A Comparative Study of Fluticasone Propionate, Mometasone Furoate, and Saline Nasal Spray in the Treatment of Children with Adenoid Hypertrophy

Introduction:Adenoidectomy is currently considered the treatment of choice for relief of the nasal airway obstruction due to adenoid hypertrophy. Evidence suggests that topical nasal steroid sprays can cause a reduction in adenoid size. We aim to compare the effectiveness of fluticasone propionate, mometasone furoate (MF) and saline nasal sprays in relieving the signs and symptoms of adenoid hypertrophy and in reducing the size of the adenoids. MaterialsandMethods: We conducted a randomized comparative study on 60 patients divided into three groups A, B, C (20 each). Group A patients treated with fluticasone propionate nasal spray (400 μg/day), Group B patients treated with MF nasal spray (100 μg/day), and Group C patients treated with saline spray (0.65% w/v in purified water which is made isotonic and buffered). Treatment was given up to 12 weeks with follow‑up at 4, 8, and 12 weeks and at each follow‑up visit assessment was done. Final data were analyzed using SPSS software version 21 and numerical variables associated with different groups were analyzed and analysis of variance test was used. Results: Diagnostic nasal endoscopy and X‑ray grades at day 1 among the study groups were not statistically significant, whereas, at 12 weeks results among fluticasone and mometasone groups were significantly better (P < 0.001) as compared to the saline group. There was a significant improvement in the symptoms under all the categories with the use of fluticasone and mometasone. Conclusion: In our study, both fluticasone propionate and MF were able to effectively reduce symptoms and signs of adenoid hypertrophy as well as help in reducing the size of the enlarged adenoid. Both these drugs were well tolerated by the patients

Application of virtual endoscopy in the diagnosis of adenoid hypertrophy and the morphologic classification of adenoid / 临床耳鼻咽喉头颈外科杂志

Objective:To discuss the application of virtual endoscopy in the diagnosis of adenoid hypertrophy and the morphologic classification of adenoid. Methods:The clinical data of 97 children with adenoid hypertrophy admitted to Department of Otorhinolaryngology Head and Neck Surgery, Shenzhen University General Hospital from July 2022 to December 2022 were collected. The virtual endoscopic reconstruction of the nasopharynx was performed by cone beam computed tomography. The results of virtual endoscopic adenoid size measurement were compared with the results of nasopharyngeal CT median sagittal position and nasopharyngeal endoscopy. Virtual endoscopic classification of adenoid based on the size of the adenoids and their relationship with the torus tubarius. Results:The t-test results of the size of adenoids measured by virtual endoscopy and nasopharyngeal CT were t=1.699 and P=0.093, and the results of intra-group correlation coefficient（ICC） analysis were ICC=0.921 and P<0.01. The proportion of adenoids measured by virtual endoscopy and nasopharyngeal CT was highly consistent. The t-test results of the size of adenoids measured virtual endoscopy and nasopharyngeal endoscopy were t=1.543 and P=0.15, and the results of intra-group correlation coefficient（ICC） analysis were ICC=0.900 and P<0.01. The proportion of adenoids measured by virtual endoscopy and nasopharyngeal endoscopy was highly consistent. Among the 97 children, the morphological classification results of adenoids were 48 cases of overall hypertrophy type, 47 cases of central bulge type, and 2 cases of flat thickening type. Conclusion:The diagnosis of adenoid hypertrophy by virtual endoscopy has high accuracy, which not only avoids the invasive operation of traditional nasopharyngeal endoscopy, but also can observe the adenoid condition and its relationship with the torus tubarius from multiple angles. And, the morphological classification of adenoids using virtual endoscopy has guiding significance for perioperative preparation.

Effects of mouth opening breathing for different reasons on maxillofacial development in children / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the effects of mouth opening breathing for different reasons on children's maxillofacial development. Methods:One hundred and fifty-one children were selected as the research objects of this experiment. They were divided into 49 cases of adenoid hypertrophy group（group A）, 52 cases of tonsillar hypertrophy group（group B） and 50 cases of adenoid with tonsillar hypertrophy group（Group C）. Healthy children in the same period were selected as the control group, a total of 45 cases. The reflex nasopharyngeal measurement parameters, facial development indexes and cephalometric parameters of group A, group B, group C and control group were analyzed, and the incidence of Angle ClassⅡand Angle Class Ⅲ in group A, group B and group C were studied. Results:Compared with the control group, the reflex nasopharyngeal measurement parameters in group A, group B and group C was significantly different（P<0.05）, and the cephalometric parameters changed with variation in groups（P<0.05）. The incidence of Angle Class Ⅱ facial pattern in group A and group C was higher, but the incidence of Angle Class Ⅲ facial pattern in group B and group C was higher（P<0.05）. Conclusion:Adenoid hypertrophy leads to mandibular retraction; tonsil hypertrophy leads to anterior mandibular arch; adenoid hypertrophy and tonsil hypertrophy are easy to lead to clockwise rotation of the mandible. In clinical practice, to avoid children's uncoordinated maxillofacial development, we should correct the maxillofacial situation of children as soon as possible.

