Adenoids and related diseases in childhood

Pediatricians consider adenoiditis, whether it is associated with concomitant obstructive hypertrophy or not, to be one of the most ancient and common problem. Anatomically, adenoids are part of the Waldeyer's ring; and, since they may create mechanical Eustachian Tube (ET) obstruction, they are relevant in the pathogenesis of Otitis Media (OM). Since 1980, adenoidectomy and sometimes adeno-tonsillectomy are believed to have a role in the management of some patients with OME or recurrent acute OM. The current American Academy of Pediatrics clinical practice guidelines candidate a child for adenoidectomy only in a few cases, unless a distinct indication, namely nasal obstruction, does exist; however, adenoidectomy (with or without concurrent myrin-gotomy) is recommended when children, who have had tympanostomy tube, have OME relapse after tubes extrusion. ET dysfunction related to adenoids may have also a functional component, potentially allergy-related. Even though the amount of studies over such topic is limited, the interest related to this issue started in 1970, since IgE on mast cells and plasma cells have been demonstrated in adenoid tissue. Nowadays, indeed, allergic adenoiditis indicate a condition in which adenoid tissue exhibit numerous IgE positive mast cells. In order to diagnose Adenoid hypertrophy or Adenoiditis, nowadays nasal endoscopy is considered to be the gold standard even in young kids, as this technique is also able to detect a possible association between adenoid inflammation/infection and OME, especially during infancy and early childhood.