2011-5-19 Patient (parent of a child surnamed Liu from Zhoukou, Henan Province): Description of the condition (onset time, main symptoms, hospital visited, etc.): The child, aged 6 years and 3 months, was examined by rhinoscopy at Beijing Children’s Hospital, with adenoid hypertrophy and tonsillar hypertrophy of 2 degrees. He has been snoring in bed at night for about 1 year. On May 13 (Friday), I asked a friend in Shenzhen to take the child’s case and test results to register for your number. You prescribed three kinds of medication, and I started the medication in the afternoon of May 15. I have been taking the medication for 4.5 days, and the snoring symptoms have been relieved for 2/3 of the time, but there are still some symptoms. How many more days do I need to continue the medication? How many days in total? How many more days of medication do I need to continue? How many days of medication are needed in total?
2011-5-20 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital.
Hi, your child’s treatment is still effective and can be continued. Clarithromycin and keratan should be used for two weeks, and special position nasal drip treatment should be used for three weeks continuously. Not enough medicine and then continue to buy, the local should have, if you are not sure, you can ask a friend to buy some more for you.
2011-5-26 Patient: Ma Bo, thank you very much for your special treatment! My child’s snoring symptoms have been mostly relieved, and there is basically no sound when sleeping on his side, but he still feels a blockage sound when sleeping on his back (especially when changing positions). However, there was still enough medicine left for two days (2 weeks in total) for the nose drops, which we have here, but when my friend took the medicine, she said there was another medicine added to the nose drops (I don’t know the name of the medicine). I assume that this medicine will be added when the child continues to take the medicine (what is it)? How can I tell if my child is completely cured after three weeks? Do I need to do any review?
2011-5-26 Ma Lingguo, Department of ENT, Shenzhen People’s Hospital: Another medicine is Pulmicortinol (1mg/2ml/each), your way of dropping the medicine may not be right. It’s basically the same as what I said in my article. You will report the method of drug drops, I see if it is correct?
2011-5-27 Patient: Mabo, the nasal drops are 3 times a day, 4 drops each time, with 5 minutes between drops and head tilted back. I took two bottles of nasal drops last time, and the drops have been in use for almost 2 weeks and are almost finished. Is this the right method? Do you add one bottle of Pramipexole to each bottle of nasal drops? (I just got one at the hospital and it says “Budesonide for inhalation” Pulmicortinex 1mg/2ml, is that the right medicine? Is it added directly to 5ml of eye drops?) Do I need to take nasal drops for 3 weeks or 4 weeks in total (or do I need to increase or decrease depending on the symptoms)? Does Clarithromycin and Keratan just take two weeks? Thank you!
2011-5-27 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital.
Basically correct, if you can come for review, the medication will be more reasonable. Let’s treat it this way first, and contact you if something happens. Contact again after you finish three bottles (2 weeks) this time.
2011-6-4 Patient: Mabo, I have been using the nasal drops for nearly three weeks, and the snoring symptoms have basically been relieved, but there are still some symptoms when the body position is changed, as if there is mucus blocking the feeling inside, and it takes a while to adapt. (On the other hand, the child often has red bumps on the skin, which will go down with the application of Wuji cream, probably because of some allergies. Can we do any tests in our area?
2011-6-5 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital.
How many drops have you used in total now? From your previous reply, it seems that one medicine can be used for a week, most people use two medicines for a week, you seem to be less than half of the average person, in this case the use time should be properly extended. It is recommended that nasal drops be used for up to 6 weeks. The oral medication can be stopped. The small red spots on the body are usually the cause of allergies, but it is best to see a dermatologist to confirm the diagnosis.
2011-6-5 Patient: Thank you, Mab, for your quick reply! We are now using a total of 3 pills for almost 3 weeks. Is Pulmicort (budesonide for inhalation, 1mg/2ml) 1ml added to the nasal drops, i.e. half a budesonide (1ml) added to the nasal drops? (I used one, i.e. 2ml) How much should I use?
2011-6-5 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital.
Use one, one dominant one. It may be a pen error.
2011-6-15 Patient: Ma Bo, now my child has been using nasal drops for nearly 5 weeks, feeling that the effect is more obvious in the first two weeks, and the effect has been maintained in a state in the last three weeks, feeling that the drug is not so sensitive (now there is basically no sound when the child sleeps on his side, but there is still sound when he sleeps on his back, it seems that the breathing passage is not too smooth, especially when the position changes from side to back sleep, the symptoms are more obvious. I would like to ask, how long should I continue to use the nasal drops? Do I need to change or increase the drug formula?
