NCT03541434

Brief Summary

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.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
134

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Feb 2017

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 1, 2017

Completed
11 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 20, 2017

Completed
5 months until next milestone

First Submitted

Initial submission to the registry

May 9, 2018

Completed
21 days until next milestone

First Posted

Study publicly available on registry

May 30, 2018

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2018

Completed
Last Updated

April 16, 2019

Status Verified

April 1, 2019

Enrollment Period

11 months

First QC Date

May 9, 2018

Last Update Submit

April 15, 2019

Conditions

Keywords

obstructive sleep apneatonsillitismiddle ear effusionpathophysiologyscore

Outcome Measures

Primary Outcomes (1)

  • Bioclinical profile of adenotonsillar hypertrophy

    Clinical, laboratory, and molecular markers of adenotonsillar hypertrophy

    One year post surgical procedure

Secondary Outcomes (5)

  • Clinical markers of adenotonsillar hypertrophy

    One year post surgical procedure

  • Laboratory markers of adenotonsillar hypertrophy

    One year post surgical procedure

  • Tympanometric findings of middle ear disease resulting from adenotonsillar hypertrophy

    One year post surgical procedure

  • Wide-Band tympanometric findings of middle ear disease resulting from adenotonsillar hypertrophy

    One year post surgical procedure

  • Molecular determinants of adenotonsillar hypertrophy

    One year post surgical procedure

Study Arms (4)

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.

Diagnostic Test: Complete Blood CountDiagnostic Test: Tympanometry

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.

Diagnostic Test: Complete Blood CountDiagnostic Test: TympanometryProcedure: Tonsillectomy and/or adenoidectomy

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.

Diagnostic Test: Complete Blood CountDiagnostic Test: TympanometryProcedure: Tonsillectomy and/or adenoidectomy

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.

Diagnostic Test: Complete Blood CountDiagnostic Test: TympanometryProcedure: Tonsillectomy and/or adenoidectomy

Interventions

Complete Blood CountDIAGNOSTIC_TEST

White blood cell subgroups count

Adenotonsillar hypertrophyHealthyMiddle ear effusionRecurrent tonsillitis
TympanometryDIAGNOSTIC_TEST

Conventional and multifrequency tympanometry, documenting middle ear admittance and absorbance

Adenotonsillar hypertrophyHealthyMiddle ear effusionRecurrent tonsillitis

Excision of palatine and/or pharyngeal tonsils.

Adenotonsillar hypertrophyMiddle ear effusionRecurrent tonsillitis

Eligibility Criteria

Age1 Year - 16 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)
Sampling MethodNon-Probability Sample
Study Population

All children presenting to the clinics of a Pediatric hospital.

You may qualify if:

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

You may not qualify if:

  • Previous tonsillectomy and/or adenoidectomy.
  • Previous ear surgery.
  • Acute infection during the past month.
  • Active severe systemic disease.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Children Hospital of Patras "Karamandaneio"

Pátrai, Achaia, 26331, Greece

Location

Patras University Hospital

Rio, Achaia, 26504, Greece

Location

Related Publications (5)

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

Biospecimen

Retention: SAMPLES WITH DNA

Blood was centrifuged and cells were separated from supernatants. Both were stored at -80 degrees. Palatine and pharyngeal tonsillar tissue specimens were divided in half. One part was fixated in 4% formaldehyde for 24 hours and then stored in saline at 4 degrees. The other part was stored immediately at -80 degrees.

MeSH Terms

Conditions

Sleep Apnea, ObstructiveTonsillitisOtitis Media with Effusion

Interventions

Blood Cell CountAcoustic Impedance Tests

Condition Hierarchy (Ancestors)

Sleep Apnea SyndromesApneaRespiration DisordersRespiratory Tract DiseasesSleep Disorders, IntrinsicDyssomniasSleep Wake DisordersNervous System DiseasesPharyngitisRespiratory Tract InfectionsInfectionsPharyngeal DiseasesStomatognathic DiseasesOtorhinolaryngologic DiseasesOtitis MediaOtitisEar Diseases

Intervention Hierarchy (Ancestors)

Cell CountCytological TechniquesClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisHematologic TestsInvestigative TechniquesCell Physiological PhenomenaBlood Physiological PhenomenaCirculatory and Respiratory Physiological PhenomenaHearing TestsDiagnostic Techniques, Otological

Study Officials

  • Georgios T Stathopoulos

    Associate Professor of Physiology

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor of Physiology

Study Record Dates

First Submitted

May 9, 2018

First Posted

May 30, 2018

Study Start

February 1, 2017

Primary Completion

December 20, 2017

Study Completion

June 30, 2018

Last Updated

April 16, 2019

Record last verified: 2019-04

Locations