Zhang Qingfeng, Li Dawei, Wang Hui
Department of Otolaryngology, Dalian Municipal Central Hospital, 826 Xinan Road, Dalian 116033, China.
Department of Otolaryngology, Dalian Municipal Central Hospital, 826 Xinan Road, Dalian 116033, China.
Auris Nasus Larynx. 2014 Jun;41(3):299-302. doi: 10.1016/j.anl.2013.12.005. Epub 2014 Jan 1.
We investigated the long-term effects of partial tonsillectomy, and potential risk factors for tonsillar regrowth in children with obstructive sleep apnea hypopnea syndrome (OSAHS).
Children affected by OSAHS with obstructive hypertrophic tonsils underwent partial tonsillectomy or total tonsillectomy with radiofrequency coblation. Polysomnography was performed prior to and 5 years following surgery. Blood samples from all participants were taken prior to and 1 month following surgery to assess immune function. All participants were interviewed 5 years following surgery to ascertain effects of the surgery, rate of tonsillar regrowth, and potential risk factors.
All parents reported alleviation of breathing obstruction. Postoperative hemorrhage did not occur in the partial tonsillectomy group compared to 3.76% in the total tonsillectomy group. Tonsillar regrowth occurred in 6.1% (5/82) in children following partial tonsillectomy. Palatine tonsil regrowth occurred a mean of 30.2 months following surgery, and 80% of children with tonsillar regrowth were younger than 5 years of age. All five patients had a recurrence of acute tonsillitis prior to enlargement of the tonsils. Four of the five had an upper respiratory tract allergy prior to regrowth of palatine tonsils. There were no differences in IgG, IgM, IgA, C3, or C4 levels following partial tonsillectomy or total tonsillectomy.
Partial tonsillectomy is sufficient to relieve obstruction while maintaining immunological function. This procedure has several post-operative advantages. Palatine tonsils infrequently regrow. Risk factors include young age, upper respiratory tract infections, history of allergy, and history of acute tonsillitis prior to regrowth.
我们研究了部分扁桃体切除术的长期效果，以及阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患儿扁桃体再生的潜在风险因素。
患有阻塞性肥大扁桃体的OSAHS患儿接受了部分扁桃体切除术或使用射频消融术的全扁桃体切除术。在手术前和手术后5年进行多导睡眠图检查。在手术前和手术后1个月采集所有参与者的血样以评估免疫功能。在手术后5年对所有参与者进行访谈，以确定手术效果、扁桃体再生率和潜在风险因素。
所有家长均报告呼吸阻塞症状有所缓解。部分扁桃体切除术组未发生术后出血，而全扁桃体切除术组的发生率为3.76%。部分扁桃体切除术后，6.1%（5/82）的儿童出现扁桃体再生。腭扁桃体再生平均发生在术后30.2个月，80%扁桃体再生的儿童年龄小于5岁。所有5例患者在扁桃体肿大前均有急性扁桃体炎复发。5例中有4例在腭扁桃体再生前有上呼吸道过敏史。部分扁桃体切除术或全扁桃体切除术后，IgG、IgM、IgA、C₃或C₄水平无差异。
部分扁桃体切除术足以缓解阻塞，同时维持免疫功能。该手术有几个术后优势。腭扁桃体很少再生。风险因素包括年龄小、上呼吸道感染、过敏史以及再生前的急性扁桃体炎病史。