Prevalence of middle ear effusion among children with adenoid hypertrophy at a national referral hospital in Tanzania

Introduction: Middle ear effusion (MEE) is a common childhood disorder that causes hearing impairment due to the presence of fluid in the middle ear which reduces the middle ear's ability to conduct sound. Temporary or persistent hearing loss as a result of MEE causes speech, language and learning delays in children. There are few studies on MEE in Tanzania despite the huge burden of hearing loss among children with adenoid hypertrophy which is a known risk factor for MEE. Method: A cross-sectional study was conducted among 420 children aged nine years and below having adenoid hypertrophy with or without MEE. The diagnosis of adenoid hypertrophy was confirmed with a lateral view x-ray of the nasopharynx and tympanometry for cases with MEE. The primary objective of the study was to assess the prevalence of MEE among children with adenoid hypertrophy. Results: The prevalence of MEE among children with adenoid hypertrophy was 61.7%, with 218 (51.9%) males and 202 (48.1%) females. The most affected age group was 2-4 years with an incidence 193 (46%) and in this age group, males (53.9%) were more affected than females (46.1%). Generally, males, 134 (51.7%) were more affected by MEE than females, 125 (48.3%) of all 259 children with MEE. In terms of age group predominance by MEE, children aged 3-4 years, 107(41.3%) were more affected than all other age groups. Additionally, 4 (1.5%) children with MEE presented with hearing loss. Conclusion: There is a high prevalence of MEE among children with adenoid hypertrophy but no significant association with hearing loss.

Effect of Modified Shuzhong Huatantang Replace Hormone on Children with Chronic Rhinosinusitis and Adenoid Hypertrophy due to Spleen Deficiency and Phlegm Obstruction After Operation / 中国实验方剂学杂志

Objective:To observe the effect of modified Shuzhong Huatantang replace hormone on children with rhinosinusitis and adenoid hypertrophy due to spleen deficiency and phlegm obstruction after operation. Method:Eighty cases were randomly divided into control group and observation group，40 cases in each group. After nasal endoscopy，the control group was given mometasone furoate，and the observation group was given modified Shuzhong Huatantang for 6 week. The nasal situation Lund-Kennedy assessment scal（Lund-Kennedy），adenoid thickness /nasopharyngeal cavity width （A/N），TCM syndrome were observed for before treatment，6，24，and 48 weeks after operation. The contents of immunoglobulin E（IgE），eosinophilic cationic protein（ECP），eosinophilic granulocyte（EOS），tumor necrosis factor-alpha（TNF-<italic>α</italic>），interleukin-1<italic>β</italic>（IL-1<italic>β</italic>），interleukin-17（IL-17） in serum and nasal secretions were detected before and 48 weeks after operation. The clinical efficacy，complications，recurrence 48 weeks after operation were compared between the two groups. Result:Three cases of abscission in the control group and one case in the observation group during the study period. The total control rate was 94.9% in the observation group higher than that 75.7% in the control group six weeks after the operation（<italic>χ</italic>²=6.972，<italic>P</italic><0.05）. The recurrence rate was 2.6% in the observation group lower than that 18.9% in the control group 48 weeks after operation（<italic>χ</italic>²=4.137，<italic>P</italic><0.05）. To compared with the control group at 6，24 and 48 weeks after operation，Lund-Kennedy，A/N，TCM syndromes in the observation group decrease in the same period （<italic>P</italic><0.05）. To compared with the control group 48 weeks after operation，The TNF-<italic>α</italic>，IL-1<italic>β，</italic>IL-17，IgE，ECP，EOS in serum and nasal secretions in the observation group were reduced （<italic>P</italic><0.05）. The incidence of adverse reactions was 2.7% in the observation group lower than that 29.7% in the control group. Conclusion:Modified Shuzhong Huatantang can significantly improve the postoperative clinical symptoms with chronic rhinosinusitis and adenoid hypertrophy due to spleen deficiency and phlegm obstruction，and the recurrence rate is lower.

