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舌扁桃体切除术:5年经验回顾及手术技术的演变

Lingual tonsillectomy: a review of 5 years experience and evolution of surgical technique.

作者信息

Barakate Michael, Havas Thomas

机构信息

The University of New South Wales, Department of Otolaryngology, Head and Neck Surgery, The Prince of Wales Hospital Campus/Sydney Children's Hospital, Sydney, Australia.

出版信息

Otolaryngol Head Neck Surg. 2008 Aug;139(2):222-7. doi: 10.1016/j.otohns.2008.01.009.

Abstract

OBJECTIVES

To assess the indications for lingual tonsillectomy; to report our experience with lingual tonsillectomy, and to present the evolution of our surgical technique.

METHODS

A review of 5-years experience from a prospectively maintained database of 28 patients was performed together with a focused review of the international literature. Therapeutic procedures included lingual tonsillectomy with access via the Boyle-Davis gag or suspended video laryngoscope and with the resection via diathermy, CO(2) laser, or microdebrider.

RESULTS

The indication for lingual tonsillectomy was upper airways obstruction in 22 patients and recurrent infection in six. The operative time for lingual tonsillectomy ranged from 35 to 80 minutes (mean time, 43 minutes). The perioperative in-hospital stay ranged from one to three days for 27 patients. All did very well postoperatively.

CONCLUSION

Lingual tonsillar pathology may cause significant morbidity and is frequently the cause of persisting peripheral obstructive sleep apnea syndrome after adenotonsillectomy. Lingual tonsillectomy performed with video laryngoscopy and microdebrider resection is feasible and safe and provides good results.

摘要

目的

评估舌扁桃体切除术的适应证;报告我们进行舌扁桃体切除术的经验,并介绍我们手术技术的演变。

方法

对前瞻性维护的28例患者数据库中的5年经验进行回顾,并对国际文献进行重点回顾。治疗方法包括通过博伊尔-戴维斯开口器或悬吊式视频喉镜进行舌扁桃体切除术,并通过透热疗法、二氧化碳激光或微型切割器进行切除。

结果

22例患者行舌扁桃体切除术的适应证为上气道梗阻,6例为反复感染。舌扁桃体切除术的手术时间为35至80分钟(平均时间为43分钟)。27例患者围手术期住院时间为1至3天。所有患者术后恢复良好。

结论

舌扁桃体病变可能导致严重发病,并且经常是腺样体扁桃体切除术后持续性外周阻塞性睡眠呼吸暂停综合征的原因。采用视频喉镜和微型切割器切除术进行舌扁桃体切除术是可行且安全的,并能取得良好效果。

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