Abstract Objectives To characterise the immune cellular landscape and paired B‐cell and T‐cell receptor repertoires of hypertrophic adenoids in children with obstructive sleep apnoea. Methods We performed 10x Genomics 5′ single‐cell RNA sequencing with paired V(D)J profiling on adenoid tissues from children (AH, n = 4; control, n = 4) and analysed 72 076 high‐quality cells. Results Compared with controls, AH adenoids exhibited an expanded B‐cell compartment (62.26% vs 51.94%, P = 0.029) and a modest increase in plasmacytoid dendritic cells (0.37% vs 0.15%, P = 0.029), accompanied by reduced T‐cell representation (34.19% vs 44.54%, P = 0.029). Within the B‐cell compartment, GC B cell populations were expanded in AH, particularly Cycling B cells (15.07% vs 2.86%, P = 0.029), whereas memory B cells were reduced (21.48% vs 32.18%, P = 0.029). B‐cell receptor analysis demonstrated reduced somatic hypermutation frequencies across multiple mature B‐cell subsets in AH, accompanied by an isotype distribution skewed towards IgM with reduced class‐switched fractions. Although CD8+ tissue‐resident memory T‐cell (TRM) frequencies were similar between groups, CD8+ TRM in AH adenoids displayed interferon‐polarised and antigen‐processing signatures, and T‐cell clonal expansion occurred predominantly within this subset. Conclusion These findings suggest that AH is not merely an anatomic cause of upper airway obstruction but also an immunologically active mucosal state associated with ongoing immune remodelling and antiviral defence.

Nasal obstruction in children is often caused by adenoid hypertrophy and allergic rhinitis (AR), both of which contribute to obstructive sleep apnea (OSA). Adenotonsillectomy (AT) is commonly performed to treat OSA, but its effect on nasal obstruction, especially in children with AR, remains unclear. We conducted a prospective cohort study at Nanjing BenQ Medical Center between October 2024 and March 2025. Eligible participants were children aged 3–12 years with OSA confirmed by level II polysomnography. AR was diagnosed using fiberoptic nasopharyngoscopy and inhalant allergen-specific IgE testing. Patients were assigned to AR and non-AR groups. Nasal symptoms were assessed at baseline and 3-month post-AT using the Nasal Obstruction Symptom Evaluation (NOSE) scale and a Visual Analog Scale (VAS). A total of 58 children were included (29 AR, 29 non-AR). At baseline, the AR group exhibited higher NOSE scores and VAS ratings for obstruction, itching, rhinorrhea, and sneezing. Three months after AT, NOSE scores decreased significantly in both groups (AR: 18.28, 95

INTRODUCTION:Allergic rhinitis (AR) has long been considered to be associated with chronic adenotonsillar disease (CATD). However, their causal relationship remains unclear. This study aims to investigate the causal relationship between AR and CATD and to examine the mediating role of chronic rhinosinusitis (CRS) in this association. METHODS:This study employed a two-sample Mendelian randomization (MR) design using genetic instrumental variable analysis. Data for allergic rhinitis (AR) were obtained from the MRC IEU OpenGWAS data infrastructure, data for chronic adenotonsillar disease (CATD) from the FinnGen biobank, and data for chronic rhinosinusitis (CRS) from the GWAS Catalog. Several MR methods were applied. In addition, a two-step MR approach was used to investigate the mediating role of CRS in the relationship between AR and CATD. RESULTS:MR analysis identified a positive correlation between AR and CATD. IVW and weighted median analyses showed significant causal effects (beta = 0.55, 95% CI: 0.26 to 0.84); p <0.001). No causal association was found between CATD and AR. AR and CRS showed a positive correlation (beta = 1.38, 95% CI: 0.78 to 1.98; p = 6.5 × 10-6). CRS had a beta value of 0.15 (95% CI: 0.06 to 0.24; p = 0.001) for CATD. CRS mediates 37.6% of the AR to CATD pathway (mediation effect = 0.20, 95% CI: 0.04 to 0.37; p = 0.013). DISCUSSION:These findings indicate that AR may contribute to CATD risk through CRS, highlighting the need for further research to explore underlying biological mechanisms and validate these findings. CONCLUSIONS:This study suggests a positive causal relationship between AR and CATD, with CRS acting as a mediator.

