Effect of adenoidectomy on cough reflex sensitivity in children

Nasopharyngeal tonsil undergoes natural enlargement in children between the ages 3 to 5 years. When it is colonized by pathogenic bacteria, a series of physiological processes can lead to loss of immunity and the incidence of hypertrophy in the organ. Excessive hypertrophy of nasopharyngeal tonsil is termed adenoid hypertrophy (AH). Further, children are highly susceptible to chronic cough.

A group of researchers conducted a study to assess the effect of hypertrophied adenoid tissue in children on chronic cough reflex sensitivity.

Method

Study participants:
01

Study participants:

17 chidlren with symptoms of chronic cough and adenoids
Assessments:
02

Assessments:

Cough reflex sensitivity assessment (single-breath capsaicin test) before and after endoscopic adenoidectomy

The definition of the cough reflex sensitivity was the lowest capsaicin concentration that caused two (C2) or five (C5) coughs.

Results

  • Cough reflex sensitivity increased (decrease in C2 and C5 values) after adenoidectomy in non-atopic children with chronic cough
    – Cough reflex sensitivity for the C2 parameter was 31.86 (12.98–78.18) µmol/L preoperatively and 11.97 (6.16–23.26) µmol/L postoperatively (p=0.064)
    – Cough reflex sensitivity for the C5 parameter was 234.91 (97.19–567.77) µmol/L preoperatively and 69.13 (29.08–164.35) µmol/L postoperatively (p=0.022)
  • After adenoidectomy, there was significant change in subjective cough assessment and a significant improvement in subjective AH symptoms

Adenoidectomy increased cough reflex sensitivity in this study. The results infer that presence of other frequent concomitant symptoms must be taken into consideration before indicating adenoidectomy.

Reference: Sojak J, Durdik P, Omar Mohamedova E, et al. Changes in cough reflex sensitivity in children after removal of hypertrophied adenoid tissue. J Asthma Allergy. 2022;15:517–524.