OBJECTIVE: To observe the clinical efficacy of deep needling at Xiaguan (ST7) combined with electroacupuncture and warm acupuncture for adenoid hypertrophy (AH) in children. METHODS: Seventy-two children with AH were randomly divided into an observation group (36 cases, 5 cases dropped out, 1 case was eliminated) and a control group (36 cases, 4 cases dropped out, 2 cases were eliminated). The observation group received deep needling at Xiaguan (ST7) combined with electroacupuncture and warm acupuncture. The needle depth of Xiaguan (ST7) was 20-30 mm. Electroacupuncture was applied at Xiaguan (ST7), Yingxiang (LI20), Yintang (GV24⁺), Baihui (GV20), with continuous wave, in frequency of 2 Hz. Warm acupuncture was applied at Zusanli (ST36). The treatment was performed 30 min each time, once a week for 12 weeks. The control group was treated with mometasone furoate aqueous nasal spray, one spray per nostril each time, once a day for 12 weeks. The symptom score, adenoid-to-nasopharynx ratio (A/N), and 18-item health-related quality-of-life survey for children with obstructive sleep apnea (OSA-18) score were observed before and after treatment in the two groups, and the clinical efficacy was evaluated after treatment. RESULTS: After treatment, the total scores of symptom, A/N, and OSA-18 scores were decreased compared with those before treatment in both groups (P<0.01), the above indexes in the observation group were lower than those in the control group (P<0.01, P<0.05). The total effective rate in the observation group was 93.3% (28/30), which was higher than 83.3% (25/30) in the control group (P<0.05). CONCLUSION Deep needling at Xiaguan (ST7) combined with electroacupuncture and warm acupuncture could effectively improve symptoms, reduce adenoid volume, and improve the quality of life in children with AH.
Humans ; Male ; Female ; Acupuncture Points ; Electroacupuncture ; Acupuncture Therapy ; Child ; Child, Preschool ; Hypertrophy/therapy* ; Adenoids/pathology* ; Treatment Outcome ; Combined Modality Therapy

Objective:To explore the hypothesis of "pathogen storage pool" by analyzing the local microbial community of adenoids. Methods:Under the guidance of a 70° nasal endoscope, sterile swabs were used to collect secretions from the adenoid crypts of the subjects. The samples were sent to the laboratory for DNA extraction and standard bacterial 16S full-length sequencing analysis. Results:At the species level, the top three microbial communities in adenoid crypts were Bacillus subtilis（18.78%）, Fusobacterium pyogenes（11.42%）, and Streptococcus pneumoniae（9.38%）. Conclusion:The local microbial community of adenoids exhibits a high degree of diversity, including microbial communities from the oral cavity and gastrointestinal tract. Our research results support the hypothesis that adenoids act as a " pathogen reservoir".
Humans ; Adenoids/microbiology* ; RNA, Ribosomal, 16S/genetics* ; Microbiota/genetics* ; Streptococcus pneumoniae/isolation & purification* ; Bacillus subtilis/genetics* ; DNA, Bacterial/analysis*

Pleomorphic adenoma arising from the torus tubarius of the nasopharynx is an extremely rare entity with limited epidemiological data and unclear etiological mechanisms. Its pathogenesis may be related to the eustachian tube salivary glands. Here we report an elderly female patient with a long history of snoring, hypernasal speech and epistaxis. Following comprehensive diagnostic evaluation, the patient underwent tumor resection under nasal endoscopy. There were no postoperative complications, the symptoms were significantly improved, and there was no obvious recurrence during the follow-up. We summarized the experience of diagnosis and treatment of giant pleomorphic adenoma of the tubal torus. The main treatment for tubal torus pleomorphic adenoma is complete surgical resection, with a good prognosis and a low recurrence rate.
Humans ; Female ; Adenoma, Pleomorphic/surgery* ; Aged ; Nasopharynx/pathology*

Day surgery is an important part of the comprehensive reform of public hospitals, which is conducive to improving hospital management level, enhancing medical service efficiency, and controlling medical expenses. The National Health Commission has included tonsillectomy and/or adenoidectomy in the recommended list of daytime surgeries. However, there is no unified understanding and clinical practice of tonsillar and/or adenoid day surgery in China. Currently, there is an urgent need to develop clinical practice guidelines for tonsillar and/or adenoid day surgery to standardize the procedure. To this end, the guideline expert group developed this guideline through literature review and two rounds of Delphi voting, selecting and focusing on the clinical key issues in tonsillar and/or adenoid day surgery, in order to provide specific and feasible guidance for otolaryngologists, anesthesiologists, nursing staff, and related medical staff engaging in pediatric tonsillar and adenoid day surgery, and promote standardized management of tonsillar and/or adenoid day surgery.
Humans ; Tonsillectomy ; Adenoids/surgery* ; Adenoidectomy ; Child ; Ambulatory Surgical Procedures ; Palatine Tonsil/surgery* ; Practice Guidelines as Topic ; China

