Ciliary beat frequency in children with adenoid hypertrophy
Lucia Marusiakova MD, PhD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Search for more papers by this authorCorresponding Author
Peter Durdik MD, PhD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Correspondence Peter Durdik MD, PhD, Department of Paediatrics, Jessenius Faculty of Medicine, University Hospital, Comenius University, Kollarova 2, 036 59 Bratislava, Slovakia.
Email: [email protected]
Search for more papers by this authorMilos Jesenak MD, PhD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Search for more papers by this authorGabriela Bugova MD, PhD
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Martin, Martin, Slovakia
Search for more papers by this authorJulia Kvassayova MD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Search for more papers by this authorDasa Oppova MD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Search for more papers by this authorPeter Banovcin MD, PhD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Search for more papers by this authorLucia Marusiakova MD, PhD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Search for more papers by this authorCorresponding Author
Peter Durdik MD, PhD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Correspondence Peter Durdik MD, PhD, Department of Paediatrics, Jessenius Faculty of Medicine, University Hospital, Comenius University, Kollarova 2, 036 59 Bratislava, Slovakia.
Email: [email protected]
Search for more papers by this authorMilos Jesenak MD, PhD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Search for more papers by this authorGabriela Bugova MD, PhD
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Martin, Martin, Slovakia
Search for more papers by this authorJulia Kvassayova MD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Search for more papers by this authorDasa Oppova MD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Search for more papers by this authorPeter Banovcin MD, PhD
Department of Paediatrics, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovakia
Search for more papers by this authorAbstract
Background
Children with adenoid hypertrophy (AH) have impaired respiratory system defense mechanisms, such as mucociliary clearance. We hypothesized that AH negatively affects one of the most important aspects of mucociliary clearance—ciliary beat frequency (CBF) and that adenoidectomy could potentially restore this essential defence mechanism of the airways. This study evaluated the influence of AH and endoscopic adenoidectomy on the CBF of the nasal respiratory epithelium in children.
Methods
This prospective study included 64 children with confirmed AH aged 3 to 18 years and 43 age- and sex-matched healthy controls. Nasal CBF was analyzed using a digital high-speed video microscope and the software application Ciliary Analysis (NI LabVIEW). The preoperative adenoid size was assessed according to Cassano. Clinical symptoms of chronic rhinosinusitis were evaluated using the SNOT-20 questionnaire.
Results
Children with AH had a median CBF of 5.35 ± 1.06 Hz. Six months after surgery, the median CBF was significantly higher (6.48 ± 0.88 Hz; P < .001) and reached the values of healthy children (6.37 ± 0.71 Hz; P = .512). The size of the adenoid tissue did not correlate with the CBF. No influence of age or gender on the CBF was found. After adenoidectomy, a significant reduction of the mean total SNOT-20 score was recorded (P < .01).
Conclusion
Children with clinically symptomatic AH have impaired mucociliary clearance due to decreased nasal CBF. Removal of hypertrophic adenoid tissue normalizes the CBF and reduces the presence of clinical symptoms of rhinosinusitis.
REFERENCES
- 1Pereira L, Monyror J, Almeida FT, et al. Prevalence of adenoid hypertrophy: a systematic review and meta-analysis. Sleep Med Rev. 2018; 38: 101-112.
- 2Scadding G. Non-surgical treatment of adenoidal hypertrophy: the role of treating IgE-mediated inflammation. Pediatr Allergy Immunol. 2010; 21: 1095-1106.
- 3Uhliarova B, Bugova G, Jesenak M, Pechacova S, Hamarova M, Hajtman A. The effect of adenotomy, allergy and smoking on microbial colonization of upper aerodigestive tract in children. Epidemiol Microbiol Immunol. 2017; 66: 67-72.
- 4Arnaoutakis D, Collins WO. Correlation of mucociliary clearance and symptomatology before and after adenoidectomy in children. Int J Pediatr Otorhinolaryngol. 2011; 75: 1318-1321.
- 5Maurizi M, Paludetti G, Ottaviani F, Almadori G, Falcetti S. Mucociliary function and nasal resistance evaluation before and after adenoidectomy. Int J Pediatr Otorhinolaryngol. 1986; 11: 295-300.
- 6Ranga RK, Singh J, Gera A, Yadav J. Nasal mucociliary clearance in adenotonsillar hypertrophy. Indian J Pediatr. 2000; 67: 651-652.
