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Effect of nasal irrigation on microplastic clearance in children with adenoid hypertrophy, with or without otitis media with effusion
Summary
Tiny plastic particles (microplastics) were found in the noses of nearly all kids studied, showing just how common these particles are in our everyday environment. Saline nasal rinsing helped flush out microplastics in healthy children, but kids with enlarged adenoids (a common cause of nasal blockage and ear infections) didn't clear the particles as well, suggesting swollen tissue in the nose and throat may make it harder for the body to wash out these unwanted particles. More research is needed to confirm this link and understand what it means for children's long-term health.
OBJECTIVE: This study aimed to evaluate microplastics (MPs) in nasal lavage samples and the effect of nasal irrigation in children with adenoid hypertrophy (AH), with or without otitis media with effusion (OME). METHODS: Children with AH, AH/OME, and healthy controls were included. Adenoid size was assessed endoscopically as the percentage of choanal obstruction. Nasal lavage samples were collected at baseline and after 1 month of twice-daily saline nasal irrigation. MP density and total MP count were quantified. RESULTS: A total of 61 children were included: 23 with AH, 19 with AH/OME, and 19 controls. Baseline MP density was 1.56 ± 0.53, 1.79 ± 0.94, and 1.97 ± 0.83 pieces/ml, respectively; total MP counts were 4.39 ± 1.61, 4.10 ± 2.53, and 6.47 ± 4.18. Baseline MP density was similar among groups, while total MP count was higher in controls than in one AH group. After irrigation, MP density and total MP count decreased significantly only in controls (p < 0.001 and p = 0.003), whereas no statistically significant reductions were detected in the AH groups. Adenoid size was negatively correlated with Δ MP density (r=-0.335, p = 0.008) and Δ total MP count (r=-0.322, p = 0.011), suggesting lower clearance with greater obstruction. Hierarchical regression showed that, after adjustment for age and baseline MP density, adenoid percentage was independently associated with reduced MP density clearance, but not with total MP count reduction. Exploratory ROC analysis showed limited discriminatory ability for adenoid percentage in identifying reduced MP clearance (AUC = 0.662). CONCLUSION: MPs were detected in nearly all children. In this exploratory study, adenoid hypertrophy showed a possible association with reduced post-lavage microplastic clearance; however, baseline findings did not support a simple microplastic trapping mechanism, and causality cannot be inferred from nasal lavage data alone. Further age-matched tissue-level studies are needed.