Adenoiditis in children: A modern view of the etiology and preventive treatment. A review

Cover Page

Cite item

Full Text

Abstract

The pharyngeal tonsil (PT) in a child is an integral part of the NALT (Nasopharynx-Associated Lymphoid Tissue), lymphoid tissue associated with the nasopharyngeal mucosa, which is part of the structure of the Waldeyer's tonsillar ring. The terminology of PT disorders in children is still debatable. In the current edition of the Russian consensus paper, "adenoiditis" means reactive inflammatory changes in the PT, as an organ of regional mucosal immunity, occurring when the nasal and pharyngeal mucosa are exposed to antigens. Currently, there is no definitive consensus on the objective markers of adenoiditis, as well as clear diagnostic criteria. In addition, the causes of adenoiditis in children are quite numerous. The article discusses these and other controversial issues, as well as practical approaches to prevent and treat adenoiditis.

Full Text

Restricted Access

About the authors

Elena P. Karpova

Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: edoctor@mail.ru
ORCID iD: 0000-0002-8292-9635

D. Sci. (Med.), Prof.

Russian Federation, Moscow

Denis A. Tulupov

Russian Medical Academy of Continuous Professional Education; Filatov Children's City Clinical Hospital

Email: edoctor@mail.ru
ORCID iD: 0000-0001-6096-2082

Cand. Sci. (Med.), Assoc. Prof.

Russian Federation, Moscow; Moscow

Oleg G. Naumov

Russian Medical Academy of Continuous Professional Education; Filatov Children's City Clinical Hospital; Bashlyaeva Children's City Clinical Hospital

Email: edoctor@mail.ru
ORCID iD: 0000-0002-8243-8385

Cand. Sci. (Med.)

Russian Federation, Moscow; Moscow; Moscow

Larisa I. Usenia

Russian Medical Academy of Continuous Professional Education

Email: edoctor@mail.ru
ORCID iD: 0009-0003-2779-5931

Cand. Sci. (Med.)

Russian Federation, Moscow

Vladimir A. Belov

Russian Medical Academy of Continuous Professional Education; Pirogov Russian National Research Medical University

Email: edoctor@mail.ru
ORCID iD: 0000-0002-2955-2015

Cand. Sci. (Med.)

