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经口内镜腺样体切除术

Transoral endoscopic adenoidectomy.

作者信息

El-Badrawy Amr, Abdel-Aziz Mosaad

机构信息

Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt.

出版信息

Int J Otolaryngol. 2009;2009:949315. doi: 10.1155/2009/949315. Epub 2009 Jul 28.

Abstract

Objective. Adenoid curette guided by an indirect transoral mirror and a headlight is a simple and quick procedure that has already been in use for a long time, but this method carries a high risk of recurrence unless done by a well-experienced surgeon. The purpose of this paper was to evaluate the efficacy of transoral endoscopic adenoidectomy in relieving the obstructive nasal symptoms. Methods. 300 children underwent transoral endoscopic adenoidectomy using the classic adenoid curette and St Claire Thomson forceps with a 70( composite function) Hopkins 4-mm nasal endoscope introduced through the mouth and the view was projected on a monitor. Telephone questionnaire was used to follow-up the children for one year. Flexible nasopharyngoscopy was carried out for children with recurrent obstructive nasal symptoms to detect adenoid rehypertrophy. Results. No cases presented with postoperative complications. Only one case developed recurrent obstructive nasal symptoms due to adenoid regrowth and investigations showed that he had nasal allergy which may be the cause of recurrence. Conclusion. Transoral endoscopic adenoidectomy is the recent advancement of classic curettage adenoidectomy with direct vision of the nasopharynx that enables the surgeon to avoid injury of important structures as Eustachian tube orifices, and also it gives him the chance to completely remove the adenoidal tissues.

摘要

目的。间接经口喉镜和头灯引导下的腺样体刮除术是一种简单快捷的手术,已经使用了很长时间,但除非由经验丰富的外科医生进行,否则这种方法复发风险很高。本文的目的是评估经口内镜腺样体切除术在缓解鼻塞症状方面的疗效。方法。300名儿童接受了经口内镜腺样体切除术,使用经典的腺样体刮匙和圣克莱尔·汤姆森钳,通过口腔插入70(复合功能)霍普金斯4毫米鼻内镜,图像投射到监视器上。采用电话问卷调查对儿童进行为期一年的随访。对有复发性鼻塞症状的儿童进行纤维鼻咽镜检查以检测腺样体再肥大。结果。无术后并发症病例。仅1例因腺样体再生出现复发性鼻塞症状,检查显示其患有鼻过敏,这可能是复发的原因。结论。经口内镜腺样体切除术是经典腺样体刮除术的最新进展,能直视鼻咽部,使外科医生避免损伤诸如咽鼓管开口等重要结构,同时也使医生有机会完全切除腺样体组织。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/920d/2809357/222c25b29cc7/IJOL2009-949315.001.jpg

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