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.