The Role of Increase of Total IgE and Passive Smoking in Adenoid Vegetation Recurrences

Abstract

Correspondence (İletişim): Selçuk Yıldız, M.D. Haydarpasa Numune Egitim ve Arastirma Hastanesi, Kulak Burun Bogaz Klinigi, Istanbul, Turkey Phone (Telefon): +90 216 542 32 32 E-mail (E-posta): selcukyildiz60@hotmail.com Submitted Date (Başvuru Tarihi): 05.03.2018 Accepted Date (Kabul Tarihi): 27.06.2018 Copyright 2019 Haydarpaşa Numune Medical Journal OPEN ACCESS This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/). 225 Yıldız et al., The Role of Allergy in Recurrence of Adenoid Vegetation / doi: 10.14744/hnhj.2018.57855 Studies advocate that AV is related to the presence of atopy in the patient. Coexistence between allergic rhinitis and AV has been reported to be significant. Also, some studies have suggested a significant relationship between increased IgE levels and adenotonsillar hypertrophy [2–12]. Smoking by parents leads to ciliary dysfunction in children and thus increases the incidence of upper respiratory tract infections, such as chronic sinusitis and chronic otitis media. Repetition of such infections may pave the way for the formation of adenoid hypertrophy by lymphoid tissue stimulation [13–17]. Allergy and passive smoking may have a role in patients who had undergone adenoidectomy and developed recurrent adenoid hypertrophy. In this study, based on this information in the literature, AV recurrence was screened in long-term control of children who had undergone adenoidectomy, and it was planned to investigate the role of atopy and exposure to cigarette smoke in recurrent cases. Materials and Methods The patients aged 4-17 years with total IgE values above 200 IU/L who had undergone adenoidectomy operation in our clinic at least 6-16 months ago between 2010 and 2014 were included in this study after approval of the Clinical Research Ethics Committee of Haydarpaşa Numune Training and Research Hospital was obtained. Patients who had undergone additional surgical procedures other than adenoidectomies, such as ventilation tube application or tonsillectomy, were not included in the study group. Files of only 30 patients who had undergone adenoidectomy were retrospectively reviewed. Identity information, anamnesis, body mass indexes, date of operation, physical examination findings and laboratory tests recorded during the application were noted on the case report forms. Anamnesis records were examined for nasal obstruction, history of frequent upper respiratory tract infections, open mouth sleep, mouth snoring and apnea, and also upper airway complaints were investigated. The findings were noted by questioning whether the patient himself/ herself smoked in the adolescent age group and whether or not his/her family was a smoker in all age groups. Among laboratory findings, total IgE values were recorded using RAST® test, and cases with higher than normal values were determined. Patients underwent a detailed ear nose throat and systemic examination at least six months postoperatively. Physical examination also investigated the presence of allergic rhinitis. Endoscopic nasopharynx examination was performed to determine the degree of choanal obstruction. The choanal obstruction was graded as according to degree of the obstruction as follows: Grade 1. 0-25%; Grade 2. 2650%; Grade 3. 51-75%; and Grade 4. 76-100% obstruction. Non-Grade 1 cases were noted as AV recurrence. After detailed interrogation and detailed physical examination, cases with symptomatic recurrence were determined Statistical analyses NCSS (Number Cruncher Statistical System) 2007 (NCSS. LLC Kaysville. Utah. USA) was used for statistical analysis. Independent Samples test was used to evaluate the study data. Yates Continuity Correction and Fisher’s Exact test were used to compare qualitative data. The results were evaluated using a 95% confidence interval and p<0.05 significance level.