No abstract available.
Adenoidectomy* ; Child* ; Humans ; Snoring* ; Tonsillectomy*

BACKGROUND AND OBJECTIVES: The changes in voice that occur after tonsillectomy and adenoidectomy are mainly the nasal sound which can be measured with nasometer. This study was designed to estimate the postoperative changes in the voice, especially the nasal sound. MATERIALS AND METHODS: The subjects of this study included 26 patients who had received tonsillectomy and adenoidectomy. Thirty normal children were also selected as the control group. The nasalance and the each formants of /a/, /i/ of preoperative state were compared with those of postoperative 4 and 8 weeks. RESULTS: The preoperative nasality of the tonsillectomy and adenoidectomy group was significantly lower than that of the control group. Comparing the preoperative and postoperative 1 month state, there was significant increase in the nasalance, whereas it was recovered in the postoperative 2 months to the same level of the preoperatve state. The changes of the formants were not significantly noticed. CONCLUSION: Although the temporary increase in the nasalance does occur immediately after adenoidectomy, the postoperative 2 months state show no significant changes compared to the preoperative state. Therefore, the voice changes that come postoperatively could be considered as no concern for the non-professional voice user.
Adenoidectomy* ; Child ; Humans ; Tonsillectomy* ; Voice

BACKGROUND: There was a difference between the past and the present in distance from the upper incisor to the carina in children. This study was performed to evaluate the distance from the upper incisor to the carina and correlation of it with age, the weight and height in korean children from 2 to 8 years old. METHODS: Two hundred twenty two children from 2 to 8 years old scheduled for receiving tonsillectomy or adenoidectomy were evaluated for the study by age groups (every 6 months from 2 to 8 years old). The X-ray was used for evaluation of distance from the incisor to the carina. The distance from the upper incisor to C7 was calculated on neck lateral view and distance from C7 to the carina was calculated on chest PA. Both distance were added and served as the distance from upper incisor to the carina. RESULTS: The coefficient of determination of the distance from the upper incisor to the carina was highest according to height. The regression equation of the distance from the upper incisor to the carina using height was Y (cm) = 0.15 X (cm) and R2 = 0.70 (Y: the upper incisor to the carina, X: the height). CONCLUSIONS: We found that the distance from the upper incisor to the carina in children correlated with both the weight and height in children and the height was the highest correlation with distance.
Adenoidectomy ; Child* ; Humans ; Incisor* ; Neck ; Thorax ; Tonsillectomy

It is well documented that adenoidectomy is attributed to hypernasality in certain cases, but not clear that the enlarged tonsils affect the quality of speech. Hypertrophied tonsils may cause and complicate the problem of velopharyngeal incompetency. The huge tonsils prevent lateral pharyngeal walls from a medial movement and interfere velar elevation, being hypernasality. Hyponasality developes as the tonsils encroach in nasopharyngeal space. Voluminous tonsils also interfere airflow in the oropharyneal passage and produce the phenomenon of cul-de-sac resonance or muffled sound. The authors and et al. present a case of velopharyngeal insufficiency accompanied with hypertrophic tonsils. Improving the lateral constricting pharyngeal wall and velar elevation after tonsillectomy minimized the velopharyngeal gap. Accordingly, the procedures of sphincter pharyngoplasty and palatal lengthening resolved the problem of hypernasality instead of pharyngeal flap. Tonsillectomy prior to pharyngeal flap surgery tends to reduce the postoperative airway problems. Sometimes, however, only tonsillectomy does without pharyngeal flap. Surgical approach by stages and intermittent evaluation are recommended at intervals of at least six weeks.
Adenoidectomy ; Palatine Tonsil* ; Tonsillectomy ; Velopharyngeal Insufficiency*

BACKGROUND: This study was doned to evaluate the rate of awakening after desflurane or isoflurane anesthesia in pediatric tonsillectomy patients. METHODS: Sixty patients, aged 5 10 years undergoing a tonsillectomy with or without an adenoidectomy were randomly assigned to receive either desflurane-N2O (group D) or isoflurane-N2O (group I). A recovery profile was assessed by a 3 point scale for the first 0, 15 and 30 min in the recovery room. RESULTS: It was statistically significant that group D had a shorter extubation time and eye opening time and a less apprehensive score than group I at 0, 15 and 30 min. CONCLUSIONS: We conclude that desflurane-N2O may offer clinical advantages over isoflurane when used for maintenance of anesthesia during a pediatric tonsillectomy.
Adenoidectomy ; Anesthesia ; Humans ; Isoflurane ; Recovery Room ; Tonsillectomy*