- 7Yazici H, Soy FK, Kulduk E, et al. Comparison of nasal mucociliary clearance in adenoid hypertrophy with or without otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2014; 78: 1143-1146.
- 8Durdik P, Banovcin P. Primary Ciliary Dyskinesia – Current Therapeutic Approach. In: M Jesenak, ed. Advances in Respiratory Therapy Research. 1st Edn. New York: Nova Science Pub Inc; 2015: 157-176.
- 9Plaza Valia P, Carrion Valero F, Marin Pardo J, Bautista Rentero D, Gonzalez Monte C. Saccharin test for the study of mucociliary clearance: reference values for a Spanish population. Arch Bronconeumol. 2008; 44: 540-545.
- 10Barbato A, Frischer T, Kuehni CE, et al. Primary ciliary dyskinesia: a consensus statement on diagnostic and treatment approaches in children. Eur Respir J. 2009; 34: 1264-1276.
- 11Kempeneers C, Chilvers MA. To beat, or not to beat, that is question! The spectrum of ciliopathies. Pediatr Pulmonol. 2018; 53: 1122-1129.
- 12Djakow J, O'Callaghan C. Primary ciliary dyskinesia. Breathe. 2014; 10: 122-133.
10.1183/20734735.007413 Google Scholar
- 13Shapiro AJ, Zariwala MA, Ferkol T, et al. Diagnosis, monitoring, and treatment of primary ciliary dyskinesia: PCD foundation consensus recommendations based on state of the art review. Pediatr Pulmonol. 2016; 51: 115-132.
- 14Pynnonen MA, Kim HM, Terrell JE. Validation of the Sino-Nasal Outcome Test 20 (SNOT-20) domains in nonsurgical patients. Am J Rhinol Allergy. 2009; 23: 40-45.
- 15Cassano P, Gelardi M, Cassano M, Fiorella ML, Fiorella R. Adenoid tissue rhinopharyngeal obstruction grading based on fiberendoscopic findings: a novel approach to therapeutic management. Int J Pediatr Otorhinolaryngol. 2003; 67: 1303-1309.
- 16 Department of Paediatrics, Jessenius Faculty of Medicine of Comenius University, University of Zilina. 2014. Automatic lighting system of inverted microscope for high-speed cinematography. Koniar D, Hargas L, Stofan S, Hrianka M, Durdik P, Banovcin P. Slovak Republic. Utility Model No 6811. 02.07.2014.
- 17Hargas L, Koniar D, Stofan S. Advanced methodology for frequency description of biomechanical systems. Procedia Eng. 2012; 48: 205-212.
10.1016/j.proeng.2012.09.506 Google Scholar
- 18Koniar D, Hargas L, Stofan S, Hrianka M. High speed video system for tissue measurement based on PWM regulated dimming and virtual instrumentation. Elektronika Ir Elektrotechnika. 2010; 106: 169-172.
- 19Loncova Z, Hargas L, Koniar D, Simonova A, Kozacek B. Objects detection and recognition in biomedical microscopic images for the purpose of non-invasive and more precise diagnostic. Progress In Electromagnetics Research Symposium – Spring (PIERS). St. Petersburg, Russia: IEEE; 2017: 3159-3165.
10.1109/PIERS.2017.8262301 Google Scholar
- 20Kocmalova M, Joskova M, Franova S, Banovcin P, Sutovska M. Airway defense control mediated via voltage-gated sodium channels. Adv Exp Med Biol. 2016; 921: 71-80.
- 21Munkholm M, Mortensen J. Mucociliary clearance: pathophysiological aspects. Clin Physiol Funct Imaging. 2014; 34: 171-177.
- 22Bertrand B, Collet S, Eloy P, Rombaux P. Secondary ciliary dyskinesia in upper respiratory tract. Acta Otorhinolaryngol Belg. 2000; 54: 309-316. In:.
- 23Ohashi Y, Nakai Y, Nakata J, et al. Ciliary activity on adenoids of patients with otitis media with effusion. Am J Otolaryngol. 1988; 9: 323-326.
- 24Andreoli SM, Schlosser RJ, Wang LF, Mulligan RM, Discolo CM, White DR. Adenoid ciliostimulation in children with chronic otitis media. Otolaryngol Head Neck Surg. 2013; 148: 135-139.
- 25Chilvers MA, Rutman A, O'Callaghan C. Functional analysis of cilia and ciliated epithelial ultrastructure in healthy children and young adults. Thorax. 2003; 58: 333-338.
