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Adenoid hypertrophy affects screening for primary ciliary dyskinesia using nasal nitric oxide

T. Rybnikar, M. Senkerik, J. Chladek, J. Chladkova, D. Kalfert, L. Skoloudik,

. 2018 ; 115 (-) : 6-9. [pub] 20180914

Language English Country Ireland

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc19000275

AIM: In patients with primary ciliary dyskinesia (PCD), the release of nitric oxide (NO) is extremely low by epithelia of the nasopharynx and sinuses. Measurement of nasal NO (nNO) is recommended as a screening test for PCD. The study aimed to evaluate if adenoids affects nNO and may deteriorate the performance of the test. METHODS: In 48 nonallergic patients between 5 and 18 years of age with chronic symptoms of nasal obstruction and indications for adenoidectomy, the measurements of nNO by chemiluminescence analyser and nasal patency by active anterior rhinomanometry were performed both before and after adenoidectomy. Adenoidal tissue size was graded during surgery under general anaesthesia using transoral endoscopy. RESULTS: Patients were stratified into groups with adenoids grades 1, 2 and 3 (<1/3, 1/3-2/3 and > 2/3 of the choana and post-nasal space covered by adenoids). Before adenoidectomy, the median of nNO decreased with the increasing grade of adenoids (920, 663, and 491 ppb, P < 0.05). The rhinomanometry results were comparable and showed no correlation with nNO. Seven patients (14.6%) were incorrectly classified to have PCD based on a subthreshold value of the volume flow of nNO (FnNO < 77 nL/min). Following adenoidectomy, nNO of the grade 3 patients increased by 107 ppb (P < 0.05) and no differences were found between groups (P = 0.40). All patients had the postadenoidectomy FnNO >77 nL/min. CONCLUSIONS: nNO and FnNO are reduced in nonallergic children with obstructive adenoids. Adenoid hypertrophy can potentially cause a false positive result of the test for PCD.

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$a Rybnikar, Tomas $u Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Czech Republic.
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$a Adenoid hypertrophy affects screening for primary ciliary dyskinesia using nasal nitric oxide / $c T. Rybnikar, M. Senkerik, J. Chladek, J. Chladkova, D. Kalfert, L. Skoloudik,
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$a AIM: In patients with primary ciliary dyskinesia (PCD), the release of nitric oxide (NO) is extremely low by epithelia of the nasopharynx and sinuses. Measurement of nasal NO (nNO) is recommended as a screening test for PCD. The study aimed to evaluate if adenoids affects nNO and may deteriorate the performance of the test. METHODS: In 48 nonallergic patients between 5 and 18 years of age with chronic symptoms of nasal obstruction and indications for adenoidectomy, the measurements of nNO by chemiluminescence analyser and nasal patency by active anterior rhinomanometry were performed both before and after adenoidectomy. Adenoidal tissue size was graded during surgery under general anaesthesia using transoral endoscopy. RESULTS: Patients were stratified into groups with adenoids grades 1, 2 and 3 (<1/3, 1/3-2/3 and > 2/3 of the choana and post-nasal space covered by adenoids). Before adenoidectomy, the median of nNO decreased with the increasing grade of adenoids (920, 663, and 491 ppb, P < 0.05). The rhinomanometry results were comparable and showed no correlation with nNO. Seven patients (14.6%) were incorrectly classified to have PCD based on a subthreshold value of the volume flow of nNO (FnNO < 77 nL/min). Following adenoidectomy, nNO of the grade 3 patients increased by 107 ppb (P < 0.05) and no differences were found between groups (P = 0.40). All patients had the postadenoidectomy FnNO >77 nL/min. CONCLUSIONS: nNO and FnNO are reduced in nonallergic children with obstructive adenoids. Adenoid hypertrophy can potentially cause a false positive result of the test for PCD.
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$a Senkerik, Marian $u Department of Pediatrics and Neonatology, Regional Hospital, Pardubice, Czech Republic.
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$a Chladek, Jaroslav $u Department of Pharmacology, Charles University, Faculty of Medicine in Hradec Kralove, Czech Republic.
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$a Chladkova, Jirina $u Department of Pediatrics, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Czech Republic.
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$a Kalfert, David $u Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, Charles University, First Faculty of Medicine, Prague, Czech Republic. Electronic address: david.kalfert@fnmotol.cz.
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$a Skoloudik, Lukas $u Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Czech Republic.
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