Shatz Anat
Pediatric Airways Service, Shaare Zedek Medical Center, Jerusalem, Israel.
Ann Otol Rhinol Laryngol. 2004 Oct;113(10):835-8. doi: 10.1177/000348940411301011.
Adenoid hypertrophy is one of the most common causes of pediatric obstructive sleep apnea. Although adenoidectomy is the only effective treatment for adenoid hypertrophy, it is rarely performed in infants less than 1 year old. This study reports on the successful use of adenoidectomy in 24 infants less than 1 year old with a triad of upper airway obstruction symptoms, findings of obstructing adenoids, and obstructive sleep apnea (but no other anomalies). This is a retrospective case series reviewing each infant's clinical data, including presenting symptoms (with special emphasis on apnea episodes), physical examination findings, and results of other investigations such as polysomnography, endoscopy, pH-metry, and echocardiography. With careful preoperative and postoperative monitoring, the 24 infants underwent adenoidectomy without complications. After the procedure, all showed marked improvement with complete disappearance of symptoms of upper airway obstruction, failure to thrive, and gastroesophageal reflux disease. Adenoidectomy was found to be sufficient and curative for such infants.
腺样体肥大是小儿阻塞性睡眠呼吸暂停最常见的病因之一。尽管腺样体切除术是治疗腺样体肥大的唯一有效方法,但在1岁以下婴儿中很少进行。本研究报告了24例1岁以下患有上呼吸道梗阻症状、阻塞性腺样体表现和阻塞性睡眠呼吸暂停(但无其他异常)三联征的婴儿成功接受腺样体切除术的情况。这是一项回顾性病例系列研究,回顾了每个婴儿的临床数据,包括出现的症状(特别强调呼吸暂停发作)、体格检查结果以及多导睡眠图、内镜检查、pH值测定和超声心动图等其他检查结果。经过仔细的术前和术后监测,这24例婴儿接受了腺样体切除术,无并发症发生。术后,所有婴儿均表现出明显改善,上呼吸道梗阻、发育不良和胃食管反流病症状完全消失。结果发现,腺样体切除术对此类婴儿足够且具有治愈性。