1. Introduction
Adenoid tissue is a peripheral lymphoid organ located at the roof of the rhinopharynx and is part of the Waldeyer’s ring. Due to its special location, especially regarding the posterior choanae and eustachian tube, it can cause various health problems in childhood. Studies have shown that adenoid hypertrophy (AH) is associated with nasal obstruction, snoring, sleep apnea, recurrent otitis media, recurrent rhinosinusitis infections, and craniofacial anomalies[1, 2]. AH is commonly diagnosed using lateral radiographs and fiberoptic nasal endoscopy [3]. Most doctors choose a combination of oral Leukotriene receptor antagonists with nasal glucocorticoids in the treatment of AH. Because previous studies showed that a combination of oral Leukotriene receptor antagonists with nasal glucocorticoids showed higher therapeutic efficacy for the treatment of with less recurrence compared with single therapy using nasal glucocorticoid alone [4]. Allergic rhinitis (AR), is a non-infectious disease of the nasal mucosa, is primarily mediated by immunoglobulin E (IgE) following contact with allergens. Children with AR exhibit four main symptoms: nasal congestion, sneezing, nasal itching, and runny nose, which are usually accompanied by mouth breathing and suffocation[5]. Oral Leukotriene receptor antagonists and nasal glucocorticoids are also the first-line treatment drugs of AR[6].
What is the immunopathology basis of AR and AH? Why are two different diseases treated with the same drugs? The appearance of AH is different. Is there any relationship between different appearance and immunopathology of AH? Here, we proposed a novel classification system of adenoids based on appearance. Additionally, we explored whether the novel classification of adenoids is helpful for drugs selection and efficacy evaluation.