Therapeutic efficacy observation of Tuina manipulation for pediatric adenoid hypertrophy / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of Tuina (Chinese therapeutic massage) manipulation for pediatric adenoid hypertrophy (AH). Methods: A total of 60 children with AH were randomized into an observation group and a medication group, with 30 cases in each group. The observation group was treated with pediatric Tuina treatment, and the medication group was treated with 0.05％ mometasone furoate nasal spray. The changes of main clinical symptom score, quality of life (QOL) score and X-ray nasopharynx lateral film were observed, and the clinical efficacy was evaluated. Results: The total effective rate of the observation group was 90.0％, and that of the medication group was 66.7％. The difference between the two groups was statistically significant (P<0.05). After treatment, the A/N value [ratio of adenoid thickness (A) and nasopharyngeal cavity width (N)] of posterior nasopharyngeal lateral film did not show significant change in either group (P>0.05). After treatment, the clinical symptom scores in both groups decreased, and the intra-group differences were statistically significant (P<0.001), but there was no statistical difference between the two groups (P>0.05). After treatment, the QOL scores of children in both groups decreased, and the intra-group differences were statistically significant (P<0.001), and the difference between the two groups was statistically significant (P<0.001). Conclusion: Tuina manipulation is effective in treating pediatric AH, and produces a better effect in improving traditional Chinese medicine symptoms and QOL than 0.05％ mometasone furoate nasal spray.

Clinical observation of Zhen'ai needling method in Nei Jing (Classic of Internal Medicine) for children with allergic rhinitis accompanied by adenoid hypertrophy / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of Zhen'ai needling method in Nei Jing (Classic of Internal Medicine) for children with allergic rhinitis (AR) accompanied by adenoid hypertrophy (AH). Methods: A total of 74 children who met the screening criteria were divided into a Zhen'ai group and a control group by the random number table method, with 37 cases in each group. The control group was treated with acupuncture at Zusanli (ST 36), Hegu (LI 4), Yingxiang (LI 20), Juliao (ST 3), Yintang (GV 29), Shangxing (GV 23) and Baihui (GV 20). The Zhen'ai group added points of Zhen'ai needling method {Shanglianquan [Extra, located at 1 cun above Lianquan (CV 23)], Tianrong (SI 17) and Lieque (LU 7)} in addition to the points in the control group. The needles were retained for 30 min. The treatment was performed twice a week. The total nasal symptom score (TNSS), sino-nasal outcome test-20 (SNOT-20) and symptom scale for AH (SSAH) were assessed before and after 10 treatments. The clinical efficacy of the two groups was compared after treatment. Results: During the treatment, 5 cases dropped out in the control group and 2 cases in the Zhen'ai group. After treatment, the total effective rate of the Zhen'ai group was 94.3％, versus 93.8％ in the control group. There was no significant difference between the two groups (P>0.05). The markedly effective rate of the Zhen'ai group was 42.9％, versus 12.5％ in the control group, and the difference was statistically significant (P<0.05). After treatment, there were significant intra-group differences in the scores of TNSS, SNOT-20 and SSAH in both groups (all P<0.05); the scores of SNOT-20 and SSAH in the Zhen'ai group were lower than those in the control group, and the differences between the groups were statistically significant (both P<0.05). Conclusion: Both conventional acupuncture and conventional acupuncture plus Zhen'ai needling method can improve clinical symptoms of children with AR accompanied by AH; and conventional acupuncture plus Zhen'ai needling method has a better effect than conventional acupuncture in improving AH symptoms.

Combination of adenoid and upper airway morphology in predicting obstructive sleep apnea hypopnea syndrome in children / 中国医学影像技术

Objective: To analyze the relationship of adenoid and upper airway morphology with obstructive sleep apnea hypopnea syndrome (OSAHS) in children, and to observe the efficacy of predicting OSAHS. Methods: Totally 109 children aged 1-10 years who received nasopharyngeal CT volume scanning were enrolled and divided into OSAHS group (n=20) and non-OSAHS group (n=89). After 3D reconstruction of all CT images, the shape and size of adenoid and the morphology of upper airway (including nasopharyngeal volume, nasal space, airway narrowest area, upper and lower diameter as well as left and right diameter) were evaluated. The shape and size of adenoid and the morphology of upper airway were compared between 2 groups, the relationships with OSAHS were analyzed, and the efficacy of combination of which for predicting OSAHS were evaluated. Results: Statistical differences of nasopharyngeal volume, nasal space, upper airway narrowest area, upper and lower diameters and left and right diameters (t=2.07, 4.55, 3.96, 3.62, 3.48, all P<0.05), also of adenoid hypertrophy and adenoid morphology (χ2=24.43, 12.94, both P<0.05) were found between 2 groups. Adenoid hypertrophy and OSAHS were more likely to occur in children with smaller nasal space, airway narrowest area and left and right diameter. Adenoid hypertrophy was a risk factor for OSAHS. The AUC, sensitivity, specificity and accuracy of combination of adenoid and upper airway morphology in prediction of OSAHS was 0.91, 90.00%, 79.78% and 81.65%, respectively. Conclusion: Adenoid hypertrophy is a risk factor of OSAHS. Combination of adenoid and upper airway morphology has good efficacy for predicting OSAHS in children.

