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Medical Physics Jun 2020Adenoid hypertrophy is a pathological hyperplasia of adenoids and may cause snoring, apnea, and impede breathing during sleep. In clinical practice, radiologists...
PURPOSE
Adenoid hypertrophy is a pathological hyperplasia of adenoids and may cause snoring, apnea, and impede breathing during sleep. In clinical practice, radiologists diagnose the severity of adenoid hypertrophy by measuring the ratio of adenoid width (A) to nasopharyngeal width (N) according to the lateral cephalogram, which indicates the locations of four keypoints. The entire diagnostic process is tedious and time-consuming due to the acquisition of A and N. Thus, there is an urgent need to develop computer-aided diagnostic tools for adenoid hypertrophy.
METHODS
In this paper, we first propose the use of deep learning to solve the problem of adenoid hypertrophy classification. Deep learning driven by big data has developed greatly in the image processing field. However, obtaining a large amount of training data is hard, making the application of deep learning to medical images more difficult. This paper proposes a keypoint localization method to incorporate more prior information to improve the performance of the model under limited data. Furthermore, we design a novel regularized term called VerticalLoss to capture the vertical relationship between keypoints to provide prior information to strengthen the network performance.
RESULTS
To evaluate the performance of our proposed method, we conducted experiments with a clinical dataset from the First Affiliated Hospital of Anhui Medical University consisting of a total of 688 patients. As our results show, we obtained a classification accuracy of 95.6%, a macro F1-score of 0.957, and an average AN ratio error of 0.026. Furthermore, we obtained a macro F1-score of 0.89, a classification accuracy of 94%, and an average AN ratio error of 0.027 while using only half of the data for training.
CONCLUSIONS
The study shows that our proposed method can achieve satisfactory results in the task of adenoid hypertrophy classification. Our approach incorporates more prior information, which is especially important in the field of medical imaging, where it is difficult to obtain large amounts of training data.
Topics: Adenoids; Deep Learning; Hypertrophy; Image Processing, Computer-Assisted
PubMed: 32017124
DOI: 10.1002/mp.14063 -
American Journal of Orthodontics and... Jul 2023Rapid maxillary expansion (RME) expands the maxillary dentition laterally and improves nasal airway obstruction. However, the incidence of nasal airway obstruction...
INTRODUCTION
Rapid maxillary expansion (RME) expands the maxillary dentition laterally and improves nasal airway obstruction. However, the incidence of nasal airway obstruction improvement after RME is approximately 60%. This study aimed to clarify the beneficial effects of RME on nasal airway obstruction in specific pathologic nasal airway diseases (nasal mucosa hypertrophy and obstructive adenoids) using computer fluid dynamics.
METHODS
Sixty subjects (21 boys; mean age 9.1 years) were divided into 3 groups according to their nasal airway condition (control, nasal mucosa hypertrophy, and obstructive adenoids), and those requiring RME had cone-beam computed tomography images taken before and after RME. These data were used to evaluate the nasal airway ventilation condition (pressure) using computer fluid dynamics and measure the cross-sectional area of the nasal airway.
RESULTS
The cross-sectional area of the nasal airway significantly increased after RME in all 3 groups. The pressures in the control and nasal mucosa groups significantly reduced after RME but did not change significantly in the adenoid group. The incidence of improvement in nasal airway obstruction in the control, nasal mucosa, and adenoid groups was 90.0%, 31.6%, and 23.1%, respectively.
CONCLUSIONS
The incidence of improvement in nasal airway obstruction after RME depends on the nasal airway condition (nasal mucosa hypertrophy and obstructive adenoids). In patients with nonpathologic nasal airway conditions, the obstruction may be sufficiently improved with RME. Furthermore, to some extent, RME may be effective in treating nasal mucosa hypertrophy. However, because of obstructive adenoids, RME was ineffective in patients with nasal airway obstruction.
