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Related Concept Videos

Chronic Pharyngitis01:23

Chronic Pharyngitis

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Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
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Tonsillitis II: Management01:26

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This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
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Tonsillitis I: Introduction01:30

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Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
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Suctioning the Oropharyngeal Airway01:25

Suctioning the Oropharyngeal Airway

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In preparing for oropharyngeal airway suctioning, a nurse must gather all necessary equipment, including a suction unit with tubing, a prepackaged suction kit, sterile gloves, water or saline for irrigation, a water-soluble lubricant, and additional personal protective equipment (such as a gown, mask, and goggles) to control infections.
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Sleep Apnea01:21

Sleep Apnea

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Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
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CO2-Lasertonsillotomy Under Local Anesthesia in Adults
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Adenoidectomy Without Tonsillectomy for Pediatric Obstructive Sleep Apnea.

Stephen R Chorney1,2, Karen B Zur1,2

  • 1Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 22, 2020
PubMed
Summary

Adenoidectomy may improve obstructive sleep apnea (OSA) in young children with large adenoids. However, younger children may require a tonsillectomy later. Further research is needed.

Keywords:
adenoidectomyobstructive sleep apneapediatricspolysomnogramtonsillectomy

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Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Pediatric Surgery

Background:

  • Obstructive sleep apnea (OSA) is a common condition in children.
  • Adenoid hypertrophy is a frequent cause of pediatric OSA.
  • The efficacy of adenoidectomy for OSA in very young children requires further investigation.

Purpose of the Study:

  • To evaluate the effectiveness of adenoidectomy in improving obstructive sleep apnea (OSA) in young children.
  • To identify factors associated with OSA improvement or the need for further intervention after adenoidectomy.

Main Methods:

  • A case series with chart review was conducted at a tertiary children's hospital.
  • Included were children under 3.5 years with large adenoids, small tonsils, and documented OSA via polysomnogram (PSG).
  • Outcomes including repeat PSG, need for tonsillectomy, and adenoid regrowth were analyzed.

Main Results:

  • Of 71 children, 36.6% had a repeat PSG post-adenoidectomy.
  • The apnea-hypopnea index decreased in 77.0% of those with repeat PSG, with a significant reduction in moderate to severe OSA.
  • Younger age predicted the need for subsequent tonsillectomy, and adenoid regrowth was noted in one case.

Conclusions:

  • Adenoidectomy can be an effective treatment for OSA in young children with significant adenoid hypertrophy and small tonsils.
  • Younger children undergoing adenoidectomy may have a higher likelihood of requiring a subsequent tonsillectomy.
  • Further prospective studies with comprehensive PSG data are warranted to confirm these findings.