Clinical Research Directory

Serum and Salivary Leptin Levels in Children With Adenoid/Adenotonsillar Hypertrophy

Adenoid and adenotonsillar hypertrophy are among the most common causes of nasal obstruction, snoring and sleep-disordered breathing in children, and chronic upper airway obstruction may affect growth, appetite and energy metabolism. Leptin is an adipose tissue-derived hormone that regulates appetite and energy balance. This prospective case-control study aims to compare serum and salivary leptin levels between children with adenoid/adenotonsillar hypertrophy and age- and sex-matched children without adenoid/adenotonsillar hypertrophy, to evaluate the relationship of leptin levels with height, weight and body mass index, and to assess whether salivary leptin, a non-invasive measure, reflects serum leptin levels.

Conventional Curettage Versus Endoscopic Microdebrider-Assisted Adenoidectomy in Children

The purpose of this randomized clinical trial is to compare two surgical methods for removing enlarged adenoids in children: conventional curettage adenoidectomy and endoscopic microdebrider-assisted adenoidectomy. Enlarged adenoids can cause problems such as snoring, mouth breathing, obstructive sleep apnea, and changes in facial appearance. The main question this study aims to answer is: * Does endoscopic microdebrider-assisted adenoidectomy result in different operative outcomes compared with conventional curettage adenoidectomy? The study will include 88 children aged 3-16 years who have enlarged adenoids and symptoms such as obstructive sleep apnea, mouth breathing, or snoring. Participants will be randomly assigned to one of two groups: * Group A: Adenoidectomy using a conventional adenoid curette. * Group B: Adenoidectomy using a microdebrider while viewing the adenoids with an endoscope. All procedures will be performed under general anesthesia. The researchers will record the duration of the operation and the amount of blood lost during surgery. These outcomes will be compared between the two groups to determine whether the surgical techniques differ in operative time and blood loss. Parents or guardians will provide informed consent before their child participates in the study.

Periostin Levels in Children With Adenoid Hypertrophy

This prospective observational study evaluated serum and tissue periostin levels in children with adenoid hypertrophy. Children with grade 3-4 adenoid hypertrophy who were scheduled for adenoidectomy were compared with children with grade 1 adenoid hypertrophy without symptoms attributable to adenoid enlargement. Serum periostin levels were compared between the two groups. In the adenoidectomy group, periostin levels in adenoid tissue were also compared with paired samples of normal nasopharyngeal mucosa obtained from the same patients. The study aimed to investigate whether periostin may be associated with the development of adenoid hypertrophy and to explore its potential role in local tissue remodeling.

Adenoidectomy With or Without Partial Inferior Turbinectomy for Pediatric Nasal Obstruction

Nasal obstruction is a common problem in children and is frequently caused by adenoid hypertrophy with concomitant inferior turbinate hypertrophy, leading to sleep-disordered breathing and reduced quality of life. Although adenoidectomy is the standard treatment, persistent nasal obstruction may occur in some patients due to inferior turbinate enlargement. Recent evidence suggests that combining inferior turbinate reduction with adenoidectomy may provide superior relief of nasal obstruction and improve postoperative outcomes compared with adenoidectomy alone. The study aims to compare the effectiveness of adenoidectomy alone versus adenoidectomy combined with endoscopic bilateral partial inferior turbinectomy in relieving nasal obstruction and sleep-disordered breathing in children with adenoid and bilateral inferior turbinate hypertrophy.

Full-wrap Versus Conventional Suspension for Reducing Soft Palate Injury Rate in Transoral Surgery

This study aims to evaluate whether the use of full-wrap suspension, compared with the traditional double-strap suspension, can effectively reduce the risk of intraoperative and postoperative soft palate injury in transoral/transnasal pharyngeal surgery. Through a prospective, multicenter, randomized controlled design, this study will provide evidence-based support for the clinical promotion and standardized application of full-wrap suspension.

Evaluation of the Effects of Adenoidectomy and Adenotonsillectomy on Voice in Children

This prospective study aims to evaluate the effects of adenoidectomy and adenotonsillectomy on voice and speech functions in children. Changes in voice quality and resonance may occur after the removal of adenoid and tonsillar tissues, particularly in pediatric patients with enlarged adenoids or tonsils. Objective voice assessments, including acoustic, aerodynamic, and nasalance measurements, as well as subjective voice-related quality of life questionnaires, will be performed before surgery and at the first and third months after surgery. The results of this study are expected to help clinicians better inform families about possible voice changes following adenoidectomy and adenotonsillectomy procedures.

Evaluation of the Effect of Adenoid Hypertrophy on the Masseter Muscle in Children: A Comparative Ultrasonographic Study

The goal of this observational study is to evaluate the effect of adenoid hypertrophy on the masseter muscle in children aged 3 to 8 years. The primary objectives are: * To assess whether adenoid hypertrophy affects the thickness or structure of the masseter muscle. * To determine whether there is a measurable difference in masseter muscle characteristics between children with and without adenoid hypertrophy. Researchers will compare children diagnosed with adenoid hypertrophy and scheduled for adenoidectomy to healthy controls without adenoid hypertrophy. Each participant will: * Undergo ultrasonographic examination of the masseter muscle using a 9L linear probe (6-15 MHz), and * Have their occlusal relationship, dental findings, age, sex, and adenoid hypertrophy grade recorded.

Metabolomic Profiling of Racial Disparity

Tonsillectomy ± adenoidectomy (T\&A) is one of the most common surgical operations with over 500,000 pediatric T\&As performed annually in the United States. Unfortunately, despite advances in anesthetic and surgical techniques, moderate-severe post-tonsillectomy pain (PTP) remains a significant problem affecting up to 62% of children. PTP is thought to arise from pharyngeal mucosal inflammation, which produces local nerve irritation and pharyngeal muscle spasm. Patient factors and surgical techniques also play major roles. Race is an important phenotypic risk factor for moderately severe early PTP. The underlying molecular basis of this differential pain experience is presently unknown. This gap in knowledge means that therapies are poorly targeted and often unsuccessful. Indeed, treatment options for PTP have not advanced substantively for many years. Metabolomics provides novel opportunities to investigate common and unique "metabolic signature" of PTP through the analysis of low molecular weight compounds produced in response to tissue injury. Therefore, the central themes of this proposal are that (1) PTP is a complex process that may be determined by molecular level factors such as preoperative systemic inflammation and metabolic profile, and (2) these molecular level factors may explain the excess burden of PTP among minority children. Here the investigators seek to utilize a combined clinical, biological and untargeted metabolomics approach to identify candidate small and large serum molecules that may influence the frequency and severity of PTP in children across racial groups. This approach to exploring the molecular basis of PTP is novel and knowledge from the study should substantially enhance understanding of the mechanisms underlying pediatric PTP - and narrow the racial disparities in post-operative pain.

It is Accepted That Adenoid Hypertrophy is Related to Otitis Media With Effusion Incidence. Better Understanding of the Correlation Between the Relative Size of AH and the Incidence of Persistent OME May Provide Evidence to Support a More Standardized Approach to the Diagnosis and Treatment of OME.

The aim of this study is to further investigate the correlation between Site and size of adenoid hypertrophy and middle ear effusion in order to provide evidence for designing a more standardized approach to the diagnosis and treatment of OME.