OBJECTIVES:To analyze risk factors for Laryngeal Web (LW) formation following CO2 laser surgery combined with topical photodynamic therapy (T-PDT) in patients with recurrent respiratory papillomatosis (RRP). METHODS:This retrospective study analyzed RRP patients treated with CO2 laser surgery combined with T-PDT at a single academic medical center between January 2021 and April 2024. The Cohen grading system was used to assess laryngeal web severity before and after treatment. The Wilcoxon rank-sum test was performed to compare pre- and post-treatment adhesion scores. Univariate and multivariate logistic regression analyses were conducted to identify risk factors for LW formation, including gender, surgical age, onset age, HPV genotype, lesion distribution (Derkay score), preoperative LW presence, previous surgical history, bilateral involvement, and preoperative bevacizumab treatment within 1 month. RESULTS:A total of 86 RRP patients received CO2 laser surgery combined with T-PDT treatment. Post-treatment LW occurred in 23.26% (20/86) of patients. No significant difference was observed in Cohen grading distribution between pre- and post-treatment groups (W = 226.5, p = 0.934). Multivariate analysis identified preoperative LW presence (OR = 8.81, p < 0.001) as an independent risk factor for post-treatment LW formation, whereas preoperative bevacizumab treatment was associated with a lower risk of LW formation (OR = 0.16, p = 0.022). CONCLUSION:CO2 laser surgery combined with T-PDT demonstrated a relatively low incidence of LW formation in RRP treatment. Preoperative LW presence significantly increased the risk of post-treatment LW formation, while preoperative bevacizumab treatment was associated with a lower risk of LW formation. LEVEL OF EVIDENCE: 3:

To evaluated the efficacy of photodynamic therapy (PDT) in improving laryngeal mucosal wound scar healing in vivo and investigated its underlying mechanisms. Laryngeal mucosal wounds were induced in Sprague-Dawley rats. Two weeks post-injury, PDT was administered via intraperitoneal injection of 100 mg/kg 5-aminolevulinic acid (5-ALA) and 635-nm red laser irradiation at varying energy doses (15, 30, and 45 J/cm²). The wounds’ histological assessment was performed one month after two PDTs (one/week), including hematoxylin-eosin, Masson staining, Immunohistochemical staining for collagen I and III, and Alcian Blue staining for the detection of hyaluronic acid. In vitro, the viability of human skin fibroblasts (HFF-1) exposed to different light energy (0.3, 0.6, and 1.2 J/cm²) was assessed using CCK-8. Sublethal-dose PDT (SL-PDT; 5-ALA: 0.125 mmol/L, light: 0.6 J/cm²) was used in subsequent experiments. The effect of PDT on fibroblast differentiation into myofibroblasts was evaluated by measuring α-SMA expression in fibroblasts through RT-qPCR and Western blotting. Histological evaluation revealed that following PDT, the trauma site thickness increased, collagen density decreased, and hyaluronic acid deposition was elevated. Immunohistochemical analysis showed improved distribution of type I and type III collagen, coupled with a reduction in density. The most prominent change was observed in the 45 J/cm² PDT group. PDT had a dose-dependent effect on fibroblast viability, and significantly reduced fibroblast differentiation into myofibroblasts by upregulating urokinase plasminogen activator receptor (uPAR) protein expression in fibroblast. PDT can alleviate scar healing of laryngeal tissue wounds by suppressing excessive myofibroblast activation, effectively preserving laryngeal function.

BACKGROUND:Recurrent respiratory papillomatosis (RRP) is a benign laryngeal tumor, and traditional surgical resection faces the dilemma between excessive tissue removal and high recurrence rates. Photodynamic therapy (PDT), as a "regional clearance" strategy, offers a novel approach to addressing this challenge. However, the anatomical distribution of recurrent lesions following PDT has not been fully elucidated. OBJECTIVE:To evaluate the distribution characteristics of recurrent lesions in different anatomical regions following PDT for RRP, thereby providing evidence to optimize PDT treatment protocols. METHODS:A retrospective study analyzed 43 RRP patients who underwent PDT (January 2021-December 2024), with 54 recurrence records examined. Postoperative laryngoscopic examinations were performed monthly to assess recurrence. An 11-region anatomical diagram was used to assess lesion distribution and calculate relative recurrence rates across anterior and posterior regions. In-situ and ectopic recurrences were statistically compared. RESULTS:The study found that the epiglottis exhibited the highest relative recurrence rate (75.00 %), indicating it is more prone to recurrence than other regions (χ² = 21.850, P = 0.016). Additionally, the recurrence rate in the posterior regions (63.16 %) was higher than that in the anterior regions (50.00 %) (χ² = 3.54, P = 0.060). Furthermore, in-situ recurrence significantly outweighed ectopic recurrence (χ² = 111.24, P < 0.001). CONCLUSION:During PDT for RRP, statistically significant differences in relative recurrence rates were observed across anatomical regions, with in-situ recurrence being the most common pattern.