Topics: Male; Humans; Child; Nasal Obstruction; Adenoids; Palatal Expansion Technique; Hydrodynamics; Nasal Mucosa; Cone-Beam Computed Tomography; Hypertrophy
PubMed: 37191595
DOI: 10.1016/j.ajodo.2023.04.014 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Oct 2022Adenoid hypertrophy is a common disease in pediatric otorhinolaryngology. Surgical resection is the main treatment at present, but many children still face the risk of... (Review)
Review
Adenoid hypertrophy is a common disease in pediatric otorhinolaryngology. Surgical resection is the main treatment at present, but many children still face the risk of postoperative recurrence or even secondary surgery. In order to reduce the postoperative recurrence rate and provide reference information for clinical medical staff and parents of the children, this review was carried out to analyze the domestic and foreign pertinent literature in recent years and put forward overall prevention strategies base on the related factors of recurrence.
Topics: Adenoids; Child; Humans; Hypertrophy; Neoplasm Recurrence, Local; Postoperative Period; Recurrence
PubMed: 36217664
DOI: 10.13201/j.issn.2096-7993.2022.10.016 -
Oral Oncology Apr 2021
Topics: Adult; Carcinoma, Adenoid Cystic; Female; Humans; Palatine Tonsil
PubMed: 33376056
DOI: 10.1016/j.oraloncology.2020.105135 -
Laryngo- Rhino- Otologie Aug 2020What is right? Tonsillotomy or tonsillectomy? Moreover, when and what has to be preferred? Is the discussion never ending? No, and this is good. Tonsil surgery is and...
What is right? Tonsillotomy or tonsillectomy? Moreover, when and what has to be preferred? Is the discussion never ending? No, and this is good. Tonsil surgery is and will remain a frequent surgical procedure for the otolaryngologist. Especially, because many children are operated, and because - also rare - significant complications can occur, a quality-controlled benefit-risk-analysis is important. Part of this is systematic analysis of the evidence of the benefits and risks of tonsillotomy and tonsillectomy, as it was performed recently by the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) by order of the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA). One result was the implementation of the tonsillotomy as a regular service paid by the insurance companies. Nevertheless, the discussion is not yet concluded. Actually, a randomized controlled trial is in preparation sponsored by the G-BA to proof the non-inferiority of tonsillotomy against tonsillectomy for the treatment of patients with recurrent acute tonsillitis. The present article on ENT specialist knowledge should put the reader, especially ENT residents, in a position to advice patients and their relatives on the pros and cons of tonsil surgery.
Topics: Adenoids; Child; Humans; Otolaryngologists; Palatine Tonsil; Risk Assessment; Tonsillectomy; Tonsillitis
PubMed: 32731293
DOI: 10.1055/a-1148-2494 -
Frontiers in Cellular and Infection... 2022Otitis media (OM) is one of the most common infections in young children, arising from bacterial and/or viral infection of the middle ear. Globally, and non-typeable...
Predominant Bacterial and Viral Otopathogens Identified Within the Respiratory Tract and Middle Ear of Urban Australian Children Experiencing Otitis Media Are Diversely Distributed.
BACKGROUND
Otitis media (OM) is one of the most common infections in young children, arising from bacterial and/or viral infection of the middle ear. Globally, and non-typeable (NTHi) are the predominant bacterial otopathogens. Importantly, common upper respiratory viruses are increasingly recognized contributors to the polymicrobial pathogenesis of OM. This study aimed to identify predominant bacteria and viruses in the nasopharynx, adenoids and middle ears of peri-urban/urban South-East Queensland Australian children, with and without clinical history of chronic otitis media with effusion (COME) and/or recurrent acute otitis media (RAOM).
METHODS
Sixty children, 43 diagnosed with OM and 17 controls with no clinical history of OM from peri-urban/urban South-East Queensland community were recruited to the study. Respiratory tract bacterial and viral presence were examined within nasopharyngeal swabs (NPS), middle ear effusions (MEE) and adenoids, using real-time polymerase chain reaction (RT-PCR) and bacterial culture.
RESULTS
At least one otopathogen present was observed in all adenoid samples, 86.1% and 82.4% of NPS for children with and without OM, respectively, and 47.1% of the MEE from the children with OM. NTHi was the most commonly detected bacteria in both the OM and control cohorts within the adenoids (90.0% vs 93.8%), nasopharynx (67.4% vs 58.8%) respectively, and in the MEE (OM cohort 25.9%). Viruses were detected in all adenoid samples, 67.4% vs 47.1% of the NPS from the OM and control cohorts, respectively, and 37% of the MEE. Rhinovirus was the predominant virus identified in the adenoids (85.0% vs 68.8%) and nasopharynx (37.2% vs 41.2%) from the OM and control cohorts, respectively, and the MEE (19.8%).
