Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2024, Vol. 38 ›› Issue (3): 43-48.doi: 10.6040/j.issn.1673-3770.0.2023.080

• Original Article • Previous Articles     Next Articles

Twenty-six cases of tubal torus hyperplasia after adenoid tonsillectomy in children

ZHAO Yun1, TENG Zhipan2, LI Qi2, SHEN Xiaofei2   

  1. 1. Department of Social development, Children's Hospital of Nanjing Medical University, Nanjing 210008, Jiangsu, China2. Department of Otorhinolaryngology, Children's Hospital of Nanjing Medical University, Nanjing 210008, Jiangsu, China
  • Published:2024-06-04

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Abstract: Objective To report the clinical phenomenon and characterisation of torus hyperplasia occurring after adenoidectomy and/or tonsillectomy in children. Methods This study included 26 pediatric patients diagnosed with torus hyperplasia. Clinical data(age, gender, time of first operation, way of operation and allergic rhinitis or not)were reviewed and analyzed. Results Twenty-six children who had underwent adenoidectomy and/or tonsillectomy had recurred snoring symptom, and were diagnosed with TTH. There were 20 males and 6 females, of whom 92.3% underwent first adenoidectomy and/or tonsillectomy before 5 years of age; the interval of diagnosis of torus hyperplasia after the operation ranged from 3 to 45 months. Eight children underwent partial resection of torus hyperplasia, the interval of two operations ranged from 3 to 48 months, and 10 exhibited definite signs and symptoms of allergic rhinitis. Twenty-one children underwent adenoidectomy or adenoidectomy with partial tonsillectomy, and 5 underwent adenoidectomy with total tonsillectomy. Conclusion TTH is a rare complication after adenoidectomy, and tended to occur in those who underwent adenoidectomy before 5 years of age. TTH was associated with allergic rhinitis, anti-allergic therapy has a certain clinical effect, and low-temperature plasma surgery is useful for torus hyperplasia. Torus hyperplasia was more common in children undergoing adenoidectomy without tonsillectomy than in those undergoing adenoidectomy with tonsillectomy.

Key words: Obstructive sleep apnea syndrome, Adenoid hypertrophy, Plasma technology, Tubal torus hyperplasia, Children

CLC Number: 