OBJECTIVE:Arytenoid dislocation (AD) is a rare laryngeal injury with diagnostic and therapeutic challenges. To identify preoperative prognostic factors for voice recovery after closed reduction and develop a simple risk scoring tool. METHODS:This retrospective study included 128 patients with AD who underwent closed reduction. Outcomes were evaluated using Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale at 1 month. Logistic regression identified predictors; a scoring model was built and internally validated. RESULTS:Delayed intervention and nonintubation-related etiology were independent predictors of poor outcomes. A three-factor scoring tool (age >58 years, intervention >29 days, nonintubation-related) showed good predictive ability (area under the receiver operating characteristic curve = 0.785; Hosmer-Lemeshow P = 0.60). CONCLUSION:This tool enables early risk stratification using routine clinical variables and may assist in the individualized management of AD. LEVEL OF EVIDENCE:Level 4.

Objective This study aims to analyze the safety and effectiveness of a new model of surgery combined with Photodynamic therapy for treating Recurrent Respiratory Papillomatosis (RRP). Methods Review the case data of patients with RRP who opted for comprehensive surgery combined with Photodynamic therapy at the Nanjing BenQ Medical Center, from January 2021 to May 2023. The efficacy of this program was evaluated by comparing the annual number of surgeries and Derkay scores before and after the surgery. Results A total of 23 RRP patients were included in the study. After treatment, the recurrence rate was 65.2 % (15/23), with an average recurrence time of 94.3 ± 50.8 days. The average Derkay score at the time of recurrence was significantly lower than the average pre-treatment Derkay score (P < 0.001). The average annual recurrence rate before treatment was 2.2 ± 1.3, compared to 1.5 ± 1.5 after treatment, with no significant difference (P = 0.16). However, subgroup analysis revealed a significant decrease in the annual recurrence rate of adult-onset RRP after treatment (P = 0.01). The most common adverse reaction was mild pharyngeal pain (11/23). There were 3 cases of new-onset vocal cord adhesions. No patients experienced serious respiratory-related adverse reactions, anesthesia-related adverse reactions, or systemic phototoxic reactions. Conclusion In conclusion, this study indicates that surgery combined with Photodynamic therapy (PDT) might be a safe and effective option for treating RRP, especially in patients with Adult-Onset Recurrent Respiratory Papillomatosis (AORRP).

OBJECTIVES:To develop and validate a novel method for quantifying the efficacy of Bevacizumab (Bev) in treating Recurrent Respiratory Papillomatosis (RRP), and to evaluate the clinical outcomes of a three-dose Bev induction therapy followed by surgical intervention. METHODS:Twenty-one RRP patients treated with a three-dose Bev regimen were included. A novel efficacy evaluation method using ImageJ software was developed to calculate the standardized lesion volume from laryngoscopic images. This was compared with the Derkay score. Clinical outcomes, including reduction rate, cumulative reduction rate, efficacy grading, recurrence, and adverse reactions, were analyzed. RESULTS:In the study cohort, the reduction rate was significantly higher after the first treatment compared with subsequent treatments. The overall response rate increased from 75% after the first treatment to 100% after the third. Among patients with localized lesions who underwent surgery, 76% experienced recurrence with a mean recurrence time of 114.23 days. Most recurrent lesions were smaller than at baseline. Adverse reactions included increased blood pressure in seven patients, which resolved without intervention. The new method showed a significant positive correlation with the Derkay score. CONCLUSION:In conclusion, based on the above findings, systemic Bev treatment for RRP is a safe and effective therapeutic approach, though further research is needed. Moreover, the new efficacy evaluation method we developed can significantly aid in studying the effectiveness of Bev treatment for RRP. LEVEL OF EVIDENCE:2 Laryngoscope, 135:257-262, 2025.