Russian Federation, Moscow; Moscow

References

  1. Синёва Е.Л., Панкова В.Б., Саранча Е.О. Распространенность и структура заболеваний ЛОР-органов у детей промышленных регионов. Вестник оториноларингологии. 2015;80(2):48-52 [Sineva EL, Pankova VB, Sarancha EO. The prevalence and structure of ENT diseases in the children residing in the industrial regions. Russian Bulletin of Otorhinolaryngology. 2015;80(2):48-52 (in Russian)]. doi: 10.17116/otorino201580248-52
  2. Гипертрофия аденоидов. Гипертрофия небных миндалин. Клинические рекомендации. 2024. Режим доступа: https://cr.minzdrav.gov.ru/recomend/662_2. Ссылка активна на 10.10.2024 [Gipertrofiia adenoidov. Gipertrofiia nebnykh mindalin. Klinicheskie rekomendatsii. 2024. Available at: https://cr.minzdrav.gov.ru/recomend/662_2. Accessed: 10.10.2024 (in Russian)].
  3. Brandtzaeg P. Immunology of tonsils and adenoids: everything the ENT surgeon needs to know. Int J Pediatr Otorhinolaryngol. 2003;67(Suppl. 1):S69-76. doi: 10.1016/j.ijporl.2003.08.018
  4. Быкова В.П. Новые аргументы в поддержку органосохраняющего направления при лечении аденоидов у детей. Детская оториноларингология. 2013;2:18-22 [Bykova VP. New arguments in support of organpreserving directions in the treatment of adenoids in children. Detskaia otorinolaringologiia. 2013;2:18-22 (in Russian)].
  5. Talks BJ, Mather MW, Chahal M, et al. Mapping Human Immunity and the Education of Waldeyer's Ring. Annu Rev Genomics Hum Genet. 2024;25(1):161-82. doi: 10.1146/annurev-genom-120522-012938
  6. Kearns DB, Pransky SM, Seid AB. Current concepts in pediatric adenotonsillar disease. Ear Nose Throat J. 1991;70(1):15-9.
  7. Антонив В.Ф. Новый взгляд на гипертрофию глоточной миндалины: аденоиды или аденоидная болезнь? Вестник оториноларингологии. 2004;4:23-4 [Antoniv VF. Novyi vzgliad na gipertrofiiu glotochnoi mindaliny: adenoidy ili adenoidnaia bolezn'? Vestnik otorinolaringologii. 2004;4:23-4 (in Russian)].
  8. Fujioka M, Young LW, Girdany BR. Radiographic evaluation of adenoidal size in children: adenoidal-nasopharyngeal ratio. AJR Am J Roentgenol. 1979;133(3):401-4. doi: 10.2214/ajr.133.3.401
  9. Duan H, Xia L, He W, et al. Accuracy of lateral cephalogram for diagnosis of adenoid hypertrophy and posterior upper airway obstruction: A meta-analysis. Int J Pediatr Otorhinolaryngol. 2019;119:1-9. doi: 10.1016/j.ijporl.2019.01.011
  10. Hamilos DL. Pediatric chronic rhinosinusitis. Am J Rhinol Allergy. 2015;29(6):414-20. doi: 10.2500/ajra.2015.29.4238
  11. Fokkens WJ, Lund VJ, Mullol J, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012;50(1):1-2. doi: 10.4193/Rhino12.000
  12. Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl. S29):1-464. doi: 10.4193/Rhin20.600
  13. Ramadan HH. Pediatric chronic rhinosinusitis. Eur Arch Otorhinolaryngol. 2024;281(3):1131-7. doi: 10.1007/s00405-023-08307-z
  14. Wang H. Chronic adenoiditis. J Int Med Res. 2020;48(11):300060520971458. doi: 10.1177/0300060520971458
  15. Brambilla I, Pusateri A, Pagella F, et al. Adenoids in children: Advances in immunology, diagnosis, and surgery. Clin Anat. 2014;27(3):346-52. doi: 10.1002/ca.22373
  16. McArdle E, Shetty S, Coutinho D, et al. Correlation of patient reported outcome measures with endoscopic findings in pediatric chronic adenoiditis and chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2024;179:111936. doi: 10.1016/j.ijporl.2024.111936
  17. Карпова Е.П., Тулупов Д.А., Божатова М.П., Вагина Е.Е. Острый и обострение хронического аденоидита у детей. Педиатрия. Consilium Medicum. 2008;2:20-4 [Karpova EP, Tulupov DA, Bozhatova MP, Vagina EE. Ostryi i obostrenie khronicheskogo adenoidita u detei. Pediatrics. Consilium Medicum. 2008;2:20-4 (in Russian)].