2011-6-16 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital.
How many drops have been used now? Do you still have snoring and open-mouth breathing during sleep? If so, do you have them often or occasionally?
2011-6-17 Patient: I’ve used up 5 sticks of the medication and just started the 6th one today. It has been 4 weeks and 5 days since the medication was administered. When sleeping, the child is basically normal when sleeping on his side, no more snoring and open-mouth breathing. However, he does not want to sleep on his back. When he is put to sleep on his back, he keeps snoring (lighter than before), but does not open his mouth to breathe. He will voluntarily adjust to sleeping on his side or stomach when he sleeps. How long should I continue to use the nasal drops? Do I need to change or increase the medication formula? Thank you Ma Bo.
2011-6-17 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital.
Usually two medications are used for the first week and 4 medications for the following 2 weeks. Although you have been using the medication for almost 5 weeks, you have used less than 3 weeks of medication according to the dosage. As I mentioned in the article, the nasal symptoms basically disappeared in three weeks, and you will have to consolidate them later. Usually 10 medications are used to cure and for consolidation purposes.
2011-6-17 Patient: The nasal drops are 3 times a day, 4 drops per nostril each time with 5 minutes interval and head tilted back. Why is it so much wrong? Do I need to increase the number of times or the number of drops? Thank you Ma Bo.
2011-6-17 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital.
It may be that the size of each drop is different. When you exert a lot of force, the drops will be bigger, and vice versa, the drops will be slightly smaller. Do not care so much, the total amount of medicine to the basic can, in this case the medication time should be relatively longer.
2011-6-27 Patient: At present, the child has been using the nasal drops for 42 days. I feel that the effect of the first two weeks of medication is obvious, and now it has been then state of continuous. Now the snoring symptom has been basically relieved, and no longer open mouth breathing. However, at present, when he sleeps on his back, there is always a slight snoring sound (much lighter than before), and he will actively adjust to sleeping on his side or on his stomach, but cannot insist on sleeping on his back. After all, there are antibiotics in the nose drops, will there be any major side effects from long-term use (42 days already)? Is it possible to use only pramipexole without oxyfloxacin? (Or do I need to switch to other sensitive medications?) Thank you!
2011-6-27 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital.
Hello, how many bottles of medication have you finished now? Have you stopped all other oral medications? The mixed nasal drops I prescribed alone have few side effects because they are topical. Chronic sinusitis routinely requires oral antibiotics for 2-3 months. It is inevitable that there are a few side effects in treating the disease. Any medicine has side effects, even the food we eat everyday no one dares to say that there are absolutely no side effects. There are pros and cons to everything, as long as the pros outweigh the cons, it’s a good thing. If you don’t cure it completely now, you’ll have to treat the same course of treatment again when it comes back after a while, if you believe me, just keep treating it. I am very confident in curing your child’s disease, and now it has reached a basic cure, so don’t worry about anything.
Also, please give me honest feedback about the treatment results and other information in the patient communication area, so that other parents with the same child can learn about my unique method that I created myself. Because this method is unique in the country, it has not yet been recognized by the majority of patients and otorhinolaryngologists. Patients who have used this method of treatment are the most vocal.
2011-6-27 Patient: Thank you Dr. Ma for your patient and detailed explanation! I have used up 6 bottles of nasal drops. After two weeks of taking the oral medication, they have all been stopped. Do I need to continue the oral medication? How many more bottles of nasal drops? Thanks, I will be firm in my faith!
2011-6-27 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital: If you insist on using two more bottles of nasal drops, you will be basically cured, and then you can take a lateral rhinitis film to see the treatment effect. By then, if I don’t expect, the adenoid hypertrophy will only be about 50%-60%. Finally I will give you a protocol to prevent future recurrence.
2011-7-1 Patient: Mab. I’m on two bottles of medication as you arranged, and now I’ve used 1 bottle, and I have the last one left. You said last time that you would give a protocol to prevent relapse. Can you tell me this plan now? (I want to get the medicine ready first) Thank you!
2011-7-1 Shenzhen People’s Hospital, Department of Otolaryngology, Ma Lingguo.
Wait for the second bottle of drops to finish, take a lateral nasopharyngeal film and see what happens. No need to rush, it will all tell you.