ABSTRACT Recurrent respiratory papillomatosis (RRP) is a rare benign tumor caused mainly by the infection of the respiratory tract epithelial cells by the human papillomavirus (HPV) type 6/11. However, the specific mechanisms underlying the inhibition of the host’s innate immune response by HPV remain unclear. For this purpose, we employed single-cell RNA sequencing to analyze the states of various immune cells in RRP samples post-HPV infection and utilized a cellular model of HPV infection to elucidate the mechanisms by which HPV evades the innate immune system in RRP. The results revealed distinct immune cell heterogeneity in RRP and demonstrated that HPV11 E7 can inhibit the phosphorylation of the stimulator of interferon genes protein, thereby circumventing the body’s antiviral response. In vitro co-culture experiments demonstrated that stimulation of macrophages to produce interferon-beta induced the death of HPV-infected epithelial cells, also reducing HPV viral levels. In summary, our study preliminarily identifies the potential mechanisms by which HPV evades the host’s antiviral immune response, as well as the latent antiviral functions exhibited by activated macrophages. This research serves as an initial exploration of antiviral immune evasion in RRP, laying a solid foundation for investigating immunotherapeutic approaches for the disease. IMPORTANCE Surgical tumor reduction is the most common treatment for recurrent respiratory papillomatosis (RRP). One of the characteristics of RRP is its persistent recurrence, and multiple surgeries are usually required to control the symptoms. Recently, some adjuvant therapies have shown effectiveness, but none of them can completely clear human papillomavirus (HPV) infection, and thus, a localized antiviral immune response is significant for disease control; after all, HPV infection is limited to the epithelium. Inhibition of interferon-beta (IFN-β) secretion by HPV11 E7 viral proteins in epithelial cells by affecting stimulator of interferon genes phosphorylation may account for the persistence of low-risk HPV replication in the RRP. Moreover, suppression of the IFN-I pathway in RRP cell types might provide clues regarding the hyporeactive function of local immune cells. However, activation of macrophage groups to produce IFN-β can still destroy HPV-infected cells.

BACKGROUND:Laryngeal leukoplakia (LL) is a white lesion with high potential of recurrence and malignant transformation. Currently, CO2 laser has become the primary surgical treatment for LL, and the recurrence and malignant transformation rates after treatment vary widely. OBJECTIVE:We performed a systematic review and meta-analysis dedicated to evaluating the rates of recurrence and malignant transformation of LL lesions treated with CO2 laser and exploring relevant risk factors for recurrence or malignant transformation. METHODS:Literature searches were conducted on ProQuest, PubMed, Web of Science, Ovid Medline, Embase, and Cochrane databases. Some articles identified through hand searching were included. RESULTS:A total of 14 articles and 1462 patients were included in this review. Pooled results showed that the overall recurrence rate was 15%, and the malignant transformation rate was 3%. Subgroup analysis showed that the dysplasia grade was not a significant risk factor for the recurrence and malignant transformation of LL (P > .05). CONCLUSIONS:The results of this systematic review and meta-analysis suggest that the CO2 laser is a safe and effective surgical instrument for the excision of LL, which yields low rates of recurrence and malignant transformation. The risk factors relevant to recurrence or malignant transformation remain unclear and require further investigation.

The article reported a novel reduction device and standardized reduction technique for patients with arytenoid dislocation. The results showed that this reduction technique has been excellent in helping patients with arytenoid dislocation. Laryngoscope, 2023

Importance:Obstructive sleep apnea (OSA) and tonsil hypertrophy may be associated with dysphagia. However, randomized clinical trials assessing dysphagia outcomes in children randomized to adenotonsillectomy (AT) vs watchful waiting with supportive care (WWSC) are lacking. Objective:To assess dysphagia outcomes in children with OSA and tonsil hypertrophy managed with AT or WWSC. Design, Setting, and Participants:This secondary analysis of a multicenter randomized clinical trial, the Childhood Adenotonsillectomy Trial (CHAT), was conducted at tertiary children's hospitals from October 2007 to June 2012. Children aged 5.0 to 9.9 years with OSA were randomized to AT or WWSC and underwent polysomnography at baseline and 7 months. Caregivers completed the OSA-18 questionnaire, which includes an item on difficulty in swallowing at baseline and 7 months. The current secondary analysis was conducted from December 1, 2022, to January 10, 2023. Interventions:AT vs WWSC. Main Outcomes and Measures:Prevalence of dysphagia, based on parental responses to the difficulty in swallowing item on the OSA-18 questionnaire, was redefined as a binary outcome at baseline and 7-month follow-up. Results:In total, 386 children were included (199 female [51.6%]; median [IQR] age, 6.0 [5.0-8.0] years). Of the total, 207 children were Black (53.6%). At baseline, the number of children with dysphagia was similar (4.0%; 95% CI, -4.9% to 12.9%) between the AT group (56 [29.8%]) and the WWSC group (51 [25.8%]). Following AT, a decrease was observed (21.3%; 95% CI, 13.5%-28.9%) in the prevalence of dysphagia among the children. In contrast, the prevalence of dysphagia did not change significantly (1.0%; 95% CI, -7.6% to 9.6%) in the WWSC group. Children in the AT group were more likely to experience a resolution of dysphagia than those in the WWSC group (adjusted odds ratio, 4.84; 95% CI, 1.91-12.25). Higher baseline AHI was associated with a lower resolution of dysphagia (AOR, 0.91; 95% CI, 0.83-0.98). Conclusions and Relevance:This secondary analysis of the CHAT randomized clinical trial suggested that children with dysphagia and OSA undergoing AT may experience dysphagia improvement. A prospective randomized trial that uses a validated dysphagia survey is needed to verify the effectiveness of AT in treating dysphagia. Trial registration:ClinicalTrials.gov Identifier: NCT00560859.

