Stupp F, Grossi A-S, Lindemann J
Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
HNO. 2020 Mar;68(3):215-226. doi: 10.1007/s00106-020-00826-z.
Adenoidectomy, paracentesis, and tonsillar interventions are the most common operations in childhood. Hypertrophy of the lymphatic tissue of Waldeyer's ring can lead to individually distinct, acute, and chronic symptoms as well as anatomical and functional changes. When presented with affected children in otolaryngologic practice, the combination of parental interview, questionnaire-based screening for obstructive sleep apnea syndrome, and physical examination including ear microscopy, inspection of the oropharynx and, if necessary, the nasopharynx, has proven its worth. Audiometric diagnosis for detection of tympanic effusion should be mandatory. The treatment of choice is adenoidectomy, if necessary plus tonsillotomy and paracentesis with a tympanic tube insert. However, the indication remains controversial, as the effectiveness of the interventions seems to depend on the preoperative severity of symptoms. With a correct indication, effective symptom reduction, improvement in quality of life, and high parent satisfaction can be expected.
腺样体切除术、穿刺术和扁桃体干预是儿童期最常见的手术。咽淋巴环淋巴组织肥大可导致个体独特的急性和慢性症状以及解剖和功能变化。在耳鼻喉科临床中遇到患病儿童时，结合家长访谈、基于问卷的阻塞性睡眠呼吸暂停综合征筛查以及包括耳镜检查、口咽检查以及必要时的鼻咽检查在内的体格检查已证明其价值。检测鼓室积液的听力诊断应成为常规。治疗的首选方法是腺样体切除术，必要时加扁桃体切除术和鼓膜置管穿刺术。然而，手术指征仍存在争议，因为这些干预措施的有效性似乎取决于术前症状的严重程度。有了正确的指征，有望有效减轻症状、改善生活质量并获得家长的高度满意度。