Relationship between adenoid hypertrophy and sleep apnea in children / Relação entre a hipertrofia das adenoides e a apneia do sono em crianças

Introdução: decidiu-se organizar este trabalho pelo pressuposto de que é necessário todos os cirurgiõesdentistas se familiarizarem com a estrutura e alterações na anatomia oral desde a infância, com atenção à possibilidade da hipertrofia da adenóides (HA) e a síndrome da apnéia obstrutiva do sono(SAOS) estar presente. Objetivo: observar por meio da revisão de literatura se existe correlação entre a hipertrofia das adenoides e apneia do sono em crianças e qual o tratamento adotado. Material e Métodos: foram feitas pesquisas indexadas nas bases de dados: LILACS, MEDLINE, PubMed, Cochrane, Web of Science e SciELO, no período de janeiro de 2014 a agosto de 2018. Resultados: somente 32 pesquisas foram inclusas na revisão de literatura porque estavam de acordo com os critérios de inclusão. Conclusão: de acordo com a literatura, os autores concluíram que há correlação entre a hipertrofia das glândulas adenoides e a apneia do sono em crianças. A hipertrofia se apresenta como a principal causa da síndrome da apneia obstrutiva do sono em pacientes pediátricos e seu tratamento poderá ser cirúrgico, pela remoção das glândulas adenoides, medicamentoso ou ortodôntico.(AU)

Introduction: It was decided to organize this work on the assumption that it is necessary for all dental surgeons to familiarize themselves with the structure and alterations in oral anatomy from childhood, with attention to the possibility of adenoid hypertrophy (AH) and obstructive sleep apnea syndrome (OSAS) to be present. Objective: to observe in the literature review if the correlation between adenotonsillar hypertrophy and sleep apnea in children was verified and which treatment were adopted. Material and Methods: the following databases were searched: LILACS, MEDLINE, PubMed, Cochrane, Web of Science and SciELO, from January 2014 to August 2018. Results: only 32 articles were included in this literature review because they met all defined inclusion criteria. Conclusion: according the literature, the authors concluded that there is a correlation between hypertrophy of the adenoid glands and apnea of the sleep in children. Hypertrophy presents as the main cause of obstructive sleep apnea syndrome in pediatric patients and its treatment may be surgical, removal of the adenoid, drug or orthodontic.(AU)

Growth and mouth breathers / Crescimento e respiradores orais

Abstract Objective: To assess the relationship between mouth breathing and growth disorders among children and teenagers. Data source: Search on MEDLINE database, over the last 10 years, by using the following terms: "mouth breathing", "adenotonsilar hypertrophy", "allergic rhinitis", "sleep disturbance" AND "growth impairment", "growth hormone", "failure to thrive", "short stature", or "failure to thrive". Data summary: A total of 247 articles were identified and, after reading the headings, this number was reduced to 45 articles, whose abstracts were read and, of these, 20 were deemed important and were included in the review. In addition of these articles, references mentioned in them and specific books on mouth breathing deemed important were included. Hypertrophy of palatine and/or pharyngeal tonsils, whether associated with allergic rhinitis, as well as poorly controlled allergic rhinitis, are the main causes of mouth breathing in children. Respiratory sleep disorders are frequent among these patients. Several studies associate mouth breathing with reduced growth, as well as with reduced growth hormone release, which are reestablished after effective treatment of mouth breathing (clinical and/or surgical). Conclusions: Mouth breathing should be considered as a potential cause of growth retardation in children; pediatricians should assess these patients in a broad manner.

Resumo Objetivo: Avaliar a relação entre respiração oral e distúrbios do crescimento entre crianças e adolescentes. Fonte de dados: Busca na base de dados do MEDLINE, nos últimos 10 anos, com o emprego dos seguintes termos: "mouth breathing" ou "adenotonsilar hypertrophy", ou "allergic rhinitis" ou sleep disturbance" AND "growth impairment" ou "growth hormone" ou "failure to thrive" ou "short stature" ou "failure to thrive". Síntese dos dados: Foram identificados 247 artigos, que após a leitura dos títulos foram reduzidos a 45, cujos resumos foram lidos e desses 20 foram considerados de importância e integraram a revisão. Além desses, referências por eles citadas e livros-texto específicos sobre respiração oral considerados importantes foram incluídos. A hipertrofia de tonsilas palatinas e/ou faríngeas, associada ou não à rinite alérgica, assim como a rinite alérgica mal controlada, é a principal causa de respiração oral na criança. Distúrbios respiratórios do sono são frequentes entre esses pacientes. Vários estudos associam a respiração oral à redução do crescimento, bem como à redução de liberação de hormônio do crescimento, que são restabelecidos após o tratamento efetivo da respiração oral (clínico e/ou cirúrgico). Conclusões: A respiração oral deve ser cogitada como possível causa de retardo de crescimento em crianças e cabe ao pediatra a tarefa de investigar esses pacientes de forma mais abrangente.

