How Does Adenotonsillectomy Affect the Olfactory Threshold in Children?

  • Samireh Farshchi
  • Osman Mohammad Karim
  • Mohammad Amir Korani
  • Mohammadamin Joulani
Original Article
  • 7 Downloads

Abstract

Adenotonsillectomy is one of the main operations on the head and neck surgery quality in children. This study aimed to compare the olfactory threshold changes in adenotonsillectomy patients. This comparative study was done on 152 children whom candidate for adenotonsillectomy before and 3 weeks after the operation referred to the Dr. Kermanshahi Hospital, Kermanshah, Iran during 2015–2016. The olfactory threshold was determined by olfactory test using phenyl butyl alcohol in propylene glycol. The orthonasal test was done by a strip and the lowest propylene glycol detection used as olfactory threshold. The mean age was 6.81 ± 3.83 of patients were boys and 69 of them were girls. The allergic rhinitis was detected in 83.6% of the patients before the adenotonsillectomy while it was only in 16.4% after adenotonsillectomy. Also, nocturia was higher before the adenotonsillectomy 104 (68.4%) compared to post-adenotonsillectomy 48 (31.6%). In 73 (48%) patients, the sleep quality score was 10 after the surgery while there was a patient with score 10 before the operation. The positive allergic rhinitis was higher in male 70 (84.3%) compared to female 57 (82.6%). Also, no significant difference detected on nocturia (P = 0.531). Also, significant difference detected between 2 groups in sleep quality score before and after the adenotonsillectomy (P = 0.001). The olfactory threshold significantly improved after surgery compared to previous (P = 0.034). These results suggest olfactory threshold improves after adenotonsillectomy in children.

Keywords

Adenotonsillectomy Olfactory threshold Allergic rhinitis Nocturia Sleep quality score 

Notes

Acknowledgements

This work was performed in partial fulfillment of the requirements for MD. Of Osman Mohammad Karim, in Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Compliance with Ethical Standards

Conflict of interest

The authors declare that there are no conflict of interest.

Data Confidentiality

The authors declare having followed the protocols in use at their working center regarding patient’s data publication.

Protection of Humans and Animals

The authors declare that the procedures were followed according to the regulations established by the Clinical Research and Ethics Committee and to the Helsinki Declaration of the World Medical Association.

