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内镜辅助与刮除腺样体切除术的比较:一项前瞻性、随机、双盲研究,具有客观的结局指标。

Endoscopic-assisted versus curettage adenoidectomy: a prospective, randomized, double-blind study with objective outcome measures.

机构信息

Department of Otorhinolaryngology, Izmir Ataturk Research and Training Hospital, Izmir, Turkey.

出版信息

Laryngoscope. 2010 Sep;120(9):1895-9. doi: 10.1002/lary.21045.

DOI:10.1002/lary.21045
PMID:20715086
Abstract

OBJECTIVE

To establish whether there is both objectively and subjectively improved recovery in children receiving endoscopic-assisted adenoidectomy, compared with children receiving curettage adenoidectomy.

STUDY DESIGN

Prospective, randomized, double-blinded study.

METHODS

Thirty-eight patients who underwent adenoidectomy alone or in combination with tonsillectomy before the planned tympanomastoid surgery with an age range from 8 to 12 years were enrolled in the study. Children were prospectively and randomly assigned into two groups: the endoscopic-assisted adenoidectomy and the curettage adenoidectomy. The main subjective parameters were the nasopharyngoscopy and the symptom improvement scale, whereas the main objective parameter was the midsagittal reformatted images of the temporal bone computerized tomographies of patients who underwent adenoidectomy before the planned tympanomastoid surgery. To adequately compare the utility of one technique versus the other, blood loss and operative time were also reviewed.

RESULTS

Evaluation of the temporal bone computerized tomographies of patients by adenoidal/nasopharyngeal ratios revealed a statistically significant difference with a mean ratio of 0.41 in the curettage and 0.30 in the endoscopic-assisted group. However, both groups had a significant improvement in the symptom improvement scale with no evidence for a significant difference between the endoscopic-assisted and curettage groups.

CONCLUSIONS

Although, objective outcomes reveal that endoscopic-assisted adenoidectomy technique was superior to curettage adenoidectomy in reducing adenoidal size after surgery, subjectively no differences were noted between two methods.

摘要

目的

与刮除术相比,评估内镜辅助腺样体切除术是否能使患儿在客观和主观上都有更好的恢复。

研究设计

前瞻性、随机、双盲研究。

方法

38 例年龄在 8 至 12 岁之间、拟行鼓室成形乳突根治术的患者接受了单纯腺样体切除术或腺样体切除术联合扁桃体切除术。前瞻性随机将患儿分为两组:内镜辅助腺样体切除术组和刮除术组。主要的主观参数是鼻咽镜和症状改善量表,而主要的客观参数是接受腺样体切除术患者的颞骨计算机断层扫描的正中矢状位重建图像。为了充分比较两种技术的实用性,还评估了出血量和手术时间。

结果

通过腺样体/鼻咽比率评估患者的颞骨计算机断层扫描结果显示,刮除组的平均比率为 0.41,而内镜辅助组为 0.30,差异有统计学意义。然而,两组的症状改善量表均有显著改善,内镜辅助组与刮除组之间无显著差异。

结论

虽然客观结果表明内镜辅助腺样体切除术在减少术后腺样体大小方面优于刮除术,但两种方法在主观上没有差异。

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