Association of Ugrp2 gene polymorphisms with adenoid hypertrophy in the pediatric population / Associação de polimorfismos do gene Ugrp2 com hipertrofia de adenoide na população pediátrica

Abstract Introduction: Adenoid hypertrophy is a condition that presents itself as the chronic enlargement of adenoid tissues; it is frequently observed in the pediatric population. The Ugrp2 gene, a member of the secretoglobin superfamily, encodes a low-molecular weight protein that functions in the differentiation of upper airway epithelial cells. However, little is known about the association of Ugrp2 genetic variations with adenoid hypertrophy. Objective: The aim of this study is to investigate the association of single nucleotide polymorphisms in the Ugrp2 gene with adenoid hypertrophy and its related phenotypes. Methods: A total of 219 children, comprising 114 patients suffering from adenoid hypertrophy and 105 healthy patients without adenoid hypertrophy, were enrolled in this study. Genotypes of the Ugrp2 gene were determined by DNA sequencing. Results: We identified four single nucleotide polymorphisms (IVS1-189G>A, IVS1-89T>G, c.201delC, and IVS2-15G>A) in the Ugrp2 gene. Our genotype analysis showed that the Ugrp2 (IVS1-89T>G) TG and (c.201delC) CdelC genotypes and their minor alleles were associated with a considerable increase in the risk of adenoid hypertrophy compared with the controls (p = 0.012, p = 0.009, p = 0.013, and p = 0.037, respectively). Furthermore, Ugrp2 (GTdelCG, GTdelCA) haplotypes were significantly associated with adenoid hypertrophy (four single nucleotide polymorphisms ordered from 5′ to 3′; p = 0.0001). Polymorfism-Polymorfism interaction analysis indicated a strong interaction between combined genotypes of the Ugrp2 gene contributing to adenoid hypertrophy, as well as an increased chance of its diagnosis (p < 0.0001). In addition, diplotypes carrying the mutant Ugrp2 (c.201delC) allele were strongly associated with an increased risk of adenoid hypertrophy with asthma and with allergies (p = 0.003 and p = 0.0007, respectively). Conclusion: Some single nucleotide polymorphisms and their combinations in the Ugrp2 gene are associated with an increased risk of developing adenoid hypertrophy. Therefore, we tried to underline the importance of genetic factors associated with adenoid hypertrophy and its related clinical phenotypes.

Resumo Introdução: A adenoide ou hipertrofia de tonsila faríngea é uma condição que se apresenta como o aumento crônico de tecidos linfoides na rinofaringe e é frequentemente observada na população pediátrica. O gene Ugrp2, um membro da superfamília da secretoglobina, codifica uma proteína de baixo peso molecular que funciona na diferenciação das células epiteliais das vias aéreas superiores. No entanto, pouco se sabe sobre a associação de variações genéticas do Ugrp2 com hipertrofia de tonsila faríngea. Objetivo: Investigar a associação de polimorfismos de nucleotídeos únicos no gene Ugrp2 com hipertrofia de tonsila faríngea e seus fenótipos relacionados. Método: Foram incluídos no estudo 219 crianças, 114 pacientes com hipertrofia de tonsila faríngea e 105 saudáveis. Os genótipos do gene Ugrp2 foram determinados por sequenciamento de DNA. Resultados: Identificamos quatro polimorfismos de nucleotídeo único (IVS1-189G>A, IVS1-89T>G, c.201delC, e IVS2-15G>A) no gene Ugrp2. Nossa análise genotípica mostrou que os genótipos Ugrp2 (IVS1-89T>G) TG e (c.201delC) CdelC e seus alelos menores foram associados a um aumento considerável no risco de HA em comparação com os controles (p = 0,012, p = 0,009, p = 0,013 e p = 0,037, respectivamente). Além disso, os haplótipos Ugrp2 (GTdelCG, GTdelCA) foram significativamente associados com hipertrofia de tonsila faríngea (quatro polimorfismos de nucleot' ordenados de 5' a 3'; p = 0,0001). A análise de interação polimorfismo-polimorfismo indicou uma forte interação entre genótipos combinados do gene Ugrp2 que contribuiu para hipertrofia de tonsila faríngea, bem como uma chance maior de seu diagnóstico (p < 0,0001). Além disso, os diplótipos que transportam o alelo mutante Ugrp2 (c.201delC) foram fortemente associados a um risco aumentado de hipertrofia de tonsila faríngea com asma e com alergias (p = 0,003 e p = 0,0007, respectivamente). Conclusão: Alguns polimorfismos de nucleotídeo único e suas combinações no gene Ugrp2 estão associados a um risco aumentado de desenvolver hipertrofia de tonsila faríngea. Portanto, tentamos enfatizar a importância dos fatores genéticos e fenótipos clínicos associados a essa hipertrofia.

