Our Summary

This research paper is about a complication that can occur after a child has their adenoids removed, a surgery known as adenoidectomy. This complication, called torus tubarius hypertrophy (TTH), is rare and can cause symptoms such as snoring, sleep apnea, nasal blockage, or mouth breathing. The causes of TTH are not fully understood.

The researchers looked at 36 children who developed TTH after an adenoidectomy from 2017 to 2023. These children were initially treated without surgery for a month, but 13 of them eventually needed part of the TTH to be surgically removed. The researchers analyzed factors like the child’s sex, age, whether they had allergic rhinitis (a type of nasal inflammation), and how the initial adenoidectomy was performed.

They found that TTH is more common in boys (75% of the cases) and in children who had their adenoids removed before the age of 5 (94.4% of the cases). TTH can happen as soon as 3 months after the adenoidectomy. The study suggests that allergic rhinitis and the way the initial adenoidectomy was performed might be linked to developing TTH.

FAQs

  1. What is torus tubarius hypertrophy (TTH) and what symptoms can it cause?
  2. What factors did the researchers analyze to understand the development of TTH after an adenoidectomy?
  3. What were the main findings of the research regarding the occurrence of TTH after adenoidectomy?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about adenoidectomy is to closely monitor their child for any new or worsening symptoms after the surgery, such as snoring, sleep apnea, nasal blockage, or mouth breathing. If these symptoms occur, it is important to follow up with the doctor to discuss further evaluation and potential treatment options. Additionally, it may be beneficial to discuss any history of allergic rhinitis with the doctor before undergoing an adenoidectomy, as this could potentially increase the risk of developing complications like TTH.

Suitable For

Patients who are typically recommended adenoidectomy are those who have symptoms such as chronic nasal obstruction, chronic sinus infections, sleep apnea, or recurrent ear infections. Adenoidectomy may also be recommended for patients with persistent middle ear fluid, known as otitis media with effusion, that does not respond to other treatments. Additionally, patients with certain craniofacial abnormalities or immune deficiencies may also be recommended adenoidectomy to improve their symptoms and quality of life.

Timeline

Before adenoidectomy:

  • Patient may experience symptoms such as chronic ear infections, difficulty breathing through the nose, snoring, sleep apnea, or recurrent sinus infections.
  • Patient may undergo a physical examination, medical history review, and possibly imaging tests to diagnose adenoid hypertrophy.
  • Patient may be advised to try conservative treatments such as antibiotics, nasal sprays, or allergy medications before considering surgery.
  • Surgery may be recommended if conservative treatments are ineffective or if the patient has severe symptoms.

After adenoidectomy:

  • Patient undergoes adenoidectomy surgery, which involves removing the adenoid tissue at the back of the throat.
  • Patient may experience sore throat, difficulty swallowing, or mild ear pain in the days following surgery.
  • Patient is typically discharged the same day as the surgery and may need a few days to a week to recover at home.
  • Patient may experience improvements in symptoms such as easier breathing, reduced snoring, and improved sleep quality in the weeks following surgery.
  • Rare complications such as torus tubarius hypertrophy (TTH) can occur after adenoidectomy, requiring further evaluation and possibly additional treatment.

What to Ask Your Doctor

  1. What are the potential risks and complications of adenoidectomy, including the rare complication of torus tubarius hypertrophy?
  2. What are the symptoms of torus tubarius hypertrophy, and how is it diagnosed?
  3. How common is torus tubarius hypertrophy after adenoidectomy, and what factors may increase the risk of developing it?
  4. If my child develops torus tubarius hypertrophy after adenoidectomy, what are the treatment options available?
  5. How long after the adenoidectomy can torus tubarius hypertrophy develop, and what should I look out for in terms of symptoms?
  6. Are there any preventive measures that can be taken to reduce the risk of developing torus tubarius hypertrophy after adenoidectomy?
  7. How will torus tubarius hypertrophy affect my child’s breathing and overall health, and what can be done to manage any symptoms that may arise?
  8. Are there any specific follow-up appointments or monitoring that should be done after an adenoidectomy to check for complications like torus tubarius hypertrophy?
  9. Is there ongoing research or studies being conducted on torus tubarius hypertrophy after adenoidectomy, and what advancements are being made in understanding and treating this complication?

Reference

Authors: Teng ZP, Li Q, Shen XF. Journal: Ear Nose Throat J. 2024 Dec;103(12):769-772. doi: 10.1177/01455613231199676. Epub 2023 Sep 12. PMID: 37700607