目的:探讨腺样体切除术治疗儿童分泌性中耳炎及鼾症的临床疗效。方法:对住院行腺样体切除术的120例分泌性中耳炎及鼾症患儿的临床表现、治疗方法和预后进行回顾性分析。结果:120例患儿经切除肥大的腺样体，辅以相应的药物治疗，临床症状均明显好转。结论:腺样体肥大较易成为儿童分泌性中耳炎及鼾症发病的基础因素。切除肥大的腺样体是治疗儿童分泌性中耳炎及鼾症有效、安全的方法。
Objective To assess the effectiveness and safety of adenoidectomy on otitis media with effusion (OME) in children. Methods Electronic databases were searched including Medline (1966-2001), EMbase (1974-2001), the Cochrane Controlled Trials Register (CCTR), Chinese Biomedical Database (CBM, 1989-2001). Five Chinese otolaryngology journals were handsearched. References of eligible studies were also screened for inclusion. Selection criteria were restricted to randomized controlled trials comparing adenoidectomy with other treatments in patients with OME in children. At least two reviewers independently assessed trial quality and extracted data. RevMan 4.1 was used for statistical analysis. Results Of the 248 literatures identified, 13 trials with 1 430 patients were eligible and were included in the systematic review. Overall, the methodological quality of the included trials was high, all from developed countries. None of the trials showed that the effects of adenoidectomy better than those of myringotomy and no treatments for OME in children. Four trials comparing adenoidectomy with grommets showed that the effects of grommets were better than those of adenoidectomy. Ten trials described post-surgical bleeding, velopharyngeal incompetence and nasopharyngeal stenosis. Conclusions At present, there is no evidence to either ascertain that adenoidectomy is better than other treatments for OME, or to suggest which type of surgery is the most effective one. Current trials indicate that early administration of adenoidectomy concomitant with grommets might be the most appropriate therapy for OME in children who fail to response to drug treatment, if multiple risk factors exist.
Adenoid hypertrophy in children with epilepsy is rarely reported. This paper analyzes the clinical characteristics and incidence of adenoid hypertrophy in children with epilepsy.Methods The clinical data in children with epilepsy from December 2014 to April 2020 in Shenzhen Children's hospital were analyzed retrospectively.Results There were 449 cases diagnosed with adenoid hypertrophy (2.74%) in 16387 children with epilepsy. Among 449 cases of adenoid hypertrophy, 276 males (61.47%) and 173 females (38.53%). The age distribution was: 28 days to 1 year old, 8 cases (2%); 1-3 years old, 78 cases (17%); 3-6 years old 167 cases (37%); 6-12 years old, 153 cases (34%); 12-18 years old, 43 cases (10%). In 40 patients the IgG antibody were positive for EB capsid antigen in 25 (62.5%). In 56 cases of EB virus DNA were detected by fluorescence quantitative PCR, 25 (44.64%) positive, and 21/44 cases (47.72%) were positive by general nucleic acid detection of enteroviruses. The neutrophil reduction rate in peripheral blood was 42.19% in 673 tests, lymphocyteincreased in 292 (43.38%), platelet count increased in 307 (45.61%), abnormal in platelet hematocrit in 311 (46.21%); the mean volume of RBC was decreased in319 (47.39%) tests. The content of \begin{document}${\rm{HCO}_3^-} $\end{document} was reduced in 20/55 cases (36.36%). 25-hydroxy vitamin D was 33 (44.5%) decreased in 74 cases. The blood glucose was measured in 146 cases, 60 (41.09%) increased, total cholesterol was 31 (40.78%) increased in 76 cases, serum C peptide was 12 (29.26%) increased in 41 cases.Conclusion Adenoid hypertrophy in children with epilepsy may be related to infection, inflammation or immune disorder, which may cause nutritional, metabolic or internal environment disorders. Therefore, there is need of nursing and health education, transferring to specialized centers for diagnosis and treatment.
ObjectiveTo investigate the differences in middle ear function between adenoid hypertrophy (AH) children with type A tympanogram and normal children, and to evaluate the value of wideband acoustic immittance (WAI) in diagnosing middle ear dysfunction in AH children with type A tympanogram. MethodsThis retrospective cohort study included 96 children (192 ears) with AH and 40 healthy children (80 ears) as the control group. All children underwent pure tone audiometry, 226 Hz tympanometry, WAI, otoscopy, and electronic nasopharyngoscopy. Type A AH children were selected as the study group (AH group) to compare the 226 Hz tympanometry index and WAI between the two groups. A binary logistic regression model was constructed after dimensionality reduction by principal component analysis of the frequencies with statistical significance, and the diagnostic value of the model was evaluated by receiver operating characteristic (ROC) curve. ResultsThere was no significant difference in 226 Hz tympanometry between the two groups (P>0.05). This study found that there were significant differences in WAI between children with AH and healthy children. Under tympanic peak pressure, the wideband absorbance (WBA) of the AH group was significantly higher than that of the control group at 226～630 Hz and 3 150～6 000 Hz; Under ambient pressure, the WBA of the AH group was significantly lower than that of the control group at 1 250～1 600 Hz and significantly higher than that of the control group at 4 000～6 000 Hz. The dimensionality of 15 statistically significant frequencies was reduced to 3 principal components (89.79% of the original information) by principal component analysis. The binary logistic regression model constructed after dimensionality reduction by principal component analysis had a high diagnostic value, with an AUC of 0.813, a sensitivity of 62.18%, and a specificity of 87.50%. ConclusionWAI can be used as an effective method for evaluating the middle ear function of AH children with type A tympanogram.