  • R246.81
[1] Ameli F, Brocchetti F, Semino L, et al. Adenotonsillectomy in obstructive sleep apnea syndrome. Proposal of a surgical decision-taking algorithm[J]. Int J Pediatr Otorhinolaryngol, 2007, 71(5): 729-734. doi:10.1016/j.ijporl.2007.01.007
[2] 周成勇, 孙宝春, 王丰, 等. 低温等离子辅助下儿童腺样体和扁桃体手术临床疗效观察[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(11): 863-866. doi:10.13201/j.issn.1001-1781.2016.11.006 ZHOU Chengyong, SUN Baochun, WANG Feng, et al. Clinical effect analysis of adenoidectomy and tonsillectomy assisted with ablation on children[J]. China Industrial Economics, 2016, 30(11): 863-866. doi:10.13201/j.issn.1001-1781.2016.11.006
[3] Di Rienzo Businco L, Coen Tirelli G. Paediatric tonsillectomy: radiofrequency-based plasma dissection compared to cold dissection with sutures[J]. Acta Otorhinolaryngol Ital, 2008, 28(2): 67-72
[4] 杨淑芝, 周成勇, 王丰, 等. 儿童圆枕增生外科处理的初步探讨[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(4):505-509. doi: 10.3760/cma.j.cn115330-20210412-00196 YANG Shuzhi, ZHOU Chengyong, WANG Feng, et al. Preliminary experience of surgical treatment for torus tubarius hypertrophy in children[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2022, 57(4):505-509. doi: 10.3760/cma.j.cn115330-20210412-00196
[5] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组、小儿学组. 儿童变应性鼻炎诊断和治疗指南(2022年,修订版)[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 4(57): 392-404
[6] 刘燕, 魏萍, 寇巍, 等. 儿童腺样体肥大与耳鼻咽喉科常见疾病关系的研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(4):149-154. doi: 10.6040/j.issn.1673-3770.0.2018.266 LIU Yan, WEI Ping, KOU Wei, et al. Research of the relationship between adenoid hypertrophy and the common diseases of pediatric otolaryngology[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4):149-154. doi: 10.6040/j.issn.1673-3770.0.2018.266
[7] 张立强. 儿童鼻窦炎与腺样体肥大的关系[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 25-28. doi: 10.6040/j.issn.1673-3770.1.2019.058 Zhang Liqiang. Relationship between sinusitis and adenoid hypertrophy in children[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 25-28. doi: 10.6040/j.issn.1673-3770.1.2019.058
[8] 王驰, 刘星, 孔磊, 等. 鼻内镜下等离子射频消融术对合并鼻窦炎的小儿腺样体肥大患者疗效及鼻腔黏膜纤毛清除功能的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(5):78-81. doi: 10.6040/j.issn.1673-3770.0.2017.219 WANG Chi, LIU Xing, KONG Lei, et al. Clinical efficacy of endoscopic plasma radiofrequency ablation in the treatment of adenoid hypertrophy and sinusitis in children and its effect on nasal mucociliary clearance[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(5):78-81. doi: 10.6040/j.issn.1673-3770.0.2017.219
[9] 沈翎, 林宗通, 林兴, 等. 儿童阻塞性睡眠呼吸暂停低通气综合征危险因素的病例对照研究[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 25-29. doi: 10.6040/j.issn.1673-3770.0.2018.086 SHEN Ling, LIN Zongtong, LIN Xing, et al. Risk factors associated with obstructive sleep apnea-hypopnea syndrome in children: a retrospective case-control study[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(2): 25-29. doi: 10.6040/j.issn.1673-3770.0.2018.086
[10] 张亚梅, 赵靖, 安嘉清, 等. 儿童阻塞性睡眠呼吸暂停低通气综合征外科治疗效果欠佳病例的分析[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(2): 90-94. doi: 10.3760/j.issn: 1673-0860.2007.02.004 ZHANG Yamei, ZHAO Jing, AN Jiaqing, et al. Analysis of poor-responding sleep apnea children to adenoidtonsillectomy and further treatment[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2007, 42(2): 90-94. doi: 10.3760/j.issn: 1673-0860.2007.02.004
[11] Lee CH, Hsu WC, Ko JY, et al. Revision adenoidectomy in children: a meta-analysis[J]. Rhin, 2019, 57(6): 411-419. doi: 10.4193/rhin19.101
[12] Elhassan HA, Bozkurt G, Emre IE. Revision adenoidectomy in children: residual vs regrowth?[J]. Eur Arch Otorhinolaryngol, 2018, 275(4): 1035. doi:10.1007/s00405-017-4850-y
[13] Bhattacharjee, Rakesh, Aydinoz, et al. Adenotonsillectomy complications: a meta-analysis[J]. Pediatrics Official Publication of the American Academy of Pediatrics, 2015, 136(4):702-718
[14] 孙宝春, 王丰, 杨淑芝, 等. 低温等离子辅助下儿童腺样体、扁桃体手术并发症分析[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(22): 1720-1723. doi:10.13201/j.issn.1001-1781.2017.22.004 SUN Baochun, WANG Feng, YANG Shuzhi, et al. Complications analysis of adenoidectomy and tonsillectomy assisted with ablation on children[J]. China Industrial Economics, 2017, 31(22): 1720-1723. doi:10.13201/j.issn.1001-1781.2017.22.004
[15] Kim JW, Rhee CS, Jung HJ. Partial resection of hypertrophic torus tubarius for recurred snoring[J]. Medicine, 2020, 99(10): e19329. doi:10.1097/md.0000000000019329