Study on related factors of repeated attack of child otitis media with effusion / 重庆医学

Objective To investigate the risk factors of repeated episodes of child otitis media with effusion(OME).Methods One hundred and twenty-one children cases of repeated OME within 1 year in the Affiliated Children's Hospital of Nanjing Medical University from February 2013 to August 2015 were selected as the repeated group and contemporaneous 125 cases of non-repeated OME were selected as the control group.The repeated OME related factors were performed the univariate and multivariate analysis.Furthermore the occurrence rates of main risk factors and annual onset frequency of nasal disease were compared among different age groups.Results The Logistic multivariate regression analysis results indicated that younger age,allergic rhinitis,recurrent upper respiratory tract infections,tonsil hypertrophy Ⅳ°,adenoid hypertrophy Ⅲ °and Ⅳ ° and poor mastoid gasification were major risk factors for recurrence of OME.The incidence rate of repeated upper respiratory tract infections in the 3-＜7 years old group and ＜3 years old group was obviously higher than that in the7-14 years old group(P＜0.05),adenoid hypertrophy in the ＜3 years old group and 7-14 years old group was lower than that in the 3-＜7 years old group(P＜0.05).The annual onset frequency of nasal disease in the repeated group was significantly higher than that in the control group(P=0.000).Conclusion Child OME is the results of multivariate factors combined action.The smaller the age,the more the annual onset frequency and the higher the possibility of OME repeated onset.

Influence of bigeminy drug regimen on short-term effects, quality of life and recurrence rate in children with adenoid hypertrophy / 中国医师进修杂志

Objective@#To investigate the influence of bigeminy drug regimen on short-term clinical effects, quality of life and recurrence rate in children with adenoid hypertrophy.@*Methods@#One hundred and thirty patients with adenoid hypertrophy were chosen in the period from January 2014 to December 2016. They were randomly divided into 2 groups:control group (65 patients, nasal glucocorticoid used alone) and observation group (65 patients, montelukast sodiumon the basis of control group). The short-term clinical effect, the levels of A/N, serum inflammatory cytokine and OSA-18 score before and after treatment and recurrence rate of 2 groups were compared.@*Results@#The short-term clinical effects of control group and observation group were separately 73.85%(60/65) and 92.31% (48/65). The levels of A/N after treatment in observation group were significantly lower than those in control group and before treatment: 0.60 ± 0.07 vs. 0.74 ± 0.10, 0.94 ± 0.15 (P<0.05). The levels of IL-1β, IL-2 and IL-4 after treatment in observation group were significantly lower than those in control group and before treatment:IL-1β: (1.50 ± 0.48) ng/L vs. (2.21 ± 0.44), (3.42 ± 0.68) ng/L; IL-2: (21.80 ± 2.08) ng/L vs. (24.28 ± 2.50), (26.61 ± 3.35) ng/L; IL-4: (179.12 ± 35.91) ng/L vs. (244.70 ± 44.42), (284.07 ± 51.87) ng/L (P<0.05). The OSA-18 score after treatment in observation group was significantly lower than that in control group and before treatment (P<0.05). The recurrence rate in control group and observation group was separately 32.31%(21/65) and 15.39%(10/65). The recurrence rate in observation group was significantly lower than that in control group (P<0.05).@*Conclusions@#Bigeminy drug regimen in the treatment of children with adenoid hypertrophy can efficiently relieve the respiratory obstruction degree, reduce the levels of inflammatory response, improve the quality of daily life and be helpful to prevent long-term recurrence.

Incidence of Otitis Media with Effusion in Adenoid Hypertrophy with Allergic Rhinitis in Children / 中山大学学报(医学科学版)

Objective]In order to study the impact of adenoid hypertrophy(AH)with allergic rhinitis(AR)in the otitis media with effusion(OME)in children,as well as to discuss the risk factors on the inducement of OME in patients with AH.[Methods]The clinical materials were collected and analyzed from 205 children with AH who admitted for surgical treatment between 2013 and 2015, including medical history and signs,acoustic immittance measurement,allergy screen as well as blood routine,and to evaluate the situation of OME and AR in patients with AH. All the data were analyzed by SPSS 20.0.[Results]Among the 205 AH children,66 cases(32.20%)were accompanying with OME. The AH patients aged 3-5 years had the highest incidence of OME,which decreased with age(P=0.018). It is significant on the prevalence of the OME in patients with AH between the two groups with and without AR (P = 0.010). In the logistic model investigating the risk factors of inducing OME among patients with AH,the third-degree AH, Type-three and the accompanying with AR were significant. The third-degree and third-type AH children were 2.729 and 6.390-folds higher than others respectively (P = 0.047,P = 0.001). The incidence of OME appeared to be 1.212-folds higher among patients with AR(P = 0.010).[Conclusion]Mechanical obstruction and AR played a superimposed role in the inducement of OME among patients with AH,which was effected by multiple factors. We should pay attention to the“lateral respiratory”allergic diseases on eustachian tube and middle ear.