References

  1. 1.
    Beebe DW, Groesz L, Wells C, Nichols A, McGee K (2003) The neuropsychological effects of obstructive sleep apnea: a meta-analysis of norm-referenced and case-controlled data. Sleep 26(3):298–307CrossRefPubMedGoogle Scholar
  2. 2.
    Mohsen N, Susan A, Shahin B, Soheila D (2014) Sleep related quality of life before and after adenotonsillar surgery in pediatric population. Int J Pediatr Otorhinolaryngol 78(2):330–333.  https://doi.org/10.1016/j.ijporl.2013.12.003 CrossRefPubMedGoogle Scholar
  3. 3.
    Friedman M, Wilson M, Lin HC, Chang HW (2009) Updated systematic review of tonsillectomy and adenoidectomy for treatment of pediatric obstructive sleep apnea/hypopnea syndrome. Otolaryngol Head Neck Surg 140(6):800–808.  https://doi.org/10.1016/j.otohns.2009.01.043 CrossRefPubMedGoogle Scholar
  4. 4.
    Roudnitzky N, Bult JH, de Wijk RA, Reden J, Schuster B, Hummel T (2011) Investigation of interactions between texture and ortho- and retronasal olfactory stimuli using psychophysical and electrophysiological approaches. Behav Brain Res 216(1):109–115.  https://doi.org/10.1016/j.bbr.2010.07.019 CrossRefPubMedGoogle Scholar
  5. 5.
    Nguyen DT, Nguyen-Thi PL, Jankowski R (2012) How does measured olfactory function correlate with self-ratings of the sense of smell in patients with nasal polyposis? Laryngoscope 122(5):947–952.  https://doi.org/10.1002/lary.23219 CrossRefPubMedGoogle Scholar
  6. 6.
    Altundag A, Salihoglu M, Cayonu M, Tekeli H (2014) Clinical assessment of olfactory functions in children who underwent adenotonsillectomy during pre- and post-operative period. Int J Pediatr Otorhinolaryngol 78(7):1138–1142.  https://doi.org/10.1016/j.ijporl.2014.04.032 CrossRefPubMedGoogle Scholar
  7. 7.
    Welge-Lussen A, Husner A, Wolfensberger M, Hummel T (2009) Influence of simultaneous gustatory stimuli on orthonasal and retronasal olfaction. Neurosci Lett 454(2):124–128.  https://doi.org/10.1016/j.neulet.2009.03.002 CrossRefPubMedGoogle Scholar
  8. 8.
    Krysta K, Bratek A, Zawada K, Stepanczak R (2017) Cognitive deficits in adults with obstructive sleep apnea compared to children and adolescents. J Neural Transm (Vienna) 124(Suppl 1):187–201.  https://doi.org/10.1007/s00702-015-1501-6 CrossRefGoogle Scholar
  9. 9.
    Stone J, Malone PS, Atwill D, McGrigor V, Hill CM (2008) Symptoms of sleep-disordered breathing in children with nocturnal enuresis. J Pediatr Urol 4(3):197–202.  https://doi.org/10.1016/j.jpurol.2007.11.011 CrossRefPubMedGoogle Scholar
  10. 10.
    Ahmadi MS, Amirhassani S, Poorolajal J (2013) The effect of adenotonsillectomy on pediatric nocturnal enuresis: a prospective cohort study. Iran J Otorhinolaryngol 25(70):37–40PubMedPubMedCentralGoogle Scholar
  11. 11.
    Weissbach A, Leiberman A, Tarasiuk A, Goldbart A, Tal A (2006) Adenotonsilectomy improves enuresis in children with obstructive sleep apnea syndrome. Int J Pediatr Otorhinolaryngol 70(8):1351–1356.  https://doi.org/10.1016/j.ijporl.2006.01.011 CrossRefPubMedGoogle Scholar
  12. 12.
    Laing DG, Segovia C, Fark T, Laing ON, Jinks AL, Nikolaus J, Hummel T (2008) Tests for screening olfactory and gustatory function in school-age children. Otolaryngol Head Neck Surg 139(1):74–82.  https://doi.org/10.1016/j.otohns.2006.11.058 CrossRefPubMedGoogle Scholar
  13. 13.
    Ahmed AO, Aliyu I, Kolo ES (2014) Indications for tonsillectomy and adenoidectomy: our experience. Niger J Clin Pract 17(1):90–94.  https://doi.org/10.4103/1119-3077.122855 CrossRefPubMedGoogle Scholar
  14. 14.
    Alcântara LJL PR, Mira JGS, Soccol AT, Tholken R, Koerner HN et al (2008) Adenotonsillectomy impact on children’s quality of life. Int Arch Otorhinolaryngol 12(2):172–178Google Scholar
  15. 15.
    Dykewicz MS, Fineman S, Skoner DP, Nicklas R, Lee R, Blessing-Moore J, Li JT, Bernstein IL, Berger W, Spector S, Schuller D (1998) Diagnosis and management of rhinitis: complete guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. American Academy of Allergy, Asthma, and Immunology. Ann Allergy Asthma Immunol 81(5 Pt 2):478–518CrossRefPubMedGoogle Scholar
  16. 16.
    Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, van Wijk RG, Ohta K, Zuberbier T, Schunemann HJ, Global A, Asthma European N, Grading of Recommendations Assessment D, Evaluation Working G (2010) Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol 126(3):466–476.  https://doi.org/10.1016/j.jaci.2010.06.047 CrossRefPubMedGoogle Scholar
  17. 17.
    van Kerrebroeck P, Abrams P, Chaikin D, Donovan J, Fonda D, Jackson S, Jennum P, Johnson T, Lose G, Mattiasson A, Robertson G, Weiss J, Standardisation Sub-committee of the International Continence S (2002) The standardisation of terminology in nocturia: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21(2):179–183CrossRefPubMedGoogle Scholar
  18. 18.