  18. Dai G, Li C, Xu D. Clinical diagnosis and treatment of 65 cases of acute adenoiditis. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012;26(6):280-1 (in Chinese).
  19. Радциг Е.Ю., Злобина Н.В. Топические антибиотики в лечении острого аденоидита у детей. Педиатрия. Журнал им. Г.Н. Сперанского. 2015;94(5):96-100 [Radtsig EY, Zlobina NV. Topical antibiotics in acute adenoiditis treatment in children. Pediatrics. Journal named after G.N. Speransky. 2015;94(5):96-100 (in Russian)].
  20. Кириченко И.М. Топическая терапия препаратами серебра в лечении острых аденоидитов и синуситов у детей. Медицинский совет. 2020;(1):101-5 [Kirichenko IM. Topical therapy drugs containing silver in acute adenoiditis sinusitis in children. Meditsinskiy sovet = Medical Council. 2020;(1):101-5 (in Russian)]. doi: 10.21518/2079-701X-2020-1-101-105
  21. Proenca-Modena JL, Pereira Valera FC, Jacob MG, et al. High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease. PLoS One. 2012;7(8):e42136. doi: 10.1371/journal.pone.0042136
  22. Günel C, Kırdar S, Ömürlü İK, Ağdaş F. Detection of the Epstein-Barr virus, Human Bocavirus and novel KI and KU polyomaviruses in adenotonsillar tissues. Int J Pediatr Otorhinolaryngol. 2015;79(3):423-7. doi: 10.1016/j.ijporl.2015.01.007
  23. Ivaska LE, Silvoniemi A, Mikola E, et al. Herpesvirus infections in adenoids in patients with chronic adenotonsillar disease. J Med Virol. 2022;94(9):4470-47. doi: 10.1002/jmv.27818
  24. Маннанова Э.Ф., Халиуллина С.В., Покровская Е.М., Павлова Т.Ю. Эпштейна–Барра вирус – ведущая причина гипертрофии глоточной миндалины у детей. Практическая медицина. 2023;21(6):48-53 [Mannanova EF, Khaliullina SV, Pokrovskaya EM, Pavlova TYu. Epstein–Barr virus as the leading cause of pharyngeal tonsil hypertrophy in children. Practical Medicine. 2023;21(6):48-53 (in Russian)].
  25. Карпова Е.П., Тулупов Д.А. О роли различных этиологических факторов в развитии хронической патологии носоглотки у детей. Лечащий врач. 2013;1:26 [Karpova EP, Tulupov D.A. O roli razlichnykh etiologicheskikh faktorov v razvitii khronicheskoi patologii nosoglotki u detei. Lechashchii Vrach. 2013;1:26 (in Russian)].
  26. Herberhold S, Eis-Hübinger AM, Panning M. Frequent detection of respiratory viruses by real-time PCR in adenoid samples from asymptomatic children. J Clin Microbiol. 2009;47(8):2682-3. doi: 10.1128/JCM.00899-09
  27. Sato M, Li H, Ikizler MR, et al. Detection of viruses in human adenoid tissues by use of multiplex PCR. J Clin Microbiol. 2009;47(3):771-3. doi: 10.1128/JCM.02331-08
  28. Faden H, Callanan V, Pizzuto M, et al. The ubiquity of asymptomatic respiratory viral infections in the tonsils and adenoids of children and their impact on airway obstruction. Int J Pediatr Otorhinolaryngol. 2016;90:128-32. doi: 10.1016/j.ijporl.2016.09.006
  29. Wishaupt JO, van der Ploeg T, de Groot R, et al. Single- and multiple viral respiratory infections in children: disease and management cannot be related to a specific pathogen. BMC Infect Dis. 2017;17(1):62. doi: 10.1186/s12879-016-2118-6
  30. Андриянова И.В. Микроэкологическая характеристика микробиоты носоглотки здоровых детей в различных возрастных группах. Мать и дитя в Кузбассе. 2023;93(2):10-6 [Andrianova IV. The study of the microbiota of the nasopharynx of healthy children in different age groups by gas chromatography. Mother and Baby in Kuzbass. 2023;93(2):10-6 (in Russian)]. doi: 10.24412/2686-7338-2023-2-10-16
