Prevalence of the Helicobacter pylori in the tonsils and adenoids

IntroductionThere is an ongoing debate about the existence and effects of Helicobacter pylori (Hp) in adenotonsillar tissue.ObjectiveA clinical study was conducted to assess the existence of Hp in the adenoid and/or adenotonsillar tissues, which were surgically excised due to chronic adenotonsillitis.MethodsPhosphoglucosamine mutase gene for the detection of Hp and cytotoxin-associated gene as virulence gene were examined in 84 adenotonsillar tissues obtained from 64 patients and patients’ serum by using polymerase chain reaction.ResultsHp IgG was detected in 57 (89%) patients’ serum. A total of seven tissue samples from 64 patients (10.9%) were found positive for Hp DNA, of which five were adenoids and two were tonsil tissues. All polymerase chain reaction positive samples were also positive for the cytotoxin-associated gene, which is a virulence determinant for the organism.ConclusionThis study suggests that children are exposed to Hp at an early age of their life in this province. Hp may have a role in the pathogenesis of chronic adenotonsillitis, especially in endemic areas.     

鼻内镜下经口腺样体切除治疗儿童阻塞性睡眠呼吸暂停综合征 89 例效果分 析简

目的 探讨鼻内镜下经口腺样体切除治疗儿童阻塞性睡眠呼吸暂停综合征（OSAHS）的效果,探讨该手术方式的优点.方法 选取宁波大学医学院附属医院2010年12月～2012年5月收治的OSAHS患儿176例为研究对象,其中89例采用鼻内镜下经口腺样体切除治疗者为观察组,87例采用传统手术治疗的患儿为对照组.观察观察组患儿疗效,比较随访6～12个月后两组患儿临床症状改善情况.结果 术后随访6～12个月发现78例（87.64％）患者打鼾症状完全消失,11例（12.36％）好转,且观察组患儿在睡眠打鼾、鼻塞、鼻漏、听力、上课注意力不集中、多动等症状改善方面明显优于对照组,差异有统计学意义（P＜0.05）.结论 鼻内镜下经口腺样体切除治疗儿童OSAHS效果显著,具有手术视野清晰、安全性高等优点.术后随访发现,与传统的手术相比,疗效更佳.     

儿童腺样体肥大致肺动脉高压3例并右心导管检查分析

目的：分析近年来收治的肺高血压合并腺样体肥大致睡眠呼吸暂停综合症病例的临床资料,为临床诊治提供经验。方法：对武汉亚洲心脏病医院自2012年至2014年收治的肺高血压病例的临床资料及随访结果进行回顾性分析,其中3例为腺样体肥大致睡眠呼吸暂停综合症并肺高血压。结果：3例右心导管结果mPAP 33.33±10.06mmHg,PVR1015±606.66(dyn.s.cm-5),经治疗后复查活动能力均明显改善,心功能改善。结论：腺样体肥大致肺高血压行病因治疗联合靶向药物波生坦口服安全有效。     

Sarcoidosis of the upper respiratory tract in children

Sarcoidosis is a multisystemic granulomatosis of unknown etiology which mainly affects young adults. It is characterized primarily by bilateral hilar adenopathies, a pulmonary infiltrate and cutaneous and ocular lesions. It rarely occurs in children under the age of 16. Localization in the upper respiratory tract (URT) is infrequent and sarcoidosis of the URT in children is exceptional, with only 13 cases reported in the literature. In the present report we describe the clinical, diagnostic explorations, histological and therapeutic aspects of 2 new cases in children.     

Microbiology of healthy and diseased adenoids

OBJECTIVE: To determine the qualitative and quantitative microbiology of core adenoid tissue obtained from four groups of 15 children each, with recurrent otitis media (ROM), recurrent adenotonsillitis (RAT), obstructive adenoid hypertrophy (OAH), and occlusion or speech abnormalities (controls). METHODS: Core cultures of surgically removed diseased adenoids and of healthy controls were cultured for aerobic and anaerobic bacteria. RESULTS: Polymicrobial aerobic-anaerobic flora were present in all instances. Ninety-four organisms were isolated from control specimens, and 148 from ROM, 142 from RAT, and 149 from OAH specimens. The predominant aerobes in all groups were alpha-hemolytic and gamma-hemolytic streptococci, Haemophilus influenzae, Staphylococcus aureus, group A beta-hemolytic streptococci, and Moraxella catarrhalis. The prominent anaerobes were Peptostreptococcus, Prevotella, and Fusobacterium species. The number, concentration and distribution of types of most organisms did not vary among the three groups of diseased adenoids. However, the number of those that are potential pathogens and those that produced beta-lactamase was lower in the control than the diseased adenoids (P < .001). CONCLUSION: The study highlights the importance of the bacterial load in the adenoids in contributing to the etiology of ROM, RAT, and OAH.     

