Mandell David L, Yellon Robert F
Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, PA 15213, USA.
Arch Otolaryngol Head Neck Surg. 2007 Apr;133(4):375-8. doi: 10.1001/archotol.133.4.375.
To determine the prevalence of synchronous airway lesions and esophagitis in children younger than 18 months undergoing adenoidectomy for adenoid hypertrophy and upper airway obstruction.
Retrospective review spanning 4.5 years.
Tertiary care children's hospital.
All children younger than 18 months who underwent adenoidectomy for upper airway obstruction by 2 pediatric otolaryngologists.
craniofacial dysmorphism and congenital syndromes.
Simultaneous interventions during adenoidectomy included flexible nasopharyngolaryngoscopy (n = 32), direct laryngoscopy (n = 31), rigid tracheobronchoscopy (n = 30), and esophagoscopy with biopsy (n = 32).
Prevalence of synchronous airway lesions and histologic esophagitis.
Thirty-five children younger than 18 months underwent adenoidectomy for airway obstruction (2 also had simultaneous tonsillectomy). Synchronous airway lesions were found in 19 (59%) of 32 patients who underwent airway endoscopy, including laryngeal edema (n = 9), laryngomalacia (n = 8), tracheal vascular compression (n = 4), subglottic stenosis (n = 4), midmembranous vocal fold lesions (n = 3), bronchial stenosis (n = 1), and true vocal fold immobility (n = 1). Among 32 patients who underwent esophageal biopsy, histologic evidence of gastroesophageal reflux disease was found in 10 patients (31%), and eosinophilic esophagitis was found in 4 patients (13%). Overall prevalence of any synchronous finding (airway and/or esophagus) was 27 (77%) of 35.
Synchronous airway lesions and esophagitis (both gastroesophageal reflux disease and eosinophilic esophagitis) were prevalent among children younger than 18 months undergoing adenoidectomy for adenoid hypertrophy and upper airway obstruction. The presence of these findings argues for consideration of endoscopy during adenoidectomy for very young children.
确定因腺样体肥大和上气道阻塞而接受腺样体切除术的18个月以下儿童中同步气道病变和食管炎的患病率。
回顾性研究，为期4.5年。
三级护理儿童医院。
所有18个月以下因上气道阻塞由2名儿科耳鼻喉科医生进行腺样体切除术的儿童。
颅面畸形和先天性综合征。
腺样体切除术期间的同步干预措施包括可弯曲鼻咽喉镜检查（n = 32）、直接喉镜检查（n = 31）、硬质气管支气管镜检查（n = 30）和食管镜检查及活检（n = 32）。
同步气道病变和组织学食管炎的患病率。
35名18个月以下儿童因气道阻塞接受了腺样体切除术（2名同时进行了扁桃体切除术）。在接受气道内镜检查的32例患者中，有19例（59%）发现同步气道病变，包括喉水肿（n = 9）、喉软化（n = 8）、气管血管受压（n = 4）、声门下狭窄（n = 4）、膜性中份声带病变（n = 3）、支气管狭窄（n = 1）和真性声带固定（n = 1）。在接受食管活检的32例患者中，10例（31%）发现胃食管反流病的组织学证据，4例（13%）发现嗜酸性食管炎。35例中任何同步发现（气道和/或食管）的总体患病率为27例（77%）。
在因腺样体肥大和上气道阻塞而接受腺样体切除术的18个月以下儿童中，同步气道病变和食管炎（胃食管反流病和嗜酸性食管炎）很常见。这些发现表明，对于非常年幼的儿童，在腺样体切除术期间应考虑进行内镜检查。