  31. Sokolovs-Karijs O, Brīvība M, Saksis R, et al. Identifying the Microbiome of the Adenoid Surface of Children Suffering from Otitis Media with Effusion and Children without Middle Ear Effusion Using 16S rRNA Genetic Sequencing. Microorganisms. 2023;11(8). doi: 10.3390/microorganisms11081955
  32. Тулупов Д.А., Карпова Е.П. О роли бактериальной микрофлоры в этиологии хронического аденоидита у детей. Вопросы современной педиатрии. 2014;13(1):172-5 [Tulupov DA, Karpova EP. On the role of bacterial microflora in etiology of chronic adenoiditis in children. Current Pediatrics. 2014;13(1):172-5 (in Russian)]. doi: 10.15690/vsp.v13i1.930
  33. Кунельская В.Я., Мачулин А.И. Особенности патогенеза и терапии грибковых аденоидитов в детском возрасте. Успехи медицинской микологии. 2013;11:236-8 [Kunel'skaia VIa, Machulin AI. Osobennosti patogeneza i terapii gribkovykh adenoiditov v detskom vozraste. Uspekhi meditsinskoi mikologii. 2013;11:236-8 (in Russian)].
  34. Круговская Н.Л. Аллергические аденоидиты у детей. Вестник оториноларингологии. 2007;5:212 [Krugovskaia NL. Allergicheskie adenoidity u detei. Vestnik otorinolaringologii. 2007;5:212 (in Russian)].
  35. Вавилова В.П., Вавилов А.М., Царькова С.А., и др. Особенности течения хронического аденоидита, сочетающегося с аллергическим ринитом, у детей Кузбасса. Уральский медицинский журнал. 2019;6(174):94-9 [Vavilova VP, Vavilov AM, Tsarkova SA, et al. Peculiarities of chronic adenoititis complicated by allergic rhinitis in children of Kuzbass. Ural Medical Journal. 2019;6(174):94-9 (in Russian)].
  36. Карпова Е.П., Тулупов Д.А. О роли гастроэзофагеального рефлюкса в развитии хронической патологии носоглотки у детей. Детская оториноларингология. 2012;2:45-7 [Karpova EP, Tulupov DA. O roli gastroezofageal'nogo refliuksa v razvitii khronicheskoi patologii nosoglotki u detei. Detskaia otorinolaringologiia. 2012;2:45-7 (in Russian)].
  37. Lin F, Zhao J, Lu YX, et al. Analysis of clinical characteristics of children with adenoid hypertrophy and pharyngolaryngeal reflux. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024;59(2):140-4 (in Chinese). doi: 10.3760/cma.j.cn115330-20231221-00318
  38. Guo Z, Jiang J, Wu H, et al. Salivary peptest for laryngopharyngeal reflux and gastroesophageal reflux disease: A systemic review and meta-analysis. Medicine (Baltimore). 2021;100(32):e26756. doi: 10.1097/MD.0000000000026756
  39. Qu XP, Huang ZX, Sun Y, et al. Expression of Innate Immunity Genes in Epithelial Cells of Hypertrophic Adenoids with and without Pediatric Chronic Rhinosinusitis: A Preliminary Report. Chin Med J (Engl). 2015;128(21):2913-8. doi: 10.4103/0366-6999.168056
  40. Gankovskaya LV, Bykova VP, Namasova-Baranova LS, et al. Innate immunity gene expression by epithelial cells of upper respiratory tract in children with adenoid hypertrophy. Auris Nasus Larynx. 2018;45(4):753-5. doi: 10.1016/j.anl.2017.11.011
  41. Atilla MH, Özdaş S, Özdaş T, et al. Association of Ugrp2 gene polymorphisms with adenoid hypertrophy in the pediatric population. Braz J Otorhinolaryngol. 2018;84(5):599-607. doi: 10.1016/j.bjorl.2017.07.004
  42. Marseglia GL, Avanzini MA, Caimmi S, et al. Passive exposure to smoke results in defective interferon-gamma production by adenoids in children with recurrent respiratory infections. J Interferon Cytokine Res. 2009;29(8):427-32. doi: 10.1089/jir.2008.0108
  43. Tagliacarne SC, Valsecchi C, Castellazzi AM, et al. Impact of passive smoke and/or atopy on adenoid immunoglobulin production in children. Immunol Lett. 2015;165(2):70-7. doi: 10.1016/j.imlet.2015.04.002