儿童鼻-鼻咽疾病对中耳功能的影响

目的探讨儿童分泌性中耳炎的病因和治疗。方法对213例患有鼻-鼻窦炎和腺样体肥大的儿童分别按腺样体肥大程度分为轻度组和重度组,按病程长短分为3个月以下组和3个月以上组。所有患者均行电耳镜、声导抗等检查,并计分评价其中耳功能。结果轻度组的中耳功能明显好于重度组（P〈0．05）;3个月以下组的中耳功能明显好于3月以上组（P〈0．05）。结论鼻-鼻窦炎和腺样体肥大影响儿童中耳功能,且随着病情的加重和病程的延长对中耳功能的影响越明显;早期对患有鼻-鼻窦炎和腺样体肥大的儿童进行干预,有利于保护儿童的中耳功能和听力言语的正常发育。     

腺样体切除术在治疗儿童慢性鼻窦炎中的意义

目的探讨腺样体切除术在治疗儿童慢性鼻窦炎中的意义。方法2006年5月-2007年3月我科住院的儿童慢性鼻窦炎伴腺样体肥大患儿50例,随机分为AB两组,A组30例为治疗组,B组20例为对照组,A组药物治疗加腺样体切除术,B组单纯药物治疗。治疗3个月和6个月后评价疗效。结果3月后对照组有效率90.0%,治疗组有效率96.6%,两组疗效无显著性差异(P>0.05)。6月后对照组有效率60.0%,治疗组有效率93.3%,两组疗效有显著性差异(P<0.05)。结论儿童慢性鼻窦炎伴腺样体肥大的患儿,治疗上除了系统的药物治疗之外,还要行腺样体切除术,可提高疗效,尤其以远期疗效显著。     

A clinical study of nasopharyngeal masses

Out of 36511 patients attending the ENT OHD of R. G,. Aur Medical Callege & Hospital. Kolkata, in one year 0.08% patients were found tuning naspharyngeal mass. 30 cases of nasopharyngeal mass were studied. The peak incidence of nasopharyngeal mass was in the age group between II to 20 years (40%). The incidence in males (73%) was more than females(27%). The maximum ineldence was found among students (74%). Commonest ntuopharyngeal nuns teas antrochoanal polyp (30%). Next commlon masses were adenoids (23%)Juvenile angwfibroma(20%) and nasophartngeal carcinoma (13%). Nasal obstruction was the main presenting symptom(83%) followed by epistaxis (40%).     

腺样体残体伴复发性分泌性中耳炎的综合治疗

目的观察综合疗法对腺样体残体伴复发性分泌性中耳炎的治疗效果。方法对2004~2007年20例伴腺样体残体的复发性分泌性中耳炎患者(29耳)行内窥镜下腺样体切除术,并行咽鼓管吹张和全身药物等治疗。结果术后随访6个月~3年,26耳(17例,89.7%)治愈,1耳(1例,3.4%)好转,2耳(2例,6.9%)治疗无效,总有效率93.1%。结论本综合疗法可有效治疗腺样体残体伴复发性分泌性中耳炎。     

低温等离子消融术在儿童鼾症手术中的应用

目的评价低温等离子消融术治疗小儿鼾症的疗效。方法多导睡眠呼吸监测确诊的82例患儿,在全麻下采用Arthrocare等离子刀系统行扁桃体摘除术,在70度鼻内镜辅助下行腺样体射频消融术。所有患儿均随访6月,总结术后并发症及其临床疗效。结果82例患儿中,1例患者术后第2天发生出血,1例患者术后第6天继发出血,其余患者无任何手术并发症。随访结果显示,82例患儿临床症状均得到改善。结论等离子消融手术时间明显缩短,术中出血量减少,是治疗儿童鼾症的有效方法。