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Article
Bacteriology of the Core of Adenoids inA group of Iraqi Patients Undergoing Adenoidectomy.

Authors: Eman F. Abdullah --- HusseinM.Hassan, --- Wifaq M.Al-Wattar
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2006 Volume: 48 Issue: 4 Pages: 391-393
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Upper air way obstruction secondary to chronically inflamed adenoid and / or tonsil is a common problem, in the presence of recurrent infection; tonsillectomy and or adenoidectomy are the most common surgery applied among pediatric population.
Objective: The aim of this study was to assess the type of bacteria encountered with- in the core of the adenoid tissue at time of operation.
Subject and Methods: During a period from Feb.2005 to May 2005, twenty two adenoid samples were removed by surgery ,and cross sectioned and sent for culture and sensitivity, at the department of ENT in Al-jerahat hospital for surgical specialties , most of the patients were under 10 year’s old.
Results: This study showed that the bacteria isolated from the core of adenoid tissue were mostly part of bacterial flora of the upper respiratory tract, only 7 patients showed a growth of pathogenic bacteria; to which special sensitivity tests were performed to detect antibiotic sensitivity.
Conclusion: The bacteria of the core of the adenoid were mostly composed of normal flora, and few of them were pathogenic and resistant to most ordinary antibiotics


Article
Is Adenoidectomy Enough as a Surgical Treatment for Otitis Media with Effusion Caused by Adenoid Hypertrophy?
هل يكفي استئصال غدة الأدينويد كعلاج جراحي لانصباب الأذن الوسطى الناتج عن تضخم غدة الأدينويد

Author: Mohammad Hassan Al-Baldawi د. محمد حسن البلداوي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2011 Volume: 24 Issue: 1 Pages: 61-65
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background :- Adenoid diseases are one of the major ENT problems in pediatrics that require surgery in high incidence of children especially in primary school as it affects the school performance due to recurrent otitis media & otitis media with effusion with resultant hearing loss. Objectives :-Comparison between adenoidectomy (As) alone & adenoidectomy with myringotomy (Ms) & grommet insertion (Gs) in children with otitis media with effusion ( OME)due to adenoid hypertrophy (AH) describing the results & postoperative complications of each operation in order to get the best helpful surgical method to treat this disease & prevent further episodes. Patients & Methods: - Fourty primary school children enrolled in this study who were attended department of otolaryngology in Al – Yermouk teaching hospital in a period from February 2007 to December 2008. All children have bilateral OME & hearing loss due to AH , they were divided into two groups each with 20 children ( i.e. 40 ears ) & underwent surgery ( the 1st group with As alone & the 2nd one with AsMsGs ) with postoperative follow up for one year by clinical evaluation of the results & postoperative complications. Results :- Postoperative clinical evaluation of both 1st & 2nd groups revealed improvement in 15 (37.5%) & 38 (95%) ears respectively, unilateral improvement encountered in 9 (22.5%) & 18 (45%) ears respectively , while bilateral improvement seen in 6 (15%) & 20 (50%) ears respectively. On the other hand recurrence & failure was seen in 25 (62.5%) & 2 (5%) ears respectively , this recurrence was unilateral in 13(32.5%) & 2(5%) ears respectively & bilateral in 12(30%) & 0 (0%) ears respectively .Recurrence was challenged mainly within 3 months in the 1st group (i.e. short term benefit ) & within 6 months in the 2nd group with longer lasting improvement because the operation include AsMsGs which achieve drainage & ventilation of the middle ear. Postoperative complications are encountered only in the 2nd group with AsMsGs as it utilized MsGs, but these complications are not associated with remote sequelae. Conclusions :- As alone seems to have no postoperative morbidity but with less beneficial results , whereas AsMsGs showed better improvement of hearing & the recurrence rate decreased remarkably as compared with As alone. However, despite Gs had relatively more complications, AsMsGs is strongly advisable than As alone for treating OME due to AH & prevention of its recurrence.Key words: - Adenoidectomy, Otitis Media with Effusion