2011-7-4 Patient: Ma Bo, today I took my child to the ENT department of the hospital, and the doctor said that it was not clear to take a lateral nasopharyngeal film, and he asked for a CT film. I haven’t taken it yet, and I want to ask your opinion, is it okay to do CT?
2011-7-5 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital.
It is fine to take a lateral nasopharyngeal film, it is not necessary to take a CT.
2011-7-10 Patient: Ma Bo, now my child is no longer snoring at night, there is no sound when he sleeps on his side, and there is some slight puffing sound when he sleeps on his back. The symptoms have improved very significantly. I found a hospital today and took a lateral nasopharyngeal film of my child, so I will upload it to you and ask you to take a look at it. You said last time that there is a protocol to be given to prevent recurrence. Can I use this program now? Thank you!
2011-7-10 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital.
Please upload the previous examination films as well to make a comparison.
2011-7-10 Patient: Ma Bo, my child has not had a lateral nasopharyngeal film before, and just started to see you with a nasal endoscopy checklist.
2011-7-10 Ma Lingguo, Department of Otolaryngology, Shenzhen People’s Hospital.
Hello, after reading your images before and after treatment, the adenoids are now much smaller than before. If the adenoids are enlarged to more than 80%, the corresponding symptoms will appear, such as snoring and open-mouth breathing, etc. If they are less than 80%, the above symptoms will not appear.
In the future, you can buy two more bottles of medicine and use them intermittently, especially after a cold, for 2-3 days to prevent recurrence. In addition, in the future, you should also pay attention to not eating too cold or too hot food, avoid getting cold, and try to prevent colds. If you have a cold or a sore throat, you should see a doctor in time for early treatment, so that adenoids will not trigger enlargement again.
Thank you for your support of this method and for your timely and objective evaluation in the treatment. I wish your child good health and happiness!
2011-7-10 Patient: I’ve been waiting to hear from you at the computer, but I didn’t expect you to reply to us so soon! Thank you, Mab! Thank you for your prompt, accurate and patient explanation and treatment of our condition over the past 2 months! Thank you for saving my child from painful surgery! Your medical ethics and skills are worthy of study by all medical professionals! At the same time, we have learned a lot from you, as a person and as a person! Thank you very much!
2011-7-12 Editor’s note.
Adenoid hypertrophy needs to be treated when it causes sleep snoring or open mouth breathing. The current medical level is difficult to cure through conservative medication, so most doctors in regular hospitals will recommend surgery. Adenoid hypertrophy is mostly seen in children. Parents see that their children are still young and cannot bear the pain of surgery, but they cannot sit back and watch their children snore and breathe with their mouths open for long periods of time, because this will lead to adenoid facial features in children in the long run, causing permanent damage to their appearance and affecting their development to varying degrees. Parents who find out that their children are suffering from adenoid hypertrophy are often torn and distressed.
In daily work, we come across many children who sleep with open mouth breathing and snoring due to adenoid hypertrophy, and in serious cases, parents are afraid to sleep at night and have to take turns holding the child, fearing that the child will not be able to breathe and suffocate when snoring. In 2007, a new topical hormone drug, budesonide suspension, was introduced in our department for the treatment of pharyngitis, which has very little systemic absorption and is safe for long-term use. After intensive research, we designed a treatment plan to treat adenoid hypertrophy by combining antibiotic eye drops with this drug through a special nasal drip method, and received unexpected results after using it, the hypertrophic adenoids can be significantly reduced after one week of treatment, and most of the symptoms of the children can subside by 1/3 to 1/2, then use one to two courses of treatment (1 to 2 weeks), the symptoms can basically disappear, and then consolidate a course of treatment, which can be basically cured. In the past 4 years, it is roughly estimated that more than 1000 people have been treated with this method, and the cure rate can be as high as 95% or more if the indications are properly chosen. After the cure, as long as attention is paid to the active treatment after the cold, the chance of recurrence is rare.
In this case of adenoid hypertrophy in a child, the number of drops was less than half that of a normal child, and the treatment course was half as long, but the treatment effect was still very good, achieving the desired effect and avoiding surgery.
The purpose of writing this article is to use this world to spread it to benefit the majority of children with adenoid hypertrophy and save them from the pain of surgery. In addition, it will gradually change the traditional concept that adenoid hypertrophy must be operated.