Clinical progress and problems of traditional Chinese and western medicine in children's adenoid hypertrophy / 国际中医中药杂志

This paper reviewed the clinical research progress of the treatment of children's adenoid hypertrophy in recent years from the aspects of Chinese medicine treatment and combined traditional Chinese and western medicine treatment. It is believed thatTraditional Chinese medicine treatment for the children with adenoid hypertrophyhas showed better curative effect and less side effects, which can reduce the operation rates. It's easy for parents and children to accept and can be widely promoted in clinical.

Comparison between the effect of endoscopic-assisted low temperature plasma and electric planer on the treatment of adenoid hypertrophy: a Meta-analysis / 中南大学学报(医学版)

Objective:To compare the effect of endoscopic-assisted low temperature plasma (ELTP) and electric planer (EP) on the treatment of adenoid hypertrophy.Methods:We searched China National Knowledge Infrastructure (CNKI),Wanfang Database,Weipu Database,Chinese Biomedical Literature (CMB),PubMed,Embase,Cochrane Database,and collected the randomized controlled studies regarding the effect of ELTP and EP on the treatment of adenoid hypertrophy from January 2007 to June 2016.Methodologies were used to evaluate the included studies,and Meta-analysis was performed by Revman 5.2.Results:Thirteen studies including 1 448 patients fulfilled the study requirement.Seven hundred and twenty-two patients were treated with ELTP,and 726 patients were treated with EP.The Meta-analysis showed:compared with EP,ELTP could improve the cure rare (OR=3.19,95％ CI 1.42to 7.15,P=0.005),reduce the blood loss during surgery (MD=-20.35,95％ CI-20.84 to-19.87,P＜0.001),shorten the operation time (MD=-15.71,95％ CI-18.06 to-12.17,P＜0.001),and reduce the incidence of complications (OR=0.13,95％ CI 0.06 to 0.30,P＜0.001),while there was no difference between the 2 groups in the postoperative residual rate of adenoid,postoperative hemorrhage rate and the rate oftorus tubarius injury.Conclusion:Comparing with EP,ELTP shows more advantages in the adenoidectomy.

Professor LIU Hong 's Experience in Treating Adenoid Hypertrophy in Children / 浙江中医药大学学报

[Objective]To summarize the main academic thoughts and clinical experience of the chief physician of LIU Hong in treating adenoid hypertrophy of children. [Methods] Through the practice of clinical practice, analysis of pediatric adenoid hypertrophy of the etiology and pathogenesis, type demonstration, at the same time, by analyzing the mentor to treat the clinical trial of the disease to prove that. [Results] LIU Shi believes that the phlegm obstruction of the disease for the pathogenesis of the core pathogenesis to phlegm Sanjie, Xuanfei Tongqiao as the basic principles of treatment, according to years of clinical experience, to self-adenoid hypertrophy as a basis for addition and subtraction drugs;wind and heat pent-up, phlegm heat mutual pent-up, blood stasis syndrome, three types of treatment of pediatric adenoid hypertrophy disease, the case effect is very good. [Conclusion]The tutor's experience in the treatment of pediatric adenoid hypertrophy is quite abundant. When the clinical evidence is emphasized, the core pathogenesis should be grasped. The method of phlegm Sanjie is the main body, and the method of heat treatment and heat removal is obviously improved. It can eliminate the surgery on children and parents troubles, but also improve the quality of life of children, with the promotion and application value.

Professor LIU Hong 's Experience in Treating Adenoid Hypertrophy in Children / 浙江中医药大学学报

[Objective]To summarize the main academic thoughts and clinical experience of the chief physician of LIU Hong in treating adenoid hypertrophy of children. [Methods] Through the practice of clinical practice, analysis of pediatric adenoid hypertrophy of the etiology and pathogenesis, type demonstration, at the same time, by analyzing the mentor to treat the clinical trial of the disease to prove that. [Results] LIU Shi believes that the phlegm obstruction of the disease for the pathogenesis of the core pathogenesis to phlegm Sanjie, Xuanfei Tongqiao as the basic principles of treatment, according to years of clinical experience, to self-adenoid hypertrophy as a basis for addition and subtraction drugs;wind and heat pent-up, phlegm heat mutual pent-up, blood stasis syndrome, three types of treatment of pediatric adenoid hypertrophy disease, the case effect is very good. [Conclusion]The tutor's experience in the treatment of pediatric adenoid hypertrophy is quite abundant. When the clinical evidence is emphasized, the core pathogenesis should be grasped. The method of phlegm Sanjie is the main body, and the method of heat treatment and heat removal is obviously improved. It can eliminate the surgery on children and parents troubles, but also improve the quality of life of children, with the promotion and application value.

