Uçar Cevat
Department of Otolaryngology, Turkey Hospital, Istanbul, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2008 Mar-Apr;18(2):66-8.
This study evaluated endoscopic adenoidectomy operations performed in children for hypertrophic adenoid tissue in the nasopharynx.
A total of 125 patients (67 boys, 58 girls; mean age 4.8+/-2.4 years; range 2 to 15 years) underwent endoscopic adenoidectomy under general anesthesia for one or more of the following complaints: nasal obstruction, mouth breathing, snoring, loss of appetite, slower development than peers, and decreased hearing. Preoperatively, 48 patients were eligible for endoscopic rhinoscopy, which showed an adenoid mass causing total or almost total obstruction of the nasal passage. In the remaining patients, lateral cranial radiographs showed a mass narrowing the air passage in the nasopharynx. Postoperative controls were carried out at one and four weeks by physical examination and an inquiry into the patients' satisfaction. In addition, endoscopic rhinoscopy was performed in the fourth week in eligible patients. Final controls were carried out at the end of the second year.
At the end four weeks, none of the patients had nasal obstruction or related complaints. Postoperative endoscopic rhinoscopy performed in 39 patients showed almost complete removal of adenoid tissues. None of the patients exhibited recurrent adenoid hypertrophy at the end of two years.
Hypertrophic adenoid tissue in the nasopharynx, especially those encroaching on the nasal cavity, can be removed completely under direct endoscopic visualization. Endoscopic adenoidectomy is a more satisfactory method than conventional adenoidectomy, because it allows control of how much adenoid tissue is removed.
本研究评估了在儿童中针对鼻咽部腺样体肥大组织进行的内镜下腺样体切除术。
共有125例患者(67例男孩,58例女孩;平均年龄4.8±2.4岁;范围2至15岁)因以下一种或多种症状在全身麻醉下接受内镜下腺样体切除术:鼻塞、口呼吸、打鼾、食欲不振、发育比同龄人迟缓以及听力下降。术前,48例患者符合内镜鼻镜检查条件,检查显示腺样体肿块导致鼻腔完全或几乎完全阻塞。其余患者的头颅侧位X线片显示肿块使鼻咽部气道变窄。术后在第1周和第4周通过体格检查及询问患者满意度进行复查。此外,符合条件的患者在第4周进行内镜鼻镜检查。在第二年末进行最终复查。
在第4周结束时,所有患者均无鼻塞或相关症状。对39例患者进行的术后内镜鼻镜检查显示腺样体组织几乎完全切除。两年末无患者出现腺样体肥大复发。
鼻咽部腺样体肥大组织,尤其是侵犯鼻腔的组织,可在内镜直视下完全切除。内镜下腺样体切除术比传统腺样体切除术更令人满意,因为它能控制腺样体组织的切除量。