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Rhinomanometry with and without decongestant used to select children for adenoidectomy: a cohort study

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

Adenoid hypertrophy may coexist, and often does, with rhinitis. Therefore, in some cases, adenoidectomy alone, despite the fact that it reduces nasal resistance, may be insufficient to restore nasal breathing. Juliusson et al. suggested using rhinomanometry with and without nasal decongestant as a method for selecting patients for adenoidectomy. In this study, we aim to assess whether the decongestant test, when using normative data, is useful to select children for adenoidectomy.

Methods

Children between 4 and 15 years old undergoing adenoidectomy were selected from two tertiary referral university hospitals. Participants underwent anterior active rhinomanometry with and without nasal decongestant before and after surgery. Parents fill in the sinus and nasal quality-of-life survey (SN5).

Results

47 participants were included, and mean age 6.5 ± 2.15. 2 cohorts were defined according to the result of the nasal decongestant test (> 40% improvement in nasal resistance or not). There is a statistically significant difference between groups, with a higher improvement in nasal resistance and airflow after adenoidectomy in the group with less than 40% improvement in nasal resistance.

Conclusions

In conclusion, this study supports the use of the decongestant test with rhinomanometry to select children for adenoidectomy; especially as it has proven to be a simple technique, harmless, fast, and easily performed on collaborative children.

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References

  1. Isaac A, Major M, Witmans M, Alrajhi Y, Flores-Mir C, Major P et al (2015) Correlations between acoustic rhinometry, subjective symptoms, and endoscopic findings in symptomatic children with nasal obstruction. JAMA Otolaryngol Head Neck Surg 141(6):550–555

    Article  Google Scholar 

  2. Cassano P, Gelardi M, Cassano M, Fiorella ML, Fiorella R (2003) Adenoid tissue rhinopharyngeal obstruction grading based on fiberendoscopic findings: a novel approach to therapeutic management. Int J Pediatr Otorhinolaryngol 67(12):1303–1309

    Article  Google Scholar 

  3. Calvo-Henriquez C, Branco AM, Lechien JR, Sandoval-Pacheco V, Maldonado-Alvarado B, Maza-Solano J et al (2021) Assessing the effect of adenoidectomy on nasal resistance and airflow. A systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol 151:110969

    Article  Google Scholar 

  4. Juliusson S, Bende M (1987) Rhinomanometry at selection for adenoidectomy. Rhinology 25(1):63–67

    CAS  Google Scholar 

  5. Zicari AM, Magliulo G, Rugiano A, Ragusa G, Celani C, Carbone MP et al (2012) The role of rhinomanometry after nasal decongestant test in the assessment of adenoid hypertrophy in children. Int J Pediatr Otorhinolaryngol 76(3):352–356

    Article  CAS  Google Scholar 

  6. Calvo-Henriquez C, Mayo-Yáñez M, Lechien JR, Moure JD, Faraldo-García A, Martinez-Capoccioni G et al (2021) Looking for a cutoff value for the decongestant test in children suffering with turbinate hypertrophy. Eur Arch Otorhinolaryngol 278:3821–3826

    Article  Google Scholar 

  7. Cervera Escario J, Del Castillo MF, Gómez Campderá JA, Gras Albert JR, Pérez Piñero B, VillafruelaSanz MA (2006) Indicaciones de adenoidectomía y amigdalectomía: documento de Consenso entre la Sociedad Española de Otorrinolaringología y Patología Cervicofacial y la Asociación Española de Pediatría. Acta Otorrinolaringol Esp 57(2):59–65

    Article  CAS  Google Scholar 

  8. Clement PR, Gordts F (2005) Standardisation Committee on Objective Assessment of the Nasal Airway, IRS, and ERS. Consensus report on acoustic rhinometry and rhinomanometry. Rhinology 43(3):169–179

    CAS  Google Scholar 

  9. Calvo-Henríquez C, Valencia-Blanco B, Boronat-Catalá B, Maza-Solano J, Díaz-Anadón Á, Kahn S et al (2020) Cross-cultural adaptation of the sinus and nasal quality of life survey (SN-5) to Spanish. Int J Pediatr Otorhinolaryngol 139:110425

    Article  Google Scholar 

  10. Kay DJ, Rosenfeld RM (2003) Quality of life for children with persistent sinonasal symptoms. Otolaryngol Head Neck Surg 128(1):17–26

    Article  Google Scholar 

  11. Kindermann CA, Roithmann R, Lubianca Neto JF (2008) Sensitivity and specificity of nasal flexible fiberoptic endoscopy in the diagnosis of adenoid hypertrophy in children. Int J Pediatr Otorhinolaryngol 72(1):63–67

    Article  Google Scholar 

  12. Camacho M, Zaghi S, Certal V, Abdullatif J, Means C, Acevedo J et al (2015) Inferior turbinate classification system, grades 1 to 4: development and validation study. Laryngoscope 125(2):296–302

    Article  Google Scholar 

  13. Calvo-Henriquez C, Branco AM, Lechien JR, Maria-Saibene A, DeMarchi MV, Valencia-Blanco B et al (2021) What is the relationship between the size of the adenoids and nasal obstruction A systematic review. Int J Pediatr Otorhinolaryngol 151:110895

    Article  Google Scholar 

  14. Occasi F, Duse M, Vittori T, Rugiano A, Tancredi G, De Castro G et al (2016) Primary school children often underestimate their nasal obstruction. Rhinology 54(2):164–169

