[射频减容手术治疗腺样体肥大所致复发性分泌性中耳炎的疗效]
[Effect of volume reduction surgery by radiofrequency for enlarged adenoid causing recurrent otitis media with effusion].
作者信息
Yagi Takeshi, Hayashi Ken, Shikii Hisayoshi, Miyamoto Yuko, Oda Makoto, Shinkawa Atsushi
机构信息
Shinkawa Medical Group, Kanagawa.
出版信息
Nihon Jibiinkoka Gakkai Kaiho. 2006 Jan;109(1):24-9. doi: 10.3950/jibiinkoka.109.24.
PURPOSE
We studied the effect of volume reduction surgery by a radiofrequency (ENTec coblator) for enlarged adenoid causing recurrent otitis media with effusion.
MATERIALS AND METHODS
The effect of volume reduction surgery by radiofrequency for enlarged adenoid was studied in 50 children with enlarged adenoid causing recurrent otitis media with effusion from June 2002 to September 2004, while a group of 50 children with tympanostomy-tube placement alone from April 2001 to September 2004, was used as the control group. Volume reduction surgery by radiofrequency system for enlarged adenoid was done with tympanostomy-tube placement under general anesthesia by laryngeal mask. We compared two groups in following 5 different aspects: (1) tympanostomy-tube replacement, (2) remyringotomy, (3) total visits to our clinic after surgery, (4) total days with antibiotics, (5) absence of effusion and normal middle ear function as seen on the tympanogram after tympanostomy-tubes loss. We evaluated the reduction of enlarged adenoid by using the pre-and postoperative obstructive rate of the choana through the nasopharyngoscope.
RESULTS
The volume of enlarged adenoid was reduced an average of 52.2% by radiofrequency. The pharyngeal opening of the eustachian tube and the choana could be opened widely. No severe intra or postoperative complications occurred. Compared to the control group treated with tympanostomy tubes alone, postoperative tympanostomy-tube replacement, postoperative remyringotomy, total postoperative visits to our clinic, total postoperative days with antibiotics, and tympanogram types C2 and B after tympanostomy-tubes loss decreased notably in cases with volume reduction surgery by radiofrequency for enlarged adenoid and tympanostomy-tube placement.
CONCLUSION
Volume reduction surgery by radiofrequency for enlarged adenoid is considered very safe, effective one-day surgery technique for recurrent otitis media with effusion.
目的
我们研究了使用射频（ENTec 消融器）进行减容手术对因腺样体肥大导致复发性分泌性中耳炎的疗效。
材料与方法
2002 年 6 月至 2004 年 9 月，对 50 例因腺样体肥大导致复发性分泌性中耳炎的儿童进行了射频减容手术治疗，同时将 2001 年 4 月至 2004 年 9 月仅行鼓膜置管术的 50 例儿童作为对照组。在全身麻醉下通过喉罩进行射频系统腺样体减容手术并同时行鼓膜置管术。我们从以下 5 个不同方面对两组进行了比较：（1）鼓膜置管更换情况；（2）再次鼓膜切开术；（3）术后到我院门诊的总就诊次数；（4）使用抗生素的总天数；（5）鼓膜置管脱落后鼓室图显示无积液且中耳功能正常的情况。我们通过鼻咽喉镜检查腺样体术前和术后的后鼻孔阻塞率来评估腺样体的缩小情况。
结果
射频治疗使腺样体体积平均缩小了 52.2%。咽鼓管咽口和后鼻孔可被广泛打开。未发生严重的术中或术后并发症。与仅行鼓膜置管术的对照组相比，射频减容手术联合鼓膜置管术治疗的患者术后鼓膜置管更换、再次鼓膜切开术、术后到我院门诊的总就诊次数、术后使用抗生素的总天数以及鼓膜置管脱落后鼓室图 C2 型和 B 型的比例均显著降低。
结论
对于复发性分泌性中耳炎，射频腺样体减容手术被认为是一种非常安全、有效的一日手术技术。
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