الخلفية :- تعتبر امراض غدة الادينويد من المشاكل المهمة في الاطفال والتي تحتاج الى تداخل جراحي خاصة في اطفال المدارس الابتدائية كونها تؤثر على الاداء المدرسي للطفل بسبب الالتهابات المتكررة للاذن الوسطى و انصباب الاذن الوسطى مع فقدان السمع .الهدف :- الغاية من البحث هو المقارنة بين استئصال غدة الادينويد لوحدها وبين استئصال الادينويد مع بزل طبلة الاذن الوسطى مع وضع انبوب التهوية للاطفال المصابين بأنصباب الاذن الوسطى بسبب تضخم غدة الادينويد حصريا لايجاد افضل طريقة جراحية لعلاج المرض ومنع تكراره .طريقة البحث :- هذا البحث هو دراسة مستقبلية أجريت في مستشفى اليرموك التعليمي للفترة الممتدة من شباط 2007 وحتى كانون الاول 2008 , وقد شمل البحث 40 طفلا بأعمار 6 – 12 عاما . لقد اختير الاطفال المصابون بأنصباب الأذن الوسطى في كلا الاذنين الناتج عن تضخم غدة الادينويد , وتم تقسيمهم الى مجموعتين من 20 طفلا (40 اذنا ) وكل مجموعة اجريت لها احدى العمليات موضوع الدراسة . تم دراسة المجموعتين من خلال متابعة النتائج والمضاعفات مابعد العملية . النتائج :- اظهر لنا التقييم السريري بعد العملية للمجموعتين وجود تحسن كبير في السمع بنسبة 5,37 % و 95% على التوالي , بينما تبين ان ضعف السمع قد تكرر بنسبة 5,62 % و 5% على التوالي . كما ان نسبة الفشل ظهرت بشكل رئيسي خلال 3 اشهر في المجموعة الاولى وخلال 6 أشهر في المجموعة الثانية . اما المضاعفات مابعد العملية فقد ظهرت في المجموعة الثانية فقط ولكنها لم تؤدي الى مشاكل مستقبلية . الاستنتاج :- بعد دراسة النتائج استطعنا الأستنتاج بأنه برغم الوجود النسبي للمضاعفات بعد العملية في المجموعة الثانية الا ان نتائج العملية كانت جيدة جدا بالمقارنة مع المجموعة الأولى فيما يخص ضعف السمع وهو السبب الذي من اجله تم اقرار العملية . كما لوحظ ان بعض هذه المضاعفات بسيطة ويمكن معالجتها وبعضها الاخر لايمكن التنبؤ بحدوثه فيما لم تحصل اطلاقا اية مضاعفات خطيرة ومؤثرة , لذلك كانت التوصية بالعملية الثانية لأن الجراح يتمكن من تلافي الكثير من هذه المضاعفات غير الخطرة للحصول على النتائج المنشودة .


Article
Relieving Symptoms of Chronic Sinusitis in Children

Author: Hussein M. Hassan
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 1 Pages: 13-16
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: To determine the efficacy of adenoidectomy in relieving symptoms of chronic sinusitisin children.Patients and methods :A prospective study carried out on 35 patients who underwent adenoidectomyor Adeno-tonsillectomy between May 2004 and October 2005.The patient ages ranged from 3 to 12years.Five patients were unavailable for follow-up and did not complete the study so they are excludedfrom. The pre-operative symptoms were Rhinorrohea, Nasal congestion, Headache, Postnasaldrainage, Cough, Halitosis and Irritability.Also recorded was Mouth breathing, Fever and Frequent antibiotic use. Telephone interviews with thepatient's caregivers were conducted to collect information following the surgery regarding the presenceof the same symptoms as well as an estimate of overall improvement. Follow-up ranged from 5 monthsto 1 year.Results :The most frequently reported symptoms before surgery were Rhinorrhoea, Nasal congestion,Mouth breathing, and Frequent antibiotic use. (26, 28, 24, 30 patients respectively). These numbersdecreased following surgery to (11, 12, 6, 24 patients respectively)Complete or near complete symptom resolution was reported in 18 (60%) patients. Some improvementwas reported in 6 (20%) patients. Minimal or no improvement was reported in another 6 (20%) patients.Conclusion In the majority of cases, symptoms of chronic sinusitis in children are relieved byadenoidectomy.


