title: ALLERGIC RHINITIS AND ADENOID HYPERTROPHY IN CHILDREN: IS ADENOIDECTOMY ALWAYS REALLY USEFUL?
abstract: Allergic rhinitis (AR) and adenoid hypertrophy (AH) are common in children and are often associated with each other. Recent studies have shown improvement of respiratory symptoms and reduction in the adenoid volume after anti-allergic medical therapy (intranasal corticosteroids, antihistamines). The aim of our retrospective study is to evaluate the effectiveness of adenoidectomy on respiratory symptoms in pediatric patients with AR. We recruited 404 pediatric patients with AR, and we divided them into 4 groups (1. intermittent-mild rhinitis; 2. intermittent-moderate/severe rhinitis; 3. persistent-mild rhinitis; 4. persistent-moderate/severe rhinitis), using ARIA classification. For each patient we evaluated: age at onset of AR; family history of allergy; the presence of other allergic diseases; serum total IgE values; skin prick test (SPT) results; presence of AH evaluated by rhino-laringeal fibroscopy; adenoidectomy and its efficacy on respiratory symptoms. Our data show an association between AR and AH: 90 of 404 (22%) children with AR had AH of a degree greater than 2nd. A significant percentage (80%) of children suffering from AR did not present satisfactory benefits from adenoidectomy. They reported persistence or recurrence of rhinitic symptoms after surgery or only partial benefits, especially of recurrent respiratory tract infections and nasal obstruction. The local allergic persistent inflammation on nasal mucosa and adenoid tissue is probably the cause of the unsatisfactory results of adenoidectomy, therefore surgery cannot be the first therapeutic step for these children. It is important to extinguish the local inflammation by medical anti-allergic therapy to obtain improvements of nasal symptoms and to prevent adenoid regrowth.
authors.affiliation: 1 Department of Pediatrics, Unit of Genetics and Pediatric Immunology, University of Messina, Policlinico G. Martino, Messina, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Colavita
authors.affiliation: Department Donna del Bambino e di Chirurgia Generale e Specialistica, Seconda Università di Napoli, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Miraglia Del Giudice
authors.affiliation: Unit of Radiology, University of Messina, Messina, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Stroscio
authors.affiliation: Unit of Radiology, University of Messina, Messina, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Visalli
authors.affiliation: Department of Pediatrics, Unit of Genetics and Pediatric Immunology, University of Messina, Policlinico G. Martino, Messina, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Alterio
authors.affiliation: Department of Pediatrics, Unit of Genetics and Pediatric Immunology, University of Messina, Policlinico G. Martino, Messina, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Pidone
authors.affiliation: Department of Pediatrics, Unit of Genetics and Pediatric Immunology, University of Messina, Policlinico G. Martino, Messina, Italy.
authors.forename: M R
authors.initials: MR
authors.lastname: Pizzino
authors.affiliation: Department of Pediatrics, Unit of Genetics and Pediatric Immunology, University of Messina, Policlinico G. Martino, Messina, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Arrigo
authors.affiliation: Department of Pediatrics, Unit of Pediatric Nephrology and Rheumatology, University of Messina, Messina, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Chimenz
authors.affiliation: Department of Pediatrics, Unit of Genetics and Pediatric Immunology, University of Messina, Policlinico G. Martino, Messina, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Salpietro
authors.affiliation: Department of Pediatrics, Unit of Genetics and Pediatric Immunology, University of Messina, Policlinico G. Martino, Messina, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Cuppari