Professor LIU Hong 's Experience in Treating Adenoid Hypertrophy in Children / 浙江中医药大学学报

[Objective]To summarize the main academic thoughts and clinical experience of the chief physician of LIU Hong in treating adenoid hypertrophy of children. [Methods] Through the practice of clinical practice, analysis of pediatric adenoid hypertrophy of the etiology and pathogenesis, type demonstration, at the same time, by analyzing the mentor to treat the clinical trial of the disease to prove that. [Results] LIU Shi believes that the phlegm obstruction of the disease for the pathogenesis of the core pathogenesis to phlegm Sanjie, Xuanfei Tongqiao as the basic principles of treatment, according to years of clinical experience, to self-adenoid hypertrophy as a basis for addition and subtraction drugs;wind and heat pent-up, phlegm heat mutual pent-up, blood stasis syndrome, three types of treatment of pediatric adenoid hypertrophy disease, the case effect is very good. [Conclusion]The tutor's experience in the treatment of pediatric adenoid hypertrophy is quite abundant. When the clinical evidence is emphasized, the core pathogenesis should be grasped. The method of phlegm Sanjie is the main body, and the method of heat treatment and heat removal is obviously improved. It can eliminate the surgery on children and parents troubles, but also improve the quality of life of children, with the promotion and application value.

Trans-oral endoscopic partial adenoidectomy does not worsen the speech after cleft palate repair / Adenoidectomia parcial endoscópica transoral não piora a fala de pacientes com correção cirúrgica de fenda palatina

ABSTRACT INTRODUCTION: Adenoid hypertrophy may play a role in velopharyngeal closure especially in patients with palatal abnormality; adenoidectomy may lead to velopharyngeal insufficiency and hyper nasal speech. Patients with cleft palate even after repair should not undergo adenoidectomy unless absolutely needed, and in such situations, conservative or partial adenoidectomy is performed to avoid the occurrence of velopharyngeal insufficiency. Trans-oral endoscopic adenoidectomy enables the surgeon to inspect the velopharyngeal valve during the procedure. OBJECTIVE: The aim of this study was to assess the effect of transoral endoscopic partial adenoidectomy on the speech of children with repaired cleft palate. METHODS: Twenty children with repaired cleft palate underwent transoral endoscopic partial adenoidectomy to relieve their airway obstruction. The procedure was completely visualized with the use of a 70° 4 mm nasal endoscope; the upper part of the adenoid was removed using adenoid curette and St. Claire Thompson forceps, while the lower part was retained to maintain the velopharyngeal competence. Preoperative and postoperative evaluation of speech was performed, subjectively by auditory perceptual assessment, and objectively by nasometric assessment. RESULTS: Speech was not adversely affected after surgery. The difference between preoperative and postoperative auditory perceptual assessment and nasalance scores for nasal and oral sentences was insignificant (p = 0.231, 0.442, 0.118 respectively). CONCLUSIONS: Transoral endoscopic partial adenoidectomy is a safe method; it does not worsen the speech of repaired cleft palate patients. It enables the surgeon to strictly inspect the velopharyngeal valve during the procedure with better determination of the adenoidal part that may contribute in velopharyngeal closure.

Resumo Introdução: A hipertrofia da adenoide pode desempenhar um papel no fechamento velofaríngeo, especialmente em pacientes com anormalidade palatal; a adenoidectomia pode levar à insuficiência velofaríngea e fala hipernasal. Os pacientes com fenda palatina, mesmo após a correção, não devem ser submetidos a adenoidectomia, exceto quando absolutamente necessário e, em tais situações, a forma conservadora ou parcial é realizada para evitar a ocorrência de insuficiência velofaríngea. A adenoidectomia endoscópica transoral permite ao cirurgião inspecionar a válvula velofaríngea durante o procedimento. Objetivo: O objetivo deste estudo foi avaliar o efeito da adenoidectomia parcial endoscópica transoral na fala de crianças submetidas à correção de fenda palatina. Método: Um total de 20 crianças com fenda palatina previamente corrigida, foi submetida a adenoidectomia parcial endoscópica transoral, para desobstrução das vias aéreas,. O procedimento foi completamente visualizado com o uso de um endoscópio de 4 mm e ângulo de 70º; a parte superior da adenoide foi removida com uma cureta para adenoide e fórceps St. ClaireThompson, enquanto a parte inferior foi conservada para manter a competência velofaríngea. Avaliações da fala foram realizadas nos períodos pré e pós-operatório, de forma subjetiva pelaavaliação perceptivo-auditiva, e objetiva pela avaliação nasométrica. Resultados: A fala não foi prejudicada após a cirurgia. A diferença entre os escores da avaliação perceptivo-auditiva e nasalância para as sentenças nasais e orais nos períodos pré e pós-operatório foi insignificante (p = 0,231, 0,442, 0,118, respectivamente). Conclusões: A adenoidectomia parcial endoscópica transoral é um método seguro, e não piora a fala dos pacientes com fenda palatina operada. Ela permite que o cirurgião inspecione rigorosamente a válvula velofaríngea durante o procedimento, com melhor determinação da parte adenoide que pode contribuir para o fechamento velofaríngeo.