Article
Adenoidectomy with Myringotomy and Tympanostomy Tube Versus Adenoidectomy with Myringotomy in Treatment of Otitis Media with Effusion in 5-7 Years Old Children

Author: Dr. Ahmed Muhei Rasheed
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2016 Volume: 12 Issue: 1 Pages: 83-86
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Adenoiditis is a common cause of otitis media with effusion (OME) in children & perhaps OME is one of the most common diseases leads to hearing impairment in children with subsequent impairment of speech development & learning difficulties , however, treatment remains controversial. Objectives: To evaluate if there is a significant advantage of tympanostomy tube insertion in association with adenoidectomy over adenoidectomy in association with myringotomy alone in treatment of children with OMEType of the study: This is a prospective study. Patients & methods: The study consisted from 63 children diagnosed as cases of bilateral OME & variable degrees of adenoid hypertrophy. The patients were divided randomly into two groups, group A (32) were subjected to adenoidectomy & myringotomy with tympanostomy tube insertion & group B (31) were subjected to adenoidectomy & myringotomy alone. Pure tone hearing threshold was measured preoperatively & at the 3rd month and 6th month postoperatively. Statistical analysis is done to compare the means of pure tone hearing threshold between group A & B. Results: The mean pure tone hearing threshold preoperatively in group A was 28.3 dB, while it was 27.9 dB in group B. Three and six months postoperatively the means in group A were 13.2 dB and 6.8 dB respectively , while the means were 19.4 dB and 13.6 dB respectively in group B. Statistical analysis showed statistically significant difference between the means of pure tone hearing thresholds in both groups during the whole follow up period (P value less than 0.05). Conclusion: There is statistically significant advantage of tympanostomy tube insertion in association with adenoidectomy compared to adenoidectomy with myringotomy alone in treatment of OME in term of hearing level.


Article
Recovery and Vomiting after Pediatric Tonsillectomy with or without Adenoidectomy: Comparison between TIVA using Propofol and Thiopentone Induced Halothane Maintained Anesthesia

Author: Hasan Sarhan*, Ahmed Saeed Abdullah**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2017 Volume: 16 Issue: 2 Pages: 122-128
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Vomiting in the first few hours after recovery is considered as the main factor that delayed hospital discharge in pediatric outpatient surgery . Children having tonsillectomy with or without adenoidectomy operations have a high incidence of vomiting. Propofol has a short duration of action with rapid recovery and a proved antiemetic effect. Using propofol in total intravenous anesthesia, the incidence of vomiting is lower than the traditional thiopentone induced halothane maintained technique.OBJECTIVE: The aim of the study is to compare recovery characteristics and vomiting between total intravenous anesthesia using propofol as the sole anesthetic agent with the anesthetic technique using thiopentone for induction and halothane for maintenance to assess which is more suitable for outpatient pediatric surgery.PATIENTS AND METHOD:Forty healthy unpremedicated children, ASA Ӏ, aged 7-12 years undergoing tonsillectomy with or without adenoidectomy were randomly allocated into 2 groups. Group (1) children were induced with 2-3 mg.kg-1 propofol while group (2) children were induce with thiopentone 5-6 mg.kg-1 . Maintenance was 0.2 mg.kg-1 propofol in group (1) and 0.8% halothane in group (2). Both groups received 0.5mg.kg -1 atracurium to facilitate intubation and maintain muscle relaxation. Oxygen 100% was administered to both groups. Other treatment and procedures were standardized intra and postoperatively . Extubation time, time for spontaneous eye opening and the state of recovery after thirty minutes were compared. Results of postoperative vomiting were analyzed in the first 6 hours and beyond that. RESULTS: Extubation time in group (1) was 4.75 ± 0.89 minutes and in group (2) it was 8.87 ± 1.86 minutes. The time for spontaneous eye opening in group (1) was 5.5 ± 1.22 minutes and in group (2) it was 13.125 ± 1.69 minutes. Both were significantly different . Nevertheless, both groups had a comparable modified Aldrete score which consists of 10 points and a score of 8-10 is considered ready to discharge to the general care unit. All patients in group (1) had a score of 10, while 1 patient had a score of 10, 14 patients with 9 and 5 patients with 8 in group (2). The incidence of vomiting in the first 6 hours after recovery was significantly lower in group (1) as well as the incidence after 6 hours. The same is applied to the incidence of recurrent vomiting (˃ 1 attack) in the first 6 hours, while recurrent vomiting after 6 hours were comparable in both groups. The overall incidence of recurrent vomiting was 35% in group (2) and 0% in group (1).CONCLUSION: Despite a comparable recovery, propofol has a lower incidence of vomiting after tonsillectomy with or without adenoidectomy in healthy children than thiopentone induced halothane maintained anesthesia and is more suitable for outpatient pediatric surgery..

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