Humans ; Herpesvirus 4, Human ; Epstein-Barr Virus Infections ; Carcinoma, Small Cell ; Nasopharynx/pathology* ; Carcinoma, Neuroendocrine/pathology* ; Nasopharyngeal Neoplasms/pathology*

Objective:To investigate the efficacy and assess the safety of transnasal nebulisation of budesonide in children with adenoid hypertrophy. Methods:Children with adenoid hypertrophy who attended the Children's Hospital of Zhejiang University School of Medicine between December 2021 and December 2022 were randomly assigned to budesonide high-dose group（Group A: budesonide 1 mg/dose + saline nasal rinse）, budesonide low-dose group（Group B: budesonide 0.5 mg/dose + saline nasal rinse）, and control group（Group C: saline nasal rinse）, and each group 20 children were collected separately, The efficacy and safety of transnasal nebulisation of budesonide in children with adenoid hypertrophy were assessed by comparing the symptomatic VAS scores, adenoidal nasopharyngeal lateral radiographs A/N values, nocturnal sleep oximetry（SaO2）, and the incidence of adverse events during the treatment period of 8-week in the three groups. Results:The 8-week baseline differences in adenoid A/N values were statistically different between groups A and B（P<0.001） and A and C（P=0.022）, with the reduced amount in adenoid volume being most pronounced in group A, which differed from the other two groups. With the increase of intervention time, SaO2 levels gradually increased（F=154.725, P<0.001） and VAS scores gradually decreased（F=165.616, P<0.001） in all three groups. After 8 weeks of treatment, there was no statistically significant difference in SaO2 level（P=0.085） between groups A and B. There was a statistically significant difference in VAS total scores between Group A and Group B （P < 0.05） . The improvement of SaO2and total VAS score in group A was higher than that in group B. There was a statistically significant difference in the comparison of SaO2 level and total VAS score between groups A and B, and between groups A and C（P<0.01）; after the intervention of the three groups, showing the greatest improvement of total VAS score and SaO2in the group A, followed by Group B. There was no statistically significant difference in the incidence of adverse events among Groups A, B, and C throughout the trial. Conclusion:The treatment of children with adenoid hypertrophy by intranasal nebulisation of budesonide suspension has good efficacy and safety, which is conducive to reducing the size of adenoids, improving the clinical symptoms of children with adenoid hypertrophy, and improving the SaO2of nocturnal sleep, and it has a certain clinical application value.
Humans ; Budesonide/administration & dosage* ; Adenoids ; Child ; Male ; Female ; Hypertrophy ; Nebulizers and Vaporizers ; Treatment Outcome ; Administration, Intranasal ; Child, Preschool

Objective:To analyze the effects of adenoidectomy, tonsillectomy and tonsillectomy combined with adenoidectomy on obstructive sleep apnea children by computational fluid dynamics numerical simulation. Methods:A case of typical tonsil with adenoid hypertrophy was selected. Mimics 21.0 software was used to establish the original preoperative model, adenoidectomy, tonsillectomy and virtual surgical models of tonsillectomy combined adenoidectomy, and the computational fluid dynamics model of the upper airway was established by ANSYS 2019 R1 software, and then the pressure and velocity of the internal flow field of the CFD model were numerically simulated. Seven planes perpendicular to the flow trace were selected as the observation planes, including the cross section of the sinusostoma complex, the anterior end of the adenoid body, the narrowest cross section of the nasopharyngeal cavity, the pharyngostoma tube, the narrowest cross section of the oropharyngeal cavity, the lower pole of the tonsil and the glottis section. The comparison indexes included pressure, flow velocity and flow distribution. Results:Compared with the original model before operation, after the adenoids were removed only, the pressure drop between the section of the ostiomeatal complex and the section of the eustachian tube decreased, the high velocity peak at the anterior end of the adenoids disappeared, and the flow trace through the middle nasal canal increased. When only bilateral tonsils were removed, the pressure drop between the eustachian tube and the glottis slowed down and the flow velocity between the eustachian tube and the glottis slowed down. Combined tonsillar-adenoidectomy resulted in the most uniform pressure distribution, the most gentle pressure change and flow rate in the upper airway, and the most ignificant increase in airflow trace through the middle nasal canal among the three operations. Conclusion:Adenoidectomy, tonsillectomy and combined tonsillar adenoidectomy can make the airflow velocity and pressure of upper respiratory tract uniform to different degrees, but there are obvious differences in the specific anatomical location and degree. The application of CFD can intuitively predict the improvement of upper airway flow field in OSA children by different surgical methods, which helps clinicians to make surgical decision.
Humans ; Sleep Apnea, Obstructive/physiopathology* ; Adenoidectomy/methods* ; Tonsillectomy/methods* ; Child ; Hydrodynamics ; Adenoids/surgery* ; Computer Simulation ; Palatine Tonsil/surgery* ; Software

