Williams R G, Preece M, Rhys R, Eccles R
Department of Otolaryngology, University Hospital of Wales, Cardiff, UK.
Clin Otolaryngol Allied Sci. 1992 Apr;17(2):136-40. doi: 10.1111/j.1365-2273.1992.tb01060.x.
The change in nasalance following adenoidectomy, tonsillectomy and adenotonsillectomy was studied in 44 children. A subjective assessment of each child's naso-pharyngeal airway was made preoperatively based on a questionnaire completed by the parents. There was no significant change in the nasalance of children following adenoidectomy, but there was a significant increase in the nasalance following tonsillectomy (P = 0.02) and after adenotonsillectomy (P = 0.001). There was no relationship between the change in nasalance and the adenoid volume removed at operation. There was good agreement between the parental subjective assessment of the naso-pharyngeal airway and the preoperative nasalance score, with the best correlation in the adenoidectomy group (r = -0.8) and the adenotonsillectomy group (r = -0.7). Nasalance is more closely related to the size of the naso-pharyngeal airway than to the actual adenoid volume, and measurements of nasalance are of no benefit in predicting adenoid volume. Tonsillectomy had a significantly greater effect on nasalance than adenoidectomy, and adenotonsillectomy had the greatest effect. Further studies are needed to relate nasalance to the size of the naso-pharyngeal airway, but it appears to relate well to the subjective assessment of the airway and may be of use in patient selection for surgery.
对44名儿童进行了腺样体切除术、扁桃体切除术及腺样体扁桃体切除术后鼻音变化的研究。术前根据家长填写的问卷对每个儿童的鼻咽气道进行主观评估。腺样体切除术后儿童的鼻音无显著变化，但扁桃体切除术后（P = 0.02）及腺样体扁桃体切除术后（P = 0.001）鼻音显著增加。鼻音变化与手术切除的腺样体体积之间无相关性。家长对鼻咽气道的主观评估与术前鼻音评分之间具有良好的一致性，在腺样体切除术组（r = -0.8）和腺样体扁桃体切除术组（r = -0.7）中相关性最佳。鼻音与鼻咽气道大小的关系比与实际腺样体体积的关系更为密切，鼻音测量对预测腺样体体积并无帮助。扁桃体切除术对鼻音的影响明显大于腺样体切除术，而腺样体扁桃体切除术的影响最大。需要进一步研究以确定鼻音与鼻咽气道大小的关系，但鼻音似乎与气道的主观评估相关性良好，可能有助于手术患者的选择。