[16] Rusetsky YY, Latysheva EN, Polunina TA, et al. Torus tubarius hypertrophy as a cause of obstructive sleep apnea in children[J]. Pediatria, 2016, 95(5): 82-85
[17] 刘燕, 林裕强, 耿聪俐, 等. 变应原皮肤点刺试验结果与免疫治疗近期疗效相关性分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018(2): 102-105. doi: 10.13201/j.issn.1001-1781.2018.02.006 LIU Yan, LIN Yuqiang, GENG Congli, et al. Influence of different levels of skin pricking test on the short-term efficacy of subcutaneous immunotherapy in allergic rhinitis[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018(2): 102-105. doi: 10.13201/j.issn.1001-1781.2018.02.006
[18] 王岩, 师晓丽. 变态反应与儿童OSAHS的关系[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 14-18. doi: 10.6040/j.issn.1673-3770.1.2018.002 WANG Yan, SHI Xiaoli. The relationship between allergic reaction and children obstructive sleep apnea hypopnea syndrome[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(2): 14-18. doi: 10.6040/j.issn.1673-3770.1.2018.002
[19] 王睿坤, 梁洁琼, 韩伟, 等. 2001—2021年中国儿童青少年过敏性鼻炎患病率的Meta分析[J]. 中华预防医学杂志, 2022, 56(6): 784-793. doi: 10.3760/cma.j.cn112150-20220315-00242 WANG Ruikun, LIANG Jieqiong, HAN Wei, et al. Prevalence of allergic rhinitis in Chinese children from 2001 to 2021: Meta analysis[J]. Chinese Journal of Preventive Medicine, 2022, 56(6): 784-793. doi: 10.3760/cma.j.cn112150-20220315-00242
[20] Zhang YM, Zhang J, Liu SL, et al. Prevalence and associated risk factors of allergic rhinitis in preschool children in Beijing[J]. Laryngoscope, 2013, 123(1): 28-35. doi:10.1002/lary.23573
[21] 王媛, 曹春婷, 漆可, 等. 北京市中小学生变应性鼻炎患病率调查[J]. 中国耳鼻咽喉头颈外科, 2015, 22(9): 465-469. doi: 10.16066/j.1672-7002.2015.09.010 WANG Yuan, CAO Chunting, QI Ke, et al. Prevalence survey of allergic rhinitis in Beijing primary and middle school students[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2015, 22(9): 465-469. doi: 10.16066/j.1672-7002.2015.09.010
[22] Chen YT, Zhu JZ, Lyu JJ, et al. Association of maternal prepregnancy weight and gestational weight gain with children's allergic diseases[J]. JAMA Netw Open, 2020, 3(9): e2015643. doi:10.1001/jamanetworkopen.2020.15643
[23] Bhandari N, Don DM, Koempel JA. The incidence of revision adenoidectomy: a comparison of four surgical techniques over a 10-year period[J]. Ear Nose Throat J, 2018, 97(6): E5-E9. doi:10.1177/014556131809700601
[24] Lee SY, Kim JW. Nasopharyngeal width and its association with sleep-disordered breathing symptoms in children[J]. Clin Exp Otorhinolaryngol, 2019, 12(4): 399-404. doi:10.21053/ceo.2018.01151
[25] 王丰, 周成勇, 张京红, 等. 儿童OSAHS和变应性鼻炎的关系探讨[J]. 临床耳鼻咽喉头颈外科杂志, 2012, 26(6): 260-262. doi: 10.3760/j.issn: 1673-0860.2007.02.002 WANG Feng, ZHOU Chengyong, ZHANG Jinghong, et al. Relationship between OSAHS and allergic rhinitis in children[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2012, 26(6): 260-262. doi: 10.3760/j.issn: 1673-0860.2007.02.002
[26] 王丰, 周成勇, 王宏伟, 等. 腺样体切除术后圆枕增生与变应性鼻炎的关系[J]. 中国耳鼻咽喉头颈外科, 2010, 17(2): 112. doi: 10.16066/j.1672-7002.2010.02.012 WANG Feng, ZHOU Chengyong, WANG Hongwei, et al. Relationship between occipital hyperplasia and allergic rhinitis after adenoidectomy[J]. Chinese Archives of otolaryngology-Head and Neck Surgery, 2010, 17(2): 112. doi: 10.16066/j.1672-7002.2010.02.012
[27] 刘炜, 陈仁杰. 糠酸莫米松鼻喷剂联合孟鲁司特钠治疗儿童腺样体肥大的疗效观察[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(5): 366-368. doi:10.13201/j.issn.1001-1781.2017.05.009 LIU Wei, CHEN Renjie. Clinical observation of mometasone furoate nasal spray combined with montelukast sodium in the treatment of adenoidal hypertrophy in children[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2017, 31(5): 366-368. doi:10.13201/j.issn.1001-1781.2017.05.009
[28] Tuhanio glu B, Erkan SO. Evaluation of the effects of montelukast, mometasone furoate, and combined therapyon adenoid size: a randomized, prospective, clinical trial with objective data[J]. Turk J Med Sci, 2017, 47: 1736-1743. doi:10.3906/sag-1701-179
[29] 耿培宏. 孟鲁司特钠、氯雷他定联合糠酸莫米松用药方案对小儿过敏性鼻炎并腺样体肥大的临床评价[J]. 当代医学, 2017, 23(32): 121-122. doi: 10.3969/j.issn.1009-4393.2017.32.053 GENG Peihong. Clinical evaluation of montelukast sodium, loratadine combined with mometasone furoate in children with allergic rhinitis complicated with adenoidal hypertrophy[J]. Contemporary Medicine, 2017, 23(32): 121-122. doi: 10.3969/j.issn.1009-4393.2017.32.053
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