Objective:To investigate the value of three-dimensional (3D) CT in diagnosing cricoarytenoid dislocation.Methods:From January 2021 to December 2021, 31 patients with unilateral cricoarytenoid dislocation who had been treated by reduction forceps at the Affiliated BenQ Hospital of Nanjing Medical University were collected retrospectively, and their voice recovered or improved significantly after therapy. The preoperative CT images were reconstructed by volume rendering (VR). The dislocated side (left and right), type of dislocation (total dislocation and subluxation), and dislocation direction (anterior, posterior, internal and external dislocation) of cricoarytenoid dislocation were observed. According to arytenoid articular surface of cricoid cartilage exposed completely or not (caused by arytenoid displacement), they were divided into complete dislocation and subluxation. According to the direction of arytenoid displacement and the part of arytenoid articular surface of cricoid cartilage exposed, they were divided into anterior, posterior, internal and external dislocation. According to the shape of the vocal cords on laryngoscope, anterior and posterior dislocation of each case was judged, and then compared with that of CT.Results:On VR images, there were 28 cases of cricoarytenoid subluxation (90.3%, 28/31) and 3 cases of complete dislocation (9.7%, 3/31). Left cricoarytenoid dislocation was 26 cases (83.9%, 26/31) and right cricoarytenoid dislocation was 5 cases (16.1%, 5/31). Posterior dislocation was 28 cases (90.3%, 28/31) and anterior dislocation was 3 cases (9.7%, 3/31). There were 23 cases of internal dislocation (74.2%, 23/31), 2 cases of external dislocation (6.4%, 2/31), and 6 cases without obvious internal and external dislocation (19.4%, 6/31). Three cases of complete dislocation were left posterior internal dislocation.There were 24 cases of left posterior dislocation (77.4%, 24/31), 4 cases of right posterior dislocation (12.9%, 4/31), 2 cases of left anterior dislocation (6.4%, 2/31) and 1 case of right anterior dislocation (3.2%, 1/31). On laryngoscope, there were 19 cases of posterior dislocation (61.3%, 19/31), 9 cases of anterior dislocation (29.0%, 9/31), 3 cases were difficult to assess (9.7%, 3/31) because of aryepiglottic fold covering. Sixteen cases (55.2%, 16/28) were consistent with 3D CT, and 12 cases (42.8%, 12/28) were inconsistent.Conclusion:The 3D CT is a reliable method to evaluate cricoarytenoid dislocation, which can show dislocated side, type and direction of cricoarytenoid dislocation clearly.

BackgroundObstructive sleep apnea (OSA) is children's most common sleep-related breathing disorder. It may develop a wide range of severe complications if not diagnosed promptly and treated effectively. However, Childhood OSA has not specifically been analyzed using a bibliometric approach. MethodsWe respectively collected the research results of childhood OSA from 2013 to 2022 through Web of Science and PubMed. Vosviewer, CiteSpace, and bibliometric online analysis platforms were used for visualizing and analyzing the literature. The MeSH terms were bi-clustered using the Bibliographic Item co-occurrence Matrix Builder (BICOMB) and graph clustering toolkit (gCLUTO) to identify the hotspots. Results4022 publications were finally identified on childhood OSA from 2013 to 2022. The United States has the largest number of publications (1902), accounting for 47.29%. University of Cincinnati is the most productive organization (196), followed by the University of Pennsylvania (151). The most prolific journal was the International Journal of Pediatric Otorhinolaryngology, with 311 documents published. In comparison, Pediatrics is the most cited journal (6936). Gozal D ranked highest among all authors in publication (192). Burst detection shows continuous positive airway pressure, Robin sequence, and nocturnal oximetry are recent keywords of great interest to researchers. Five hotspots were identified by co-word biclustering. ConclusionResearch over the past ten years has been fruitful, establishing the foundation for childhood OSA. Clusters (0-4) of high-frequency Major Mesh topics have attracted extensive attention. Evaluation and treatment methods of childhood OSA remain major focuses. We believe this article will provide other researchers with new directions and may contribute to a future breakthrough in this field.