  44. Стагниева И.В., Затуливетрова Д.О., Стагниев С.Д. Эндотипы и фенотипы хронического аденоидита. Оториноларингология Восточная Европа. 2024;14(2):236-44 [Stagnieva IV, Zatulivetrova DO, Stagniev SD. Endotypes and Phenotypes of Chronic Adenoiditis. Otorhinolaryngology Eastern Europe. 2024;14(2):236-44 (in Russian)]. doi: 10.34883/PI.2024.14.2.036
  45. Jefferson T, Dooley L, Ferroni E, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev. 2023;1(1):CD006207. doi: 10.1002/14651858.CD006207.pub6
  46. Yu H, Gu D, Yu F, Li Q. Social distancing cut down the prevalence of acute otitis media in children. Front Public Health. 2023;11:1079263. doi: 10.3389/fpubh.2023.1079263
  47. Nearchou F, Flinn C. The Impact of COVID-19 on Children and Adolescents with Chronic Illness. Adv Exp Med Biol. 2024;1457:385-99. doi: 10.1007/978-3-031-61939-7_22
  48. Cabaillot A, Vorilhon P, Roca M, et al. Saline nasal irrigation for acute upper respiratory tract infections in infants and children: A systematic review and meta-analysis. Paediatr Respir Rev. 2020;36:151-5. doi: 10.1016/j.prrv.2019.11.003
  49. Лопатин А.С., Шиленкова В.В., Карпова Е.П., и др. Ирригационная терапия в ринологии и ринохирургии. Практические рекомендации для врачей. Фармакология и фармакотерия. 2024;1:70-85 [Lopatin AS, Shilenkova VV, Karpova EP, et al. Irrigatsionnaia terapiia v rinologii i rinokhirurgii. Prakticheskie rekomendatsii dlia vrachei. Farmakologiia i Farmakoteriia. 2024;1:70-85 (in Russian)]. doi: 10.46393/27132129_2022_S_54
  50. Henocq A, Moreau C, Mallet E, et al. Changes in IgA levels in nasal mucus after upper respiratory tract diseases in infants treated with carbocysteine. Ann Otolaryngol Chir Cervicofac. 1985;102(5):373-5 (in French).
  51. Zheng CH, Ahmed K, Rikitomi N, et al. The effects of S-carboxymethylcysteine and N-acetylcysteine on the adherence of Moraxella catarrhalis to human pharyngeal epithelial cells. Microbiol Immunol. 1999;43(2):107-3. doi: 10.1111/j.1348-0421.1999.tb02381.x
  52. Ndour CT, Ahmed K, Nakagawa T, et al. Modulating effects of mucoregulating drugs on the attachment of Haemophilus influenzae. Microb Pathog. 2001;30(3):121-7. doi: 10.1006/mpat.2000.0417
  53. Cakan G, Turkoz M, Turan T, et al. S-carboxymethylcysteine inhibits the attachment of Streptococcus pneumoniae to human pharyngeal epithelial cells. Microb Pathog. 2003;34(6):261-5. doi: 10.1016/s0882-4010(03)00048-2
  54. Yasuda H, Yamaya M, Sasaki T, et al. Carbocisteine inhibits rhinovirus infection in human tracheal epithelial cells. Eur Respir J. 2006;28(1):51-8. doi: 10.1183/09031936.06.00058505
  55. Yamaya M, Nishimura H, Shinya K, et al. Inhibitory effects of carbocisteine on type A seasonal influenza virus infection in human airway epithelial cells. Am J Physiol Lung Cell Mol Physiol. 2010;299(2):L160-8. doi: 10.1152/ajplung.00376.2009
  56. Гаращенко Т.И. Бактериальные лизаты для местного применения в лечении и профилактике хронических аденоидитов у детей. Вопросы современной педиатрии. 2007;6(1):92-6 [Garashchenko T. Bacterial lysates for local administration in prevention and treatment of chronic adenoiditis among children. Current Pediatrics. 2007;6(1):92-6 (in Russian)].
  57. Schaad UB. OM-85 BV, an immunostimulant in pediatric recurrent respiratory tract infections: a systematic review. World J Pediatr. 2010;6(1):5-12. doi: 10.1007/s12519-010-0001-x
