The role of adenoids in pediatric rhinosinusitis.
OBJECTIVE
To evaluate adenoids' importance in pediatric rhinosinusitis as a cause of mechanical blockage or as a reservoir for pathogenic bacteria.


METHODS
A retrospective chart review of prospectively collected data was performed, which included 410 children under the age of 14 who underwent adenoidectomy in the study. Adenoid bacteriology was evaluated with adenoid tissue culture, and sinusitis grade and adenoid size were determined using preoperative PNS X-ray. A potential correlation between these factors was then analyzed.


RESULTS
The overall adenoid bacteria isolation rate was 79.3%. The most common bacteria were Haemophilus influenza (28.5%), Streptococcus pneumonia (21.7%), Streptococcus pyogenes (21.0%), and Staphylococcus aureus (15.6%), and bacterial isolation rate increased significantly according to sinusitis grade (p=0.000). This was especially true of Haemophilus influenzae and Streptococcus pneumonia, whose isolation rates increased significantly (p=0.011, p=0.001 each). There was no statistically significant difference in sinusitis grade or bacterial isolation rate according to adenoid size.


CONCLUSIONS
Based on these results, adenoids contain many potentially pathogenic bacteria. We suggest that in pediatric rhinosinusitis, adenoids act as a reservoir for pathogenic bacteria rather than as a barrier causing mechanical obstruction.
Shin
Kwang Soo
KS
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Haengdang-dong 17, Sungdong-gu, Seoul 133-792, Republic of Korea.
Cho
Seok Hyun
SH
Kim
Kyung Rae
KR
Tae
Kyung
K
Lee
Seung Hwan
SH
Park
Chul Won
CW
Jeong
Jin Hyeok
JH
D000233:Adenoidectomy; D000234:Adenoids / Q000382:microbiology* / Q000473:pathology*; D002648:Child; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D012220:Rhinitis / Q000145:classification*; D012852:Sinusitis / Q000145:classification*