    Article  Google Scholar 

  15. Jiang ZY, Pereira KD, Friedman NR, Mitchell RB (2012) Inferior turbinate surgery in children: a survey of practice patterns. Laryngoscope 122(7):1620–1623

    Article  Google Scholar 

  16. Dinis PB, Haider H, Gomes A (1999) The effects of adenoid hypertrophy and subsequent adenoidectomy on pediatric nasal airway resistance. Am J Rhinol 13(5):363–369

    Article  CAS  Google Scholar 

  17. Kim YK, Kang JH, Yoon KS (1998) Acoustic rhinometric evaluation of nasal cavity and nasopharynx after adenoidectomy and tonsillectomy. Int J Pediatr Otorhinolaryngol 44(3):215–220

    Article  CAS  Google Scholar 

  18. Calvo-Henriquez C, Capasso R, Martínez-Capoccioni G, Rangel-Chaves J, Liu SY, O’Connor-Reina C et al (2020) Safeness, subjective and objective changes after turbinate surgery in pediatric patients: a systematic review. Int J Pediatr Otorhinolaryngol 135:110128

    Article  Google Scholar 

  19. Ta NH, Gao J, Philpott C (2021) A systematic review to examine the relationship between objective and patient-reported outcome measures in sinonasal disorders: recommendations for use in research and clinical practice. Int Forum Allergy Rhinol 11(5):910–923

    Article  Google Scholar 

  20. Saito K, Ono T, Mochida M, Ohyama K (2006) Changes in nasorespiratory function in association with maxillary distraction osteogenesis in subjects with cleft lip and palate. Cleft Palate Craniofac J 43(1):75–83

    Article  Google Scholar 

  21. Lee CH, Hsu WC, Ko JY, Yeh TH, Lin MT, Kang KT (2019) Revision adenoidectomy in children: a meta-analysis. Rhinology 57(6):411–419

    Google Scholar 

  22. Huang SW, Giannoni C (2001) The risk of adenoid hypertrophy in children with allergic rhinitis. Ann Allergy Asthma Immunol 87(4):350–355

    Article  CAS  Google Scholar 

  23. Parker AJ, Maw AR, Powell JE (1989) Rhinomanometry in the selection for adenoidectomy and its relation to preoperative radiology. Int J Pediatr Otorhinolaryngol 17(2):155–161

    Article  CAS  Google Scholar 

  24. Jones AS, Lancer JM, Stevens JC, Beckingham E (1987) Rhinomanometry: do the anterior and posterior methods give equivalent results? Clin Otolaryngol Allied Sci 12(2):109–114

    Article  CAS  Google Scholar 

  25. Kobayashi R, Miyazaki S, Karaki M, Kobayashi E, Karaki R, Akiyama K et al (2011) Measurement of nasal resistance by rhinomanometry in 892 Japanese elementary school children. Auris Nasus Larynx 38(1):73–76

    Article  Google Scholar 

  26. Fielder CP (1985) The effect of adenoidectomy on nasal resistance to airflow. Acta Otolaryngol 100(5–6):444–449

    Article  CAS  Google Scholar 

  27. Ciprandi G, Cirillo I, Klersy C, Castellazzi AM, Barberi S, Marseglia GL (2007) Nasal decongestion test in allergic rhinitis: definition of responder. Int Immunopharmacol 7(3):372–374

    Article  CAS  Google Scholar 

  28. Principato JJ, Wolf P (1985) Pediatric nasal resistance. Laryngoscope 95(9 Pt 1):1067–1069

    CAS  Google Scholar 

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Authors and Affiliations

  1. Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France

    Christian Calvo-Henriquez, Irene Rivero, Byron Maldonado-Alvarado, Beatriz Valencia-Blanco, Borja Boronat-Catala & Paula Rodriguez-Rivas

  2. Service of Otolaryngology, Rhinology Unit, Hospital Complex of Santiago de Compostela, Travesía de Choupana s/n, 15706, Santiago de Compostela, Spain

    Christian Calvo-Henriquez, Byron Maldonado-Alvarado, Beatriz Valencia-Blanco, Borja Boronat-Catala, Paula Rodriguez-Rivas & Carlos Martin-Martin

  3. Service of Otolaryngology, 12 de Octubre Hospital, Madrid, Spain

    Irene Rivero

  4. Service of Otolaryngology, Pediatric Otolaryngology Unit, Gregorio Marañon University Hospital, Madrid, Spain

    Ignacio Jimenez-Huerta

Authors
  1. Christian Calvo-Henriquez
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  2. Irene Rivero
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  3. Byron Maldonado-Alvarado
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  4. Beatriz Valencia-Blanco
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Corresponding author

Correspondence to Christian Calvo-Henriquez.

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Conflict of interest

This work is part of the research completed by Christian Calvo-Henriquez, MD, to obtain a PhD degree. The rest of authors declare no disclosure or conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Calvo-Henriquez, C., Rivero, I., Maldonado-Alvarado, B. et al. Rhinomanometry with and without decongestant used to select children for adenoidectomy: a cohort study. Eur Arch Otorhinolaryngol 280, 723–729 (2023). https://doi.org/10.1007/s00405-022-07549-7

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  • DOI: https://doi.org/10.1007/s00405-022-07549-7

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