Search

The aim of this study was to determine whether cough sensitivity is changed after adenoidectomy in atopic children with chronic cough. 21 Children having symptoms of chronic cough and adenoid hypertrophy verified by nasal fiberoptic endoscopy were submitted to cough sensitivity measurement before and after adenoidectomy. Their pulmonary function was within normal range. Concentrations of capsaicin causing two (C2) and five coughs (C5) were reported. Children' (14 boys and 7 girls, mean age 6,52 yrs) cough sensitivity (geometric mean, with 95% CI) for C2 was preoperatively (before adenoidectomy) 19.95 (9.95-39.98) micromol/l vs. children' C2 postoperatively 14.04 (7.16-27.55) (P = .083 for Wilcoxon paired two sample test). Children' C5 was preoperatively 86.26 (39.25-189.57) micromol/l vs. C5 postoperatively 95.23 (46.33-195.75) micromol/l (P = .794 for Wilcoxon paired two sample test). We conclude that cough sensitivity for C2 and C5 was not significantly changed after adenoidectomy in atopic children with chronic cough., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Jan Sojak,1 Peter Durdik,2 Eva Omar Mohamedova,3 Marian Grendar,4 Miroslava Lucanska,5 Martin Jozef Pec,6 Milos Tatar,7 Renata Pecova7 1Clinic of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, Slovak Medical University in Bratislava, Central Military Hospital in Ruzomberok, Ruzomberok, Slovak Republic; 2Clinic of Children and Adolescent, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic; 3Outpatient Department of Clinical Immunology and Allergology in Ruzomberok, Ruzomberok, Slovak Republic; 4Biomedical Center, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic; 5Clinic of Otorhinolaryngology and Head and Neck Surgery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic; 6Clinic of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, Martin, Slovak Republic; 7Department of Pathological Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak RepublicCorrespondence: Renata Pecova, Department of Pathological Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Malá Hora 4C, Martin, 036 01, Slovak Republic, Tel +421 43 2633 622, Email renata.pecova@uniba.skPurpose: The co-occurrence of adenoids and chronic cough is common in children. The goal of this research was to specify changes in cough reflex sensitivity as a result of adenoid tissue removal.Patients and Methods: The sample group consisted of 17 children (six boys and 11 girls, aged 4– 12 years, mean age 6.24 years), all of them possessing symptoms of chronic cough and adenoids, confirmed by nasal fiberoptic endoscopy. This sample group underwent cough reflex sensitivity assessment, which took place both prior to and after endoscopic adenoidectomy. The definition of the cough reflex sensitivity is the lowest capsaicin concentration that caused two (C2) or five (C5) coughs. Capsaicin aerosol in ascending concentrations (from 0.61 to 1250 μmol/L) was inhaled by a single-breath method (KoKo DigiDoser), with the addition of an inspiratory flow regulator valve (RIFR).Results: Concentrations of capsaicin causing two (C2) and five coughs (C5) were reported. Cough sensitivity (geometric mean with 95% CI) for C2 was 31.86 (12.98– 78.18) μmol/L preoperatively and 11.97 (6.16– 23.26) μmol/L postoperatively (P=0.064). Cough sensitivity for C5 was 234.91 (97.19– 567.77) μmol/L preoperatively and 69.13 (29.08– 164.35) μmol/L postoperatively (P=0.022). The children’s pulmonary function was within the normal range.Conclusion: In our study, adenoidectomy significantly increased cough reflex sensitivity in non-atopic children suffering from chronic cough.Keywords: adenoids, adenoidectomy, cough, cough reflex sensitivity, chronic cough, children

Background: The aim of this study was to clarify changes of transnasal airflow resulting from adenoidectomy and to assess the effect of surgery depending on adenoid hypertrophy (AH) obstruction grade. Materials and Methods: Altogether fifty children having symptoms of nasal obstruction and adenoids were submitted to a rhinomanometric assessment before and after adenoidectomy. At the same time, using the nasal fiberoptic endoscopy, the grade of AH obstruction was determined, according to which the children were divided into four classes. We assessed the change of total transnasal inspiratory airflow and total nasal resistance due to adenoidectomy. Results: Values of transnasal airflow and nasal resistance measured in the study group of fifty children were preoperatively 262 mL/s and 0.565 kPa/L/s; postoperatively 288 mL/s and 0.52 kPa/L/s. We have noticed statistically significant increase of the airflow (P = 0.015); however, decrease of the resistance (P = 0.054) was not significant. In the group of children suffering from the 1st to 2nd grade (29 children) preoperatively measured values presented 280 mL/s and 0.52 kPa/L/s; postoperatively, 276 mL/s and 0.54 kPa/L/s; change of the airflow (P = 0.634) and resistance (P = 0.829) was not significant. In the study group having the 3rd and 4th grade (21 children), the values indicated preoperatively 240 mL/s and 0.62 kPa/L/s; postoperatively, 340 mL/s and 0.44 kPa/L/s; there were significant airflow increase (P = 0.012) and resistance decrease (P = 0.033). Conclusions: Adenoidectomy significantly increased the airflow; however, we observed the different effect in the group of children with the 1st and 2nd grade compared to the group with the 3rd and 4th grade. A significant increase of the airflow and decrease of the resistance were present only in the group with the 3rd and 4th grade; therefore, the significant reduction of nasal obstruction symptoms might be expected only in this group of patients.