Samareh Fekri Mitra, Arabi Mianroodi Aliasghar, Shakeri Hossein, Khanjani Narges
Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Department of Otorhinolaryngology Head and Neck Surgery, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Iran J Otorhinolaryngol. 2016 Jan;28(84):61-6.
Adenotonsillar hypertrophy is a typical cause of surgery in children. Evaluation and identification of patients as potential candidates tonsillectomy is a primary concern for otolaryngologists. This study focuses on the results of pulmonary function tests (PFTs) after tonsillectomy in children.
This cross-sectional study examined 50 patients suffering from tonsillar hypertrophy in 2013. Full details and results of otolaryngology examinations were recorded. Moreover, patients were examined with respect to forced inspiratory flow at 50% of vital capacity (FIF50%), forced expiratory flow at 50% of vital capacity (FEF50%), forced expiratory volume in 1 second (FEV1)/peak expiratory flow rate (PEFR), and FEV1/forced expired volume in 0.5 seconds (FEV0.5) before and after surgery using spirometry. All data were analyzed using SPSS Software (version 19), and central descriptive measures, and data were compared by performing T-test and Chi-square tests.
According to tonsil size, patients were distributed as follows: 18 patients (36%) with +1 tonsil size, 18 patients (36%) with +2 tonsil size, and seven patients (14%) with +3 tonsil size, and seven patients (14%) with +4 tonsil size. Thirty-three (66%) and 17 patients (34%) were female and male, respectively, with a mean of age of 9.7[Formula: see text]2.97 years (range, 7-18 years). Seventy-eight percent of patients were aged 10 years or less. Moreover, 25 patients (50%), 17 patients (34%), and eight patients (16%), respectively, reported obstructive symptoms, recurrent tonsillitis, and both symptoms. In patients with +3 and +4 tonsil size, spirometric parameters indicated relief of symptoms of obstruction. Only in patients with +4 tonsil size were the changes statistically significant.
Tonsillectomy can relieve obstructive symptoms in patients with tonsils larger than +3 to a great extent. Additionally, spirometry can identify patients with +3 and +4 tonsils who do not have clinical signs of an obstructive upper airway.
腺样体扁桃体肥大是儿童手术的典型病因。评估和确定哪些患者是扁桃体切除术的潜在候选者是耳鼻喉科医生首要关注的问题。本研究聚焦于儿童扁桃体切除术后的肺功能测试（PFT）结果。
这项横断面研究在2013年检查了50例患有扁桃体肥大的患者。记录了耳鼻喉科检查的全部细节和结果。此外，使用肺活量测定法在手术前后对患者进行了如下检查：肺活量50%时的用力吸气流量（FIF50%）、肺活量50%时的用力呼气流量（FEF50%）、1秒用力呼气量（FEV1）/呼气峰值流速（PEFR）以及FEV1/0.5秒用力呼气量（FEV0.5）。所有数据使用SPSS软件（版本19）进行分析，并采用中心描述性指标，通过进行T检验和卡方检验对数据进行比较。
根据扁桃体大小，患者分布如下：扁桃体大小为+1的患者18例（36%），扁桃体大小为+2的患者18例（36%），扁桃体大小为+3的患者7例（14%），扁桃体大小为+4的患者7例（14%）。女性患者33例（66%），男性患者17例（34%），平均年龄为9.7[公式：见正文]2.97岁（范围7至18岁）。78%的患者年龄在10岁及以下。此外，分别有25例（50%）、17例（34%）和8例（16%）患者报告有阻塞性症状、复发性扁桃体炎以及两种症状都有。在扁桃体大小为+3和+4的患者中，肺活量测定参数显示阻塞性症状有所缓解。仅在扁桃体大小为+4的患者中，这些变化具有统计学意义。
扁桃体切除术可在很大程度上缓解扁桃体大于+3的患者的阻塞性症状。此外，肺活量测定法可识别出扁桃体大小为+3和+4但无阻塞性上呼吸道临床体征的患者。
