Skip to main content

Role of adenoids and adenoiditis in children with allergy and otitis media

Current Allergy and Asthma Reports volume 9, pages 460–464 (2009)Cite this article

Abstract

Adenoids and/or tonsil inflammation with concomitant obstructive hypertrophy is one of the oldest and most common pediatric problems. Adenoids are a component of Waldeyer’s ring and because of their anatomic position can be relevant in the pathogenesis of otitis media when they are inflamed and/or enlarged. Adenoid pads can create mechanical eustachian tube obstruction. Therefore, in some cases, adenoidectomy may have a role in the clinical management of otitis media with effusion. However, eustachian tube dysfunction related to the adenoids may also have an allergy-related functional component. Allergic inflammation has been described for middle ear effusion, and some studies have reported that mast cells increase and allergic mediators release in adenoids as well. Nasal endoscopy has a key role in confirming a diagnosis of adenoid hypertrophy and/or adenoiditis and in detecting an association between adenoid inflammation/infection and otitis media with effusion, especially during infancy and early childhood.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References and Recommended Reading

  1. van Kempen MJP, Rijkers GT, van Cauwenberge PB: The immune response in adenoids and tonsils. Int Arch Allergy Immunol 2000, 122:8–19.

    Article  PubMed  Google Scholar 

  2. Avanzini AM, Castellazzi AM, Marconi M, et al.: Children with recurrent otitis show defective IFN-gamma producing cells in adenoids. Pediatr Allergy Immunol 2008, 19:523–526.

    Article  PubMed  Google Scholar 

  3. Casselbrant ML: What is wrong in chronic adenoiditis/tonsillitis: anatomical considerations. Int J Pediatr Otorhinolaryngol 1999, 49(Suppl 1):S133–S135.

    Article  Google Scholar 

  4. Swidinsky A, Goktas O, Bessler C, et al.: Spatial organization of microbiota in quiescent adenoiditis and tonsillitis. J Clin Pathol 2007, 60:253–260.

    Article  Google Scholar 

  5. Bernstein JM: Waldeyer’s ring and otitis media: the nasopharyngeal tonsil and otitis media. Int J Pediatr Otorhinolaryngol 1999, 49(Suppl 1):S127–S132.

    Article  PubMed  Google Scholar 

  6. Ricci A, Avanzini MA, Scaramuzza C, et al.: Toll-like receptor 2-positive and Toll-like receptor 4-positive cells in adenoids of children exposed to passive smoking. J Allergy Clin Immunol 2005, 115:631–632.

    Article  CAS  PubMed  Google Scholar 

  7. Marseglia GL, Avanzini MA, Caimmi S, et al.: Passive exposure to smoke results in defective IFN-gamma production by adenoids in children with recurrent respiratory infections. J Interferon Cytokine Res 2009 Jun 10 (Epub ahead of print).

  8. Post JC, Hiller NL, Nistico L, et al.: The role of biofilms in otolaryngologic infections: update 2007. Curr Opin Otolaryngol Head Neck Surg 2007, 15:347–351.

    Article  PubMed  Google Scholar 

  9. Kilty SJ, Desrosiers MY: The role of bacterial biofilms and the pathophysiology of chronic rhinosinusitis. Curr Allergy Asthma Rep 2008, 8:227–233.

    Article  CAS  PubMed  Google Scholar 

  10. Tosca MA, Riccio AM, Marseglia GL, et al.: Nasal endoscopy in asthmatic children: assessment of rhinosinusitis and adenoiditis incidence, correlations with cytology and microbiology. Clin Exp Allergy 2001, 31:609–615.

    Article  CAS  PubMed  Google Scholar 

  11. Cassano P, Gelardi M, Cassano M, et al.: Adenoid tissue rhinopharyngeal obstruction grading based on fiberendoscopic findings: a novel approach to therapeutic management. Int J Pediatr Otorhinolaryngol 2003, 67:1303–1309.

    Article  PubMed  Google Scholar 

  12. Kveton JF, Pillsbury HC, Sasaki CT: Nasal obstruction. Arch Otolaryngol 1982, 108:315–318.

    CAS  PubMed  Google Scholar 

  13. Darrow DH, Siemens C: Indications for tonsillectomy and adenoidectomy. Laryngoscope 2002, 112:6–10.

    Article  PubMed  Google Scholar 

  14. Rosenfeld R, Culpepper L, Doyle KJ, et al.: Clinical practice guidelines: otitis media with effusion. Otolaryngol Head Neck Surg 2004, 130:S95–S118.

    Article  PubMed  Google Scholar 

  15. Hammaren-Malmi S, Saxen H, Tarkkanen J, et al.: Adenoidectomy does not significantly reduce the incidence of otitis media in conjunction with the insertion of tympanostomy tubes in children who are younger than 4 years: a randomized trial. Pediatrics 2005, 116:185–189.