Objective: To determine a normative value for the nasopharyngeal depth from the anterior nasal spine (ND-ANS) among normal adult Filipinos using Computed Tomography scans. Methods: Design: Cross-sectional study. Setting: Tertiary National University Hospital. Participants: Of 516 adult patients that underwent facial, neck and temporal bone CT scans in our hospital between January 1 to June 30, 2019, 100 cases were randomized to be included in the study and 91 CT scans were analyzed. Results: The mean nasopharyngeal depth from the anterior nasal spine among Filipino adults is 7.17 ± 0.42. There was a significant difference between sexes with a mean measurement of 7.23 cm ± 0.44 in males and 7.09 ± 0.37 cm in females. There was no statistically significant difference in mean nasopharyngeal depth across age groups. Conclusion A statistically significant difference was observed between sexes in our study sample. Our study provides initial normative values of nasopharyngeal depth among adult Filipinos, and additional studies may use this as a basis for further research.
Nasopharynx ; Adult ; Anthropometry

Child ; Humans ; Adenoids/surgery* ; Hypertrophy/surgery*

Objective: To investigate the feasibility of isolation and culture of human adenoid-derived mesenchymal stem cells (aMSCs) in vitro, and to observe the differentiation of aMSCs into olfactory sensory neurons. Methods: Adenoid tissues surgically removed from children with adenoid hypertrophy in the Second Xiangya Hospital of Central South University from September to November of 2020 were collected. The adenoid tissues were digested and isolated by trypsin and then cultured with adhesion method. The expressions of cell surface antigens CD45, CD73 and CD90 on aMSCs of P5 generation were tested by flow cytometry, and the ability of osteogenic and adipogenic induction were used to identify cell differentiation ability. Then, aMSCs were induced into differentiation by retinoic acid (RA), sonic hedgehog (SHH), basic fibroblast growth factor (bFGF), RA+SHH, RA+bFGF, SHH+bFGF and RA+SHH+bFGF, respectively. The morphology of differentiated cells was observed under inverted microscope. The expression of β-tubulin 3, which was the specific marker of sensory neuron, the expressions of growth associated protein-43 (GAP43) and olfactory maker protein (OMP), which were the specific markers of olfactory sensory neuron, were detected by immunofluorescence antibody assay. The expression intensities were compared by Chi-square test of four-grid table data. Results: aMSCs were successively isolated and cultured from human adenoid tissues. P0 cells generation had good adhesion and proliferation performance. P2 cells were basically purified. P5 cells expressed CD73 and CD90 with the purity of 99.3% and 99.75% respectively, without CD45 expression. P5 cells had a good ability of osteogenic differentiation and adipogenic differentiation. Neuron-like morphology and expression of β-tubulin 3 were found in differentiated cells after induced by RA, SHH, or bFGF, respectively. An induction of expression of GAP43 was found in differentiated cells of bFGF+SHH group and RA+SHH+bFGF group, without expression of OMP of each group. The intensity of GAP43 expression of RA+SHH+bFGF group was stronger than that of bFGF+SHH group (χ²=17.48, P<0.005). Conclusions: aMSCs can be cultured from human adenoid tissues, with the stably passaged and good differentiation ability. As a new population of mesenchymal stem cells, aMSCs have the neuroregenerative properties and could differentiate into immature olfactory sensory neurons under the induction of RA+SHH+bFGF in vitro.
Child ; Humans ; Hedgehog Proteins ; Olfactory Receptor Neurons ; Tubulin ; Adenoids ; Osteogenesis ; Cell Differentiation