Bioclinical Profile of Adenotonsillar Hypertrophy in the Pediatric Population

NCT ID: NCT03541434

Last Updated: 2019-04-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

134 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-02-01

Study Completion Date

2018-06-30

Brief Summary

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Adenotonsillar hypertrophy is the principal cause of obstructive sleep apnea of childhood, yet little is known with regard to its pathophysiologic and molecular mechanisms. The present trial examines potential bioclinical markers of the disease.

Detailed Description

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Background: Tonsils and adenoids comprise the main bulk of Waldeyer's ring, which is commonly enlarged in childhood, until the age of 11. Obstructive sleep apnea caused by adenotonsillar hypertrophy is a major contributing factor to cardiorespiratory morbidity in the pediatric population. It is also responsible for otitis media with effusion, the most frequent cause of children's hearing loss. Even so, there is scarce knowledge of its molecular pathogenesis.

Objective: Identification of clinical/molecular markers of adenotonsillar enlargement and investigation of their participation in the process of tissue hypertrophy.

Methods: A prospective cohort of children with adenotonsillar hypertrophy were recruited starting on 02/01/2017 and ending on 12/22/2017. Demographic and clinical data including age, gender, sleep apnea severity, tonsillar size, presence of middle ear effusion, family history, review of systems as well as tympanometric and complete blood count results were recorded. Blood samples and tissue specimens from the therapeutic adenotonsillectomy procedure were archived for future analyses. Children with chronic tonsillitis and/or adenoiditis, who also underwent excision of tonsils and/or adenoids served as study controls. Informed consent was obtained from parents of all study participants.

Conditions

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Enlargement of Tonsil or Adenoid

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Healthy

Children with no history of adenotonsillar hypertrophy, recurrent tonsillitis, or middle ear effusion. They presented to the clinic for examination or a scheduled procedure.

Complete Blood Count

Intervention Type DIAGNOSTIC_TEST

White blood cell subgroups count

Tympanometry

Intervention Type DIAGNOSTIC_TEST

Conventional and multifrequency tympanometry, documenting middle ear admittance and absorbance

Recurrent tonsillitis

Children with a history of recurret tonsillitis but no adenotonsillar hypertrophy. Diagnosis was based on physical exam and complete blood count. They presented to the clinic for a sceduled tonsillectomy.

Complete Blood Count

Intervention Type DIAGNOSTIC_TEST

White blood cell subgroups count

Tympanometry

Intervention Type DIAGNOSTIC_TEST

Conventional and multifrequency tympanometry, documenting middle ear admittance and absorbance

Tonsillectomy and/or adenoidectomy

Intervention Type PROCEDURE

Excision of palatine and/or pharyngeal tonsils.

Middle ear effusion

Children with chronic middle ear effusion but no adenotonsillar hypertrophy. Diagnosis was based on physical exam and tympanometry. They presented to the clinic for scheduled myringotomy with or without adenoidectomy.

Complete Blood Count

Intervention Type DIAGNOSTIC_TEST

White blood cell subgroups count

Tympanometry

Intervention Type DIAGNOSTIC_TEST

Conventional and multifrequency tympanometry, documenting middle ear admittance and absorbance

Tonsillectomy and/or adenoidectomy

Intervention Type PROCEDURE

Excision of palatine and/or pharyngeal tonsils.

Adenotonsillar hypertrophy

Children with tonsillar and/or adenoidal hypertrophy. Diagnosis was based on physical exam and partly on x-ray of nasopharynx or nasopharyngoscopy. They presented to the clinic for scheduled tonsillectomy and/or adenoidectomy.

Complete Blood Count

Intervention Type DIAGNOSTIC_TEST

White blood cell subgroups count

Tympanometry

Intervention Type DIAGNOSTIC_TEST

Conventional and multifrequency tympanometry, documenting middle ear admittance and absorbance

Tonsillectomy and/or adenoidectomy

Intervention Type PROCEDURE

Excision of palatine and/or pharyngeal tonsils.

Interventions

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Complete Blood Count

White blood cell subgroups count

Intervention Type DIAGNOSTIC_TEST

Tympanometry

Conventional and multifrequency tympanometry, documenting middle ear admittance and absorbance

Intervention Type DIAGNOSTIC_TEST

Tonsillectomy and/or adenoidectomy

Excision of palatine and/or pharyngeal tonsils.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Available history and physical exam findings
* Available complete blood count and tympanometry at admission

Exclusion Criteria

* Previous tonsillectomy and/or adenoidectomy.
* Previous ear surgery.
* Acute infection during the past month.
* Active severe systemic disease.
Minimum Eligible Age

1 Year

Maximum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Patras

OTHER

Sponsor Role lead

Responsible Party

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Georgios Stathopoulos

Associate Professor of Physiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Georgios T Stathopoulos

Role: PRINCIPAL_INVESTIGATOR

Associate Professor of Physiology

Locations

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Children Hospital of Patras "Karamandaneio"

Pátrai, Achaia, Greece

Site Status

Patras University Hospital

Rio, Achaia, Greece

Site Status

Countries

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Greece

References

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Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J, Schechter MS, Ward SD, Sheldon SH, Shiffman RN, Lehmann C, Spruyt K; American Academy of Pediatrics. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012 Sep;130(3):e714-55. doi: 10.1542/peds.2012-1672. Epub 2012 Aug 27.

Reference Type RESULT
PMID: 22926176 (View on PubMed)

Liou HC. Regulation of the immune system by NF-kappaB and IkappaB. J Biochem Mol Biol. 2002 Nov 30;35(6):537-46. doi: 10.5483/bmbrep.2002.35.6.537.

Reference Type RESULT
PMID: 12470586 (View on PubMed)

Heneghan AF, Pierre JF, Kudsk KA. JAK-STAT and intestinal mucosal immunology. JAKSTAT. 2013 Oct 1;2(4):e25530. doi: 10.4161/jkst.25530. Epub 2013 Jun 26.

Reference Type RESULT
PMID: 24416649 (View on PubMed)

Min HJ, Kim SJ, Kim TH, Chung HJ, Yoon JH, Kim CH. Level of secreted HMGB1 correlates with severity of inflammation in chronic rhinosinusitis. Laryngoscope. 2015 Jul;125(7):E225-30. doi: 10.1002/lary.25172. Epub 2015 Jan 30.

Reference Type RESULT
PMID: 25639490 (View on PubMed)

Kourelis K, Marazioti A, Kourelis T, Stathopoulos GT. Haematologic Markers and Tonsil-to-Body Weight Ratio to Assist Adenotonsillar Hypertrophy Diagnosis. Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):5604-5610. doi: 10.1007/s12070-021-02943-9. Epub 2021 Oct 25.

Reference Type DERIVED
PMID: 36742935 (View on PubMed)

Other Identifiers

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14/30-09-2016 CHPatras

Identifier Type: -

Identifier Source: org_study_id

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