Wang D, Clement P, Kaufman L, Derde M P
Department of Otorhinolaryngology, University Hospital, Brussels, Belgium.
Int J Pediatr Otorhinolaryngol. 1992 Jul;24(1):35-44. doi: 10.1016/0165-5876(92)90064-v.
In this prospective study, a flexible fiberoptic nasolaryngoscope with color video camera was used to examine the nasal cavity and nasopharynx in 180 pediatric patients. The relative size of the adenoid tissue was judged by endoscopy, which lead to a classification into 3 types according to the distance from the vomer to the adenoid tissue. The condition of the nasopharyngeal orifice of the Eustachian tube was also described and differentiated into 3 types relating to the condition of adenoid tissue. Assessment was performed by correlating these measurements with the tympanogram, lateral X-ray and clinical complaints. The authors conclude that: (1) fiberoptic examination allows direct visualization of the size and condition of the adenoid tissue, as well as of the condition of the nasopharyngeal orifice of the Eustachian tube. (2) The size of the adenoid tissue correlates very well with the nasal obstruction complaints as well as with the type of tympanogram. (3) The condition of the nasopharyngeal orifice of the Eustachian tube significantly corresponds with the type of tympanogram. (4) For the indication of adenoidectomy, fiberscopy gives more accurate information than standard X-ray. (5) With a correct choice of premedication and local anesthesia, it is a minor invasive technique which is very well tolerated by children. It is possible in all cases, provided it is performed by a skilled endoscopist and preceded by careful explanation to the child. (6) Finally, thanks to the possibility of direct visualization of the fiberscopic image via a monitor, it allows a better explanation of the indication for adenoidectomy to the child's parents.
在这项前瞻性研究中，使用带有彩色摄像机的可弯曲纤维鼻咽喉镜对180名儿科患者的鼻腔和鼻咽部进行检查。通过内窥镜检查判断腺样体组织的相对大小，并根据从犁骨到腺样体组织的距离将其分为3种类型。还描述了咽鼓管鼻咽口的情况，并根据腺样体组织的情况将其分为3种类型。通过将这些测量结果与鼓室图、X线侧位片和临床症状相关联来进行评估。作者得出结论：（1）纤维内镜检查可直接观察腺样体组织的大小和情况以及咽鼓管鼻咽口的情况。（2）腺样体组织的大小与鼻塞症状以及鼓室图类型密切相关。（3）咽鼓管鼻咽口的情况与鼓室图类型显著相关。（4）对于腺样体切除术的指征，纤维内镜检查比标准X线检查提供更准确的信息。（5）正确选择术前用药和局部麻醉，这是一种微创技术，儿童耐受性良好。只要由熟练的内镜医师进行操作并在术前向儿童仔细解释，在所有情况下都是可行的。（6）最后，由于可以通过监视器直接观察纤维内镜图像，因此能够更好地向患儿家长解释腺样体切除术的指征。