  58. Zhang W, Huang J, Liu H, et al. Whether Immunostimulants Are Effective in Susceptible Children Suffering From Recurrent Respiratory Tract Infections: A Modeling Analysis Based on Literature Aggregate Data. J Clin Pharmacol. 2022;62(2):245-53. doi: 10.1002/jcph.1969
  59. Карпычева И.Е., Тулупов Д.А., Карпова Е.П. Возможности оральных пробиотиков в профилактике хронического аденоидита у детей. Медицинский совет. 2015;6:94-100 [Karpycheva IE, Tulupov DA, Karpova EP. Vozmozhnosti oral'nykh probiotikov v profilaktike khronicheskogo adenoidita u detei. Meditsinskii sovet. 2015;6:94-100 (in Russian)]. doi: 10.21518/2079-701X-2015-6-94-100
  60. La Mantia I, Varricchio A, Di Girolamo S, et al. The role of bacteriotherapy in the prevention of adenoidectomy. Eur Rev Med Pharmacol Sci. 2019;23(1 Suppl):44-7. doi: 10.26355/eurrev_201903_17348
  61. Passali D, Passali GC, Vesperini E, et al. The efficacy and tolerability of Streptococcus salivarius 24SMB and Streptococcus oralis 89a administered as nasal spray in the treatment of recurrent upper respiratory tract infections in children. Eur Rev Med Pharmacol Sci. 2019;23(Suppl. 1):67-72. doi: 10.26355/eurrev_201903_17352
  62. Смирнова Г.И. Опыт применения Синупрета и Тонзилгона Н для профилактики и лечения острых респираторных заболеваний у часто болеющих детей. Детский доктор. 2001;4:25-9 [Smirnova GI. Experience of use of Sinupret and Tonsilgon N in prophylaxis and treatment of frequent acute respiratory diseases in children. Detskii doctor. 2001;4:25-9 (in Russian)].
  63. Hostanska K, Melzer J, Amon A, Saller R. Suppression of interleukin (IL)-8 and human beta defensin-2 secretion in LPS-and/or IL-1β-stimulated airway epithelial A549 cells by a herbal formulation against respiratory infections (BNO 1030). J Ethnopharmacol. 2011;134(2):228-33. doi: 10.1016/j.jep.2010.12.006
  64. Дрынов Г.И., Иванюшина О.К., Дюякова Ф.Н. Препарат Тонзилгон® Н в лечении хронического тонзиллита у детей. Эффективная фармакотерапия. 2014;59:4-6 [Drynov GI, Ivanyushina OK, Dyakova FN. Tonsilgon® N in Therapy of Chronic Tonsillitis in Children. Effective Pharmacotherapy. 2014;59:4-6 (in Russian)].
  65. Вавилова В.П., Вавилов А.М., Черкаева А.Х., Нечаева И.А. Эффективность экстракта из корня алтея, цветков ромашки, травы хвоща, листьев грецкого ореха, травы тысячелистника, коры дуба и травы одуванчика у детей дошкольного возраста с патологией глоточной и/или небных миндалин и частыми рецидивирующими респираторными инфекциями. Педиатрия. Consilium Medicum. 2022;2:160-5 [Vavilova VP, Vavilov AM, Cherkaeva AKh, Nechaeva IA. Efficacy of the extract of marshmallow root, chamomile flowers, horsetail herb, walnut leaves, yarrow herb, oak bark, and dandelion herb in preschool children with pharyngeal and/or palatine tonsil disorders and frequent recurrent respiratory infections. Pediatrics. Consilium Medicum. 2022;2:160-5 (in Russian)]. doi: 10.26442/26586630.2022.2.201719
  66. Климова И.И., Баженов Д.В. Эффективность препарата Tонзилгон Н в лечении детей с хроническим аденоидитом. Вестник оториноларингологии. 2014;(2):75-8 [Klimova II, Bazhenov DV. The effectiveness of a herbal preparation Tonsilgon N for the treatment of the children presenting with chronic adenoiditis. Russian Bulletin of Otorhinolaryngology. 2014;(2):75-8 (in Russian)].
  67. Büttner R, Schwermer M, Ostermann T, et al. Complementary and alternative medicine in the (symptomatic) treatment of acute tonsillitis in children: A systematic review. Complement Ther Med. 2023;73:102940. doi: 10.1016/j.ctim.2023.102940

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2024 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 74329 от 19.11.2018 г.