CONCLUSIONS
NTHi and rhinovirus are predominant otopathogens within the upper respiratory tract of children with and without OM from peri-urban and urban South-East Queensland, Australia. The presence of bacterial otopathogens within the middle ear is more predictive of concurrent URT infection than was observed for viruses, and the high otopathogen carriage within adenoid tissues confirms the complex polymicrobial environment in children, regardless of OM history.
Topics: Australia; Bacteria; Child; Child, Preschool; Ear, Middle; Humans; Nasopharynx; Otitis Media
PubMed: 35360096
DOI: 10.3389/fcimb.2022.775535 -
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke... Aug 2021
Topics: Adenoidectomy; Adenoids; Humans; Hypertrophy; Microbiota; Palatine Tonsil; Tonsillectomy
PubMed: 34521179
DOI: 10.3760/cma.j.cn115330-20201009-00792 -
Archives of Iranian Medicine Mar 2022Adenoid cystic carcinoma (ADCC) is a malignant tumor of salivary gland origin. ADCC of sinonasal tract is rare. We present a rare and unresectable case of sinonasal ADCC...
Adenoid cystic carcinoma (ADCC) is a malignant tumor of salivary gland origin. ADCC of sinonasal tract is rare. We present a rare and unresectable case of sinonasal ADCC with intracranial extension in an 83-year-old man with the chief complaint of nasal congestion. Invasion to the maxillary sinus, nasopharynx, anterior cranial fossa, sella turcica and extension to cavernous sinus, dura mater and infratemporal fossa were evident on MRI and CT scan. The patient was treated only by palliative radiotherapy, but unfortunately, he died 3 months after the initial diagnosis.
Topics: Aged, 80 and over; Carcinoma, Adenoid Cystic; Humans; Magnetic Resonance Imaging; Male; Tomography, X-Ray Computed
PubMed: 35429962
DOI: 10.34172/aim.2022.32 -
Acta Otorrinolaringologica Espanola 2020This document is intended as a guide for Spanish ENT specialists who want to perform drug-induced sleep endoscopy. Indications, sedation method and important findings...
This document is intended as a guide for Spanish ENT specialists who want to perform drug-induced sleep endoscopy. Indications, sedation method and important findings are discussed to unify criteria and methodology.
Topics: Adenoids; Airway Obstruction; Child; Child, Preschool; Computer Systems; Continuous Positive Airway Pressure; Digital Technology; Endoscopy; Female; Fiber Optic Technology; Humans; Hypertrophy; Infant; Male; Palatine Tonsil; Practice Guidelines as Topic; Preoperative Care; Sleep; Sleep Aids, Pharmaceutical; Sleep Apnea, Obstructive; Video-Assisted Surgery
PubMed: 31056108
DOI: 10.1016/j.otorri.2019.03.002 -
Romanian Journal of Morphology and... 2021The aim of the study was to observe, using scanning electron microscopy (SEM), the ratio of bacterial biofilm coverage of adenoidal tissue in children diagnosed with...
The aim of the study was to observe, using scanning electron microscopy (SEM), the ratio of bacterial biofilm coverage of adenoidal tissue in children diagnosed with chronic rhinosinusitis (CR), compared to the ratio of adenoid bacterial biofilm coverage in children diagnosed with obstructive sleep apnea (OSA). We also performed histopathological and immunohistochemical tests to correlate the results with the images obtained from SEM. We estimated, using an image analysis program, the coverage ratio with bacterial biofilm on the surface of the lymphatic tissue. Adenoid vegetation extracted from children with CR had a higher percentage of bacterial biofilm coverage compared to the group diagnosed with OSA. In the nasopharynx of children with CR, the bacterial biofilm had a constant role of infection generator, and adenoidectomy was the only effective therapeutic procedure to relieve the symptoms. Allergy tests were performed in all children to establish a link between CR, OSA and allergic rhinitis.
Topics: Adenoidectomy; Adenoids; Biofilms; Child; Humans; Sinusitis; Sleep Apnea, Obstructive
PubMed: 35024736
DOI: 10.47162/RJME.62.2.14