, Istanbul, TUR
                [3 ] Otolaryngology - Head and Neck Surgery, Basaksehir Cam and Sakura State Hospital, Istanbul, TUR
                Author notes
                Abdurrahman B. Cengiz drcengiz@ 123456gmail.com
                Article
                DOI: 10.7759/cureus.12378
                PMC ID: 7845784
                PubMed ID: 33532146
                SO-VID: a6f9139d-2870-4c97-b417-7e90d8b8bd1d
                Copyright © Copyright © 2020, Cengiz et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 30 December 2020
                Categories
                Subject: Otolaryngology
                Subject: Pediatric Surgery

                Keywords: peak nasal inspiratory flow,adenoidectomy,simple visual analogue scale
                Data availability:
                Keywords: peak nasal inspiratory flow, adenoidectomy, simple visual analogue scale

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