Novel Classification System Of Adenoids Based On Appearance And Its
Relationship With Drug Therapy
Objective: To investigate the appropriate drug therapy based on a novel
classification system for adenoids based on their appearance. Methods:
We used fiberoptic nasal endoscopy to determine the degree and
appearance of adenoid hypertrophy (AH). The adenoids were divided into
three types: edematous type, common type, and fibrous type. In adenoid
tissues, the eosinophils were counted. Immunohistochemistry and western
blot were done to determine the expression of CysLTR1, CysLTR2, CGR-α,
and CGR-β in different types of adenoids. Results: 70.67% (106/150) AH
patients with AR, and of them 68% (72/106) of adenoids were the
edematous type. The expression of CGR-α and CGR-β and eosinophil count
were higher in the edematous type but not in common and fibrous types.
The expression of the leukotriene receptor was stable in all types.
There was a positive correlation between eosinophil count in the blood
and in the adenoid tissue. Conclusion: AR was the risk factor for the
development of AH. Leukotriene receptor antagonist was an important drug
for the treatment of AH. The glucocorticoid was only useful in the
edematous type. Therefore, for AH patients with AR, patients with
edematous type adenoids and/or patients with increased eosinophils in
blood routine choose nasal glucocorticoid combined with leukotriene
receptor antagonist is appropriate. On the contrary, leukotriene
receptor antagonists alone can be selected to treat AH.