Clinical, bacteriological, and histological study of adenoids in children

The adenoid has long been recognized as an important factor in the pathogenesis of otitis media with effusion (OME). However, there is still considerable debate concerning how the condition of the adenoid tissue is involved in the cause of OME. The purpose of this study is to investigate whether the adenoid is an active agent of OME.

One hundred forty-six patients aged from 3 to 6 years who underwent adenoidectomy at Oita Medical University (Japan) were retrospectively compared with patients with and without OME regarding macroscopic size of the adenoid, adenoidal-nasopharyngeal ratio (AN ratio), incidence of sinusitis and nasal allergy, bacteriological examination of adenoid tissues, reticular formation of the epithelium, and the percent of ciliated epithelium.

There was no significant difference in the size of adenoids. Haemophilus influenzae (HI) was cultured more frequently in adenoid specimens from patients with OME. A tendency toward increased stratified squamous epithelium and decreased ciliated epithelium was apparent in patients with OME. Reticular epithelium extension was greater in patients with than without OME.

Adenoid inflammation is implicated in the pathogenesis of OME and the adenoids have an important role in the cause of OME by being a reservoir for HI.