The Prevalence of Adenoid Hypertrophy among Children with Zika Related Microcephaly
Mariana C Leal1,2, Danielle Seabra Ramos1,3, Thiago Pinto Bezerra1
1Surgery Department, Federal University of Pernambuco, Recife 50670-901, Brazil.
Insights
Children with Zika-related microcephaly (ZRM) often experience upper airway obstruction. This study found a high prevalence of adenoid hypertrophy (AH) in these children, which surgery effectively treated in most cases.
Area of Science:
- Pediatrics
- Otorhinolaryngology
- Infectious Diseases
Background:
- Upper respiratory obstruction is a frequent complication in children with Zika-related microcephaly (ZRM).
- Adenoid hypertrophy (AH) is a potential cause of airway obstruction in pediatric populations.
Purpose of the Study:
- To determine the prevalence of adenoid hypertrophy (AH) in children with Zika-related microcephaly (ZRM) presenting with respiratory obstruction symptoms.
- To evaluate the efficacy of surgical intervention for obstructive AH in children with ZRM.
Main Methods:
- Cross-sectional analysis nested within a cohort study.
- Nasopharyngoscopy evaluation of 57 children with confirmed ZRM and respiratory symptoms.
- Histological and immunohistochemical analysis to assess direct Zika virus (ZIKV) involvement.
Main Results:
- 54% (31 of 57) of evaluated children with ZRM had obstructive adenoid hypertrophy.
- Surgery for obstructive AH resolved symptoms completely in 11 of 13 children.
- No direct Zika virus (ZIKV) infection was found in adenoid tissues.
Conclusions:
- Adenoid hypertrophy is highly prevalent and presents early in children with Zika-related microcephaly (ZRM).
- Obstructive AH contributes to upper airway obstruction, secretory otitis media, and dysphagia in this population.
- Surgical treatment of AH offers significant symptom relief for children with ZRM.
Abstract:
Upper respiratory obstruction is a common sequela in children with Zika-related microcephaly (ZRM). As a cross-sectional analysis nested in a cohort study, this study aims to investigate the prevalence of adenoid hypertrophy (AH) in children with ZRM and symptoms of respiratory obstruction. The data were collected in the first three years of life from children with ZRM who were followed in two reference centers for otorhinolaryngological care of patients with congenital Zika syndrome. Out of 92 children with confirmed ZRM, 57 were evaluated by nasopharyngoscopy after presenting with upper respiratory obstruction symptoms. In this study, 31 of the 57 (54%) children with ZRM who were evaluated had obstructive AH. Thirteen children with obstructive AH were submitted to surgery, which resulted in the complete resolution of symptoms for 11, partial resolution in 1, and no improvement in 1. No evidence of direct involvement by Zika virus (ZIKV) infection in the adenoid tissues was demonstrated by histology or immunohistochemistry. Our results suggest that there is a high prevalence and early presentation of AH in children with ZRM, with consequent upper airway obstruction causing upper airway obstructive disorder, secretory otitis media, and dysphagia.