    Article  PubMed  Google Scholar 

  16. Mattila PS, Joki-Erkkila VP, Kilpi T, et al.: Prevention of otitis media by adenoidectomy in children younger than 2 years. Arch Otolaryngol Head Neck Surg 2003, 129:163–168.

    Article  PubMed  Google Scholar 

  17. Collins MP, Church MK, Bakhshi KN, et al.: Adenoid histamine and its possible relationship to secretory otitis media. J Laryngol Otol 1985, 99:685–691.

    CAS  PubMed  Google Scholar 

  18. Loesel LS: Detection of allergic disease in adenoid tissue. Am J Clin Pathol 1984, 81:170–175.

    CAS  PubMed  Google Scholar 

  19. Skoner DP: Complications of allergic rhinitis. J Allergy Clin Immunol 2000, 105:S605–S609.

    Article  CAS  PubMed  Google Scholar 

  20. Ulualp SO, Sahin D, Yilmaz N, et al.: Increased adenoid mast cells in patients with otitis media with effusion. Int J Pediatr Otorhinolaryngol 1999, 49:107–114.

    Article  CAS  PubMed  Google Scholar 

  21. Abdullah B, Hassan S, Sidek D, et al.: Adenoid mast cells and their role in the pathogenesis of otitis media with effusion. J Laryngol Otol 2006, 120:556–560.

    Article  CAS  PubMed  Google Scholar 

  22. Drake-Lee A, Price J, Varley R: Mast cell ultrastructure in the adenoids of children with and without secretory otitis media. J Laryngol Otol 1994, 108:1058–1063.

    Article  CAS  PubMed  Google Scholar 

  23. van Nieuwkerk EBJ, De Wolf CJM, Kamperdijk EWA, et al.: Lymphoid and non-lymphoid cells in the adenoid of children with otitis media with effusion: a comparative study. Clin Exp Allergy 1990, 79:233–239.

    Google Scholar 

  24. Mattila PS, Tarkkanen J: B- and T-lymphocytes subpopulations in the adenoids of children with otitis media. APMIS 1996, 104:698–704.

    Article  CAS  PubMed  Google Scholar 

  25. Kiroglu MM, Ozbilgin K, Aydogan B, et al.: Adenoids and otitis media with effusion: a morphological study. Am J Otolaryngol 1998, 19:244–250.

    Article  CAS  PubMed  Google Scholar 

  26. van Nieuwkerk EBJ, van der Baan S, Hoefsmit ECM, et al.: Localization and morphology of antigen-presenting cells in the adenoid of children with otitis media with effusion. Clin Immunol Immunopathol 1995, 74:59–69.

    Article  PubMed  Google Scholar 

  27. Vinke JG, Fokkens WJ: The role of adenoid in allergic sensitization. Int J Pediatr Otorhinolaryngol 1999, 49:S145–S149.

    Article  PubMed  Google Scholar 

  28. Papatziamos G, van Hage-Hamsten M, Lundahl J, et al.: IgE-positive plasma cells are present in adenoids of atopic children. Acta Otolaryngol 2006, 126:180–185.

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Article  Google Scholar 

  30. Marseglia GL, Pagella F, Klersy C, et al.: The 10-day mark is a good way to diagnose not only acute rhinosinusitis but also adenoiditis, as confirmed by endoscopy. Int J Pediatr Otorhinolaryngol 2007, 71:581–583.

    Article  PubMed  Google Scholar 

  31. Marseglia GL, Pagella F, Caimmi D, et al.: Increased risk of otitis media with effusion in allergic children presenting with adenoiditis. Otolaryngol Head Neck Surg 2008, 138:572–575.

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Pediatric Sciences, Foundation IRCCS Policlinico San Matteo-University of Pavia, P.le Golgi, 2-27100, Pavia, Italy

    Gian Luigi Marseglia

Authors
  1. Gian Luigi Marseglia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dimitri Poddighe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Davide Caimmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alessia Marseglia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Silvia Caimmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giorgio Ciprandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Catherine Klersy
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Fabio Pagella
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Anna Maria Castellazzi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gian Luigi Marseglia.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Marseglia, G.L., Poddighe, D., Caimmi, D. et al. Role of adenoids and adenoiditis in children with allergy and otitis media. Curr Allergy Asthma Rep 9, 460–464 (2009). https://doi.org/10.1007/s11882-009-0068-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11882-009-0068-4

Keywords

  • Otitis Medium
  • Allergic Rhinitis
  • Otitis Medium With Effusion
  • Nasal Endoscopy
  • Adenoid Hypertrophy