目的 分析应用贝伐珠单抗静脉给药治疗复发性呼吸道乳头状瘤(recurrent respiratory papillomatosis,RRP)患者的初步疗效,为RRP治疗提供新思路.方法 回顾性分析2022年3月～9月于南京医科大学附属明基医院因RRP就诊并行贝伐珠单抗静脉给药治疗的11例患者临床资料,其中女2例(18.18％),男9例(81.82％),年龄2～44(15.82±13.36)岁.治疗前描绘瘤体范围(Mapping)及进行Derkay评分.具体给药方法:全身静脉给药,药物剂量为10 mg/kg混于100 ml生理盐水中,90 min静脉滴注,治疗后监测瘤体大小范围并重新进行Derkay评分,并记录药物不良反应.结果 11例患者平均随访时间为1～6(3.5±1.83)个月.截止到目前,4例患者仍在接受贝伐珠单抗静脉给药治疗,5例现已接受手术治疗,2例失访.11例患者乳头瘤瘤体均有所缩小,Derkay评分改善.中位给药频次为3(1～6)次,治疗过程中1例患者出现经期改变,1例轻微腹痛及咯血,3例出现鼻出血.11例RRP患者应用贝伐珠单抗治疗前后Derkay评分明显改善,差异有统计学意义(t=6.754,P＜0.0001).结论 贝伐珠单抗全身治疗可有效控制RRP的疾病进展.长期疗效及不良反应仍需观察,治疗方案需进一步探索和完善.

The patient repeatedly suffer from pain in the left side neck for 4 years and had 1-2 recurrence per year. We used neck ultrasound and neck CT examination to find an abnormal soft tissue lumps exist in the patient's left neck root to the trachea esophageal ditch. Diagnostic analysis combines embryogenesis and anatomy, and the diagnosis results are infection with the fourth branchial fissure. The lesion site was completely excisioned with full hemp surgery, the incision showed I type healing after surgery, and there was no recurrence after six months of follow-up.

目的 探讨应用腺样体切除和扁桃体部分切除术治疗婴幼儿阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)的安全性及临床疗效.方法 回顾性分析2016年3月～2018年8月收治的40例年龄在36个月以下的OSA患儿的临床资料.其中男31例,女9例,男女比例3.4:1;年龄(24.9±7.3)个月,病程(9.2±6.3)个月.40例患儿因睡眠打鼾、张口呼吸、呼吸暂停、反复上呼吸道感染、喂奶困难等症状就诊.经体格检查和鼻咽侧位片检查确诊腺样体和(或)扁桃体肥大,多道睡眠图监测明确OSA诊断,监测前填写儿童生活质量调查表OSA-18问卷.40例均行手术治疗,其中腺样体切除术35例、腺样体+扁桃体部分切除术5例.术后随访6～12个月.结果 40例OSA婴幼儿中以男性患儿居多,术中、术后无并发症发生.术后2～4周患儿打鼾、张口呼吸症状消失,术后6个月再次填写OSA-18问卷,手术前后问卷评分分5项维度进行比较,其差别具有统计学意义(P<0.05).结论 腺样体肥大是造成婴幼儿OSA的主要病因,应早期检查,明确诊断,积极采取手术治疗安全且有效.

股骨颈骨折是老年人群常见的骨折,目前的治疗观点是建议老年股骨颈骨折的病人在全身情况能耐受的情况下早期手术,使病人早期恢复活动,能减少病人的死亡率[ 1-2]. 人工髋关节置换手术是常用的手术方式,如何提高手术的安全性和缩短手术时间成为手术成功的关键. 随着手术室专业化、专科化的不断发展,专科手术护理被证明可以明显提高手术成功率,降低手术并发症[3]. 我院将骨科专科化护理应用于老年人工髋关节置换手术中,取得了良好的临床效果.