BACKGROUND AND OBJECTIVES: Because of its advantage over the conventional method, power-assisted adenoidectomy has become an increasingly popular procedure in adenoidectomy. The purpose of this paper is to find the best combination of endoscope and microdebrider to achieve the most successful outcome in patients with various configuration of adenoid vegetation. SUBJECTS AND METHOD: One hundred ninety-one patients who underwent adenoidectomy in the department of Otolaryngology at Inje University Seoul Paik Hospital from January 2000 to February 2006 were reviewed by charts and recorded video tapes for the techniques that we applied to these patients. RESULTS: Four different combinations can be created from two different angles of endoscope and microdebrider ; transnasal 0degrees endoscopic guided transnasal adenoidectomy using straight microdebrider (TNTN), transnasal 0degrees endoscopic guided transoral adenoidectomy using curved microdebrider (TNTO), transoral 70degrees endoscopic guided transnasal adenoidectomy using straight microdebrider (TOTN) and transoral 70degrees endoscopic guided transoral adenoidectomy using curved microdebrider (TOTO). TOTO was the most frequent combination for simple adenoid vegetation. However, it is not suitable for removal of adenoid located high in the pharyngeal roof. In this case, we added TNTO to TOTO. The least frequent combined technique was TNTN, which has inherent limitation to use in small sized nares and younger age. In this situation, TOTN is a better alternative to use. CONCLUSION: From six years of experience, we confirmed that endoscopic guided powerassisted adenoidectomy should be performed with proper combination of endoscope and microdebrider based on the location and configuration of adenoid vegetation. The most ideal combination we consistently applied for removal of adenoid is as follows ; first, TNTO, secondly, TOTO. Lastly, TOTN could be useful in selected cases.
Adenoidectomy* ; Adenoids ; Endoscopes* ; Humans ; Otolaryngology ; Seoul

BACKGROUND AND OBJECTIVES: Adenoid enlargement occurs most commonly between the age of three and ten. Atrophy usually begins at the age of ten and is completed before the age of twenty. In recent years, an increasing number of adolescents undergoing adenoidectomy has been noticed. We investigated the age change in 1990s. MATERIALS AND METHOD: A retrospective study was performed on 1,198 patients who underwent adenoidectomy due to adenoid vegetation confirmed by physical, radiologic, and endoscopic studies. The mean age was analyzed annually and the period of 1990s was divided into the first (from January 1990 to December 1994) and second half (from January 1995 to December 1999). In addition, the same analysis was performed for each age group below ten and above eleven. RESULTS: The study showed that the mean age of study population was 7.35, with the mean age of the first half being 7.10 and the second 7.52. Specifically, the mean age of the group below ten was 6.37 in the first half and 6.16 in the second half, and the group above eleven was 12.56 in the first half and 13.32 in the second half. CONCLUSION: The mean age of the patients who underwent adenoidectomy have increased during the econd half, especially in the age groups greater more than eleven.
Adenoidectomy* ; Adenoids ; Adolescent ; Atrophy ; Humans ; Retrospective Studies

BACKGROUND: This study was designed to compare intramuscular diclofenac with intravenous fentanyl in the prevention of pain after tonsillectomy and adenoidectomy for day-surgery. METHODS: We studied 60 patients, aged 3-13 years, undergoing tonsillectomy with or without adenoidectomy. Patients were randomly assigned to receive placebo injecton (Group 1), intramuscular diclofenac 1 mg/kg (Group 2) or intravenous fentanyl 1 microgram/kg (Group 3) after induction of anesthesia. Pain was evaluated by using an observer pain score for the first 30 min, 60 min and 4 hrs postoperatively. RESULTS: It is statistically significant that group 2 and group 3 had lesser pain than group 1 at 30 min and 60 min. But there is no difference among any groups at 4 hr postoperatively. CONCLUSIONS: We conclude that diclofenac may have advantages compared to fentanyl in safety and convenience for the treatment of pain after tonsillectomy in children.
Adenoidectomy ; Anesthesia ; Child ; Diclofenac* ; Fentanyl* ; Humans ; Pain, Postoperative ; Tonsillectomy*

This study was made to investigate the effect of adenoidectomy on dentofacial skeleton in naso-respiratory dysfunction children. The clinical material compromised the 24 children in a previous study who had naso-respiratory dysfunction and 24 children who were the nasal breathing with normal occlusion. The cephalograms were taken at the initial examination and 1 year later for the control group and experimental group the paired sample statistical analysis was performed. The results were as follows. 1. In cranial base variable, difference between two groups were not statistically significant. 2. In craniofacial variables, experimental group showed brachyfacial pattern but control groups didn't show significant growth pattern. 3. In maxillary variables, experimental group showed flattening the plane. 4. In mandibular variables, experimental group showed the decrease of mandibular plane angle and gonial angle. 5. In facial height variables, experimental group showed horizontal growth rotation.
Adenoidectomy* ; Adenoids ; Child* ; Humans ; Respiration ; Skeleton* ; Skull Base

BACKGROUNDs: It is widely known that desflurane provides fast emergence but with a high incidence of emergence agitation. This study was designed to investigate the emergence agitation resulting from thiopental or ketamine induction with desflurane anesthesia for pediatric patients. METHODS: Forty patients, aged 3-8 years, scheduled for a tonsillectomy or a tonsillectomy and adenoidectomy were randomly allocated into two groups. Anesthesia was induced using 5 mg/kg thiopental sodium (Group T patients) or 2 mg/kg ketamine (Group K patients), and was maintained using O2-N2O-desflurane. The recovery time and incidence of emergence agitation were assessed. RESULTS: The incidence of emergence agitation was less in patients in the ketamine induction group. There were no differences in the recovery time and reported side effects. CONCLUSIONS: We conclude that ketamine induction provides less emergence agitation when compared to thiopental induction for desflurane anesthesia for a pediatric tonsillectomy or a tonsillectomy and adenoidectomy without delayed recovery.
Adenoidectomy ; Anesthesia* ; Child* ; Dihydroergotamine* ; Humans ; Incidence ; Ketamine* ; Thiopental* ; Tonsillectomy*