Honda K, Tanke M, Kumazawa T
Department of Otolaryngology, Kansai Medical University, Osaka, Japan.
Acta Otolaryngol Suppl. 1988;454:218-21. doi: 10.3109/00016488809125031.
Carbon dioxide laser surgery was performed on children aged 5 to 11 years, on whom either adenoidectomy or tonsilloadenoidectomy had been performed to restore their hearing. We examined 177 ears 18 to 24 months after surgery. Thirty ears (17%) were diagnosed as having otitis media with effusion. Analysis of the endoscopic findings revealed 51% marked tubal tonsil hypertrophy and 33% adenoid tissue hypertrophy. Subjects were operated upon in the dorsal position for a duration of point one second at an amplitude of 15 watts. Six months after surgery, most patients' hearing had returned to almost normal. The tympanograms which were taken 6 months after surgery showed good results in almost every case. Otitis media with effusion was found to have recurred in 3 ears. The effect of adenoidectomy is apparently dependent upon age, the size of adenoids, and the influence of allergies and sinusitis. Furthermore, our cases suggested that tubal tonsil hypertrophy was one of the factors found in recurrent otitis media with effusion in older children. It can thus be inferred that endoscopic examination of the postnasal space is recommended in children with recurrent otitis media with effusion after adenoidectomy, and that carbon dioxide laser surgery is a reliable therapeutic method in the topical treatment of this disease.
对5至11岁接受过腺样体切除术或扁桃体腺样体切除术以恢复听力的儿童进行了二氧化碳激光手术。术后18至24个月，我们对177只耳朵进行了检查。30只耳朵（17%）被诊断为伴有积液的中耳炎。对内镜检查结果的分析显示，51%有明显的咽鼓管扁桃体肥大，33%有腺样体组织肥大。患者在背部卧位接受手术，功率为15瓦，持续时间为0.1秒。术后6个月，大多数患者的听力几乎恢复正常。术后6个月进行的鼓室图检查几乎在每个病例中都显示出良好的结果。发现有3只耳朵再次出现了伴有积液的中耳炎。腺样体切除术的效果显然取决于年龄、腺样体大小以及过敏和鼻窦炎的影响。此外，我们的病例表明，咽鼓管扁桃体肥大是大龄儿童复发性伴有积液的中耳炎的因素之一。因此可以推断，对于腺样体切除术后复发性伴有积液的中耳炎患儿，建议进行鼻后间隙的内镜检查，并且二氧化碳激光手术是这种疾病局部治疗的可靠治疗方法。