    Appell RA, Sand PK (2008) Nocturia: etiology, diagnosis, and treatment. Neurourol Urodyn 27(1):34–39.  https://doi.org/10.1002/nau.20484 CrossRefPubMedGoogle Scholar
  19. 19.
    van den Akker EH, Schilder AG, Kemps YJ, van Balen FA, Hordijk GJ, Hoes AW (2003) Current indications for (adeno)tonsillectomy in children: a survey in The Netherlands. Int J Pediatr Otorhinolaryngol 67(6):603–607CrossRefPubMedGoogle Scholar
  20. 20.
    Kern RC, Conley DB, Haines GK 3rd, Robinson AM (2004) Pathology of the olfactory mucosa: implications for the treatment of olfactory dysfunction. Laryngoscope 114(2):279–285.  https://doi.org/10.1097/00005537-200402000-00018 CrossRefPubMedGoogle Scholar
  21. 21.
    Chalouhi C, Faulcon P, Le Bihan C, Hertz-Pannier L, Bonfils P, Abadie V (2005) Olfactory evaluation in children: application to the CHARGE syndrome. Pediatrics 116(1):e81–e88.  https://doi.org/10.1542/peds.2004-1970 CrossRefPubMedGoogle Scholar
  22. 22.
    Hugh SC, Siu J, Hummel T, Forte V, Campisi P, Papsin BC, Propst EJ (2015) Olfactory testing in children using objective tools: comparison of Sniffin’ Sticks and University of Pennsylvania Smell Identification Test (UPSIT). J Otolaryngol Head Neck Surg 44:10.  https://doi.org/10.1186/s40463-015-0061-y CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Sienkiewicz-Jarosz H, Scinska A, Kuran W, Ryglewicz D, Rogowski A, Wrobel E, Korkosz A, Kukwa A, Kostowski W, Bienkowski P (2005) Taste responses in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 76(1):40–46.  https://doi.org/10.1136/jnnp.2003.033373 CrossRefPubMedGoogle Scholar
  24. 24.
    Parker NP, Walner DL (2011) Trends in the indications for pediatric tonsillectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol 75(2):282–285.  https://doi.org/10.1016/j.ijporl.2010.11.019 CrossRefPubMedGoogle Scholar
  25. 25.
    Konstantinidis I, Triaridis S, Triaridis A, Petropoulos I, Karagiannidis K, Kontzoglou G (2005) How do children with adenoid hypertrophy smell and taste? Clinical assessment of olfactory function pre- and post-adenoidectomy. Int J Pediatr Otorhinolaryngol 69(10):1343–1349.  https://doi.org/10.1016/j.ijporl.2005.03.022 CrossRefPubMedGoogle Scholar
  26. 26.
    Cain WS, Gent JF, Goodspeed RB, Leonard G (1988) Evaluation of olfactory dysfunction in the Connecticut Chemosensory Clinical Research Center. Laryngoscope 98(1):83–88.  https://doi.org/10.1288/00005537-198801000-00017 CrossRefPubMedGoogle Scholar
  27. 27.
    Basha S, Bialowas C, Ende K, Szeremeta W (2005) Effectiveness of adenotonsillectomy in the resolution of nocturnal enuresis secondary to obstructive sleep apnea. Laryngoscope 115(6):1101–1103.  https://doi.org/10.1097/01.MLG.0000163762.13870.83 CrossRefPubMedGoogle Scholar
  28. 28.
    Costa MO, Lacerda MT, Garcia Otaduy MC, Cerri GG, Da Costa Leite C (2002) Proton magnetic resonance spectroscopy: normal findings in the cerebellar hemisphere in childhood. Pediatr Radiol 32(11):787–792.  https://doi.org/10.1007/s00247-002-0777-5 CrossRefPubMedGoogle Scholar
  29. 29.
    Halbower AC, Degaonkar M, Barker PB, Earley CJ, Marcus CL, Smith PL, Prahme MC, Mahone EM (2006) Childhood obstructive sleep apnea associates with neuropsychological deficits and neuronal brain injury. PLoS Med 3(8):e301.  https://doi.org/10.1371/journal.pmed.0030301 CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Cinar U, Vural C, Cakir B, Topuz E, Karaman MI, Turgut S (2001) Nocturnal enuresis and upper airway obstruction. Int J Pediatr Otorhinolaryngol 59(2):115–118CrossRefPubMedGoogle Scholar
  31. 31.
    Leiberman A, Stiller-Timor L, Tarasiuk A, Tal A (2006) The effect of adenotonsillectomy on children suffering from obstructive sleep apnea syndrome (OSAS): the Negev perspective. Int J Pediatr Otorhinolaryngol 70(10):1675–1682.  https://doi.org/10.1016/j.ijporl.2006.06.002 CrossRefPubMedGoogle Scholar
  32. 32.
    Bucks RS, Olaithe M, Eastwood P (2013) Neurocognitive function in obstructive sleep apnoea: a meta-review. Respirology 18(1):61–70.  https://doi.org/10.1111/j.1440-1843.2012.02255.x CrossRefPubMedGoogle Scholar
  33. 33.
    Gagnon K, Baril AA, Gagnon JF, Fortin M, Decary A, Lafond C, Desautels A, Montplaisir J, Gosselin N (2014) Cognitive impairment in obstructive sleep apnea. Pathol Biol (Paris) 62(5):233–240.  https://doi.org/10.1016/j.patbio.2014.05.015 CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  • Samireh Farshchi
    • 1
  • Osman Mohammad Karim
    • 2
  • Mohammad Amir Korani
    • 3
  • Mohammadamin Joulani
    • 4
  1. 1.Department of Otorhinolaryngology, Imam Khomaini HospitalKermanshah University of Medical SciencesKermanshahIran
  2. 2.Student Research Committee, Faculty of MedicineKermanshah University of Medical SciencesKermanshahIran
  3. 3.Faculty of MedicineKermanshah University of Medical SciencesKermanshahIran
  4. 4.Student Research Committee, Faculty of MedicineIran University of Medical SciencesTehranIran

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