- 26De Iongh RU, Rutland J. Ciliary defects in healthy subjects, bronchiectasis, and primary ciliary dyskinesia. Am J Respir Crit Care Med. 1995; 151: 1559-1567.
- 27Ho JC, Chan KN, Hu WH, et al. The effect of aging on nasal mucociliary clearance, beat frequency, and ultrastructure of respiratory cilia. Am J Respir Crit Care Med. 2001; 163: 983-988.
- 28Green A, Smallman LA, Logan AC, Drake-Lee AB. The effect of temperature on nasal ciliary beat frequency. Clin Otolaryngol Allied Sci. 1995; 20: 178-180.
- 29Jorissen M, Willems T, Van der Schueren B. Nasal ciliary beat frequency is age independent. Laryngoscope. 1998; 108: 1042-1047.
- 30Lee SS, Jung IH, Mo JH, et al. Ciliary beat frequency in the airways of humans: influences of lidocaine, age, sex and smoking. J Rhinol. 2004; 11: 12-17.
- 31Lee MC, Kim DW, Kim DY, Rhee CS. The effect of histamine on ciliary beat frequency in the acute phase of allergic rhinitis. Am J Otolaryngol. 2011; 32: 517-521.
- 32Ozerskaya I, Maljavina U, Geppe N. Ciliary motility of nasal epithelium in children with asthma and allergic rhinitis. Eur Respir J. 2017; 50:PA4498.
- 33Ye S, Wang T. Laboratory epidemiology of respiratory viruses in a large children's hospital: A STROBE-compliant article. Medicine (Baltimore). 2018; 97:e11385.
- 34D'Amato M, Molino A, Calabrese G, Cecchi L, Annesi-Maesano I, D'Amato G. The impact of cold on the respiratory tract and its consequences to respiratory health. Clin Transl Allergy. 2018; 8: 20.
- 35Bugova G, Janickova M, Uhliarova B, Babela R, Jesenak M. The effect of passive smoking on bacterial colonisation of the upper airways and selected laboratory parameters in children. Acta Otorhinolaryngol Ital. 2018; 38: 431-438.
- 36Shin KS, Cho SH, Kim KR, et al. The role of adenoids in pediatric rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2008; 72: 1643-1650.
- 37Bercin AS, Ural A, Kutluhan A, Yurttas V. Relationship between sinusitis and adenoid size in pediatric age group. Ann Otol Rhinol Laryngol. 2007; 116: 550-553.
- 38Lee D, Rosenfeld RM. Adenoid bacteriology and sinonasal symptoms in children. Otolaryngol Head Neck Surg. 1997; 116: 301-307.
- 39Fukuda K, Matsune S, Ushikai M, Imamura Y, Ohyama M. A study on the relationship between adenoid vegetation and rhinosinusitis. Am J Otolaryngol. 1989; 10: 214-216.
- 40Bernstein JM, Dryja D, Murphy TF. Molecular typing of paired bacterial isolates from the adenoid and lateral wall of the nose in children undergoing adenoidectomy: implications in acute rhinosinusitis. Otolaryngol Head Neck Surg. 2001; 125: 593-597.
- 41Boudewyns A, Abel F, Alexopoulos E, et al. Adenotonsillectomy to treat obstructive sleep apnea: Is it enough? Pediatr Pulmonol. 2017; 52: 699-709.
- 42Tuncer U, Aydogan B, Soylu L, Simsek M, Akcali C, Kucukcan A. Chronic rhinosinusitis and adenoid hypertrophy in children. Am J Otolaryngol. 2004; 25: 5-10.
- 43Takahashi H, Honjo I, Fujita A, Kurata K. Effects of adenoidectomy on sinusitis. Acta Otorhinolaryngol Belg. 1997; 51: 85-87.
- 44Ungkanont K, Damrongsak S. Effect of adenoidectomy in children with complex problems of rhinosinusitis and associated diseases. Int J Pediatr Otorhinolaryngol. 2004; 68: 447-451.
- 45Lachanas VA, Woodard TD, Antisdel JL, Kountakis SE. Sino-nasal outcome test tool assessment in patients with chronic rhinosinusitis and obstructive sleep apnea. ORL J Otorhinolaryngol Relat Spec. 2012; 74: 286-289.
- 46Boatsman JE, Calhoun KH, Ryan MW. Relationship between rhinosinusitis symptoms and mucociliary clearance time. Otolaryngol Head Neck Surg. 2006; 134: 491-493.
Citing Literature
