Lu Yuanyuan, Zhang Qingxiang, Yu Zhenkun
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Jul;29(13):1209-12.
To achieve targeted and meticulous surgery of adenoid hypertrophy, a comprehensive analysis of adenoid hypertrophy space occupying effect and morphological evaluation were conducted and the clinical results were retrospectively analyzed.
One hundred and sixty-three children with adenoid hypertrophy were treated in our department from May 2013 to May 2014. All children received three examinations preoperatively, including: Nasopharyngo-fiberoscopy, Audiometry and Tympanometry. Based on the results, space occupying effect of adenoid hypertrophy was divided into three types: vertical hypertrophy type, horizontal hypertrophy type and vertical & horizontal hypertrophy type. We assumed the causal relationship with vertical hypertrophy type to snoring (nasal blockage) and horizontal hypertrophy type to secretory otitis media respectively. All children received transoral endoscopic adenoidectomy with radiofrequency ablation.
The postoperative followup of these children for 6 to 12 months showed that the vertical hypertrophy type and horizontal hypertrophy type children all recovered from the syndromes of snoring (nasal blockage) and secretory otitis media respectively. The nasopharyngo-fiberoscopy showed that the nasopharyngeal space was smooth and the bilateral choanas opened well. No recurrence was found.
The philosophy of comprehensive analysis on adenoid hypertrophy space occupying effect could help the surgeons understand adenoid hypertrophy better and can guide the adenoidectomy more meticulously.
为实现腺样体肥大的精准手术，对腺样体肥大的占位效应进行综合分析及形态学评估，并对临床结果进行回顾性分析。
2013年5月至2014年5月，我科收治163例腺样体肥大患儿。所有患儿术前均接受三项检查，包括：鼻咽喉纤维镜检查、听力测定和鼓室图检查。根据检查结果，将腺样体肥大的占位效应分为三种类型：垂直肥大型、水平肥大型和垂直与水平肥大型。我们分别假设垂直肥大型与打鼾（鼻塞）以及水平肥大型与分泌性中耳炎存在因果关系。所有患儿均接受经口内镜下射频消融腺样体切除术。
对这些患儿进行6至12个月的术后随访，结果显示垂直肥大型和水平肥大型患儿分别从打鼾（鼻塞）和分泌性中耳炎综合征中康复。鼻咽喉纤维镜检查显示鼻咽部空间通畅，双侧后鼻孔开放良好。未发现复发情况。
对腺样体肥大占位效应进行综合分析的理念有助于外科医生更好地了解腺样体肥大，并能更精准地指导腺样体切除术。
