Department of Otolaryngology, Selcuk University, Konya, Turkey.
Department of Pediatric Radiology, Selcuk University, Konya, Turkey.
Ear Nose Throat J. 2022 Jan;101(1):42-47. doi: 10.1177/0145561320934918. Epub 2020 Jul 7.
Tonsillectomy is one of the most common surgical procedures in pediatric patients. The tonsillar retractor, which is routinely used during a tonsillectomy, applies high pressure to the patient's tongue and can lead to various complications.
This study aimed to explore tongue edema induced by the pressure applied by tonsillar retractor, using ultrasonography in pediatric patients undergoing tonsillectomy surgeries.
Sixty-one patients were included in the study. The tonsillectomy group included 31 patients who underwent tonsillectomy surgery, while the control group included 30 patients who underwent inguinal hernia and circumcision surgery. Submental coronal plane ultrasonography examinations of the tongue were performed twice for each patient. In the tonsillectomy group, the first examination of tongue area (TA) was done immediately after intubation but before the placement of tonsillar retractor. The second examination (TA) was done at the end of the tonsillectomy surgery after the removal of the tonsillar retractor but before extubation. In the control group, the first examination (TA) was done immediately after intubation, whereas the second examination (TA) was done at the end of the surgery before extubation. These results were compared with those for the control group.
Groups were similar in terms of demographics and intubation duration. Groups did not significantly differ in terms of TA ( = .212), but they significantly differed in terms of TA ( = .000). They also significantly differed in terms of tongue edema defined as TA - TA ( = .000).
Tonsillar retractor does cause tongue edema in tonsillectomy surgeries. This tongue edema seems to be a result of the pressure applied by the tonsillar retractor. This study is the first to demonstrate the possible role of ultrasonography examination in determining the tonsillar retractor-induced tongue edema in pediatric patients.
扁桃体切除术是小儿患者最常见的手术之一。在扁桃体切除术中，常规使用的扁桃体牵开器会对患者的舌头施加高压，从而导致各种并发症。
本研究旨在通过超声检查探讨扁桃体切除术中扁桃体牵开器施加的压力引起的小儿患者舌肿胀。
本研究纳入 61 例患者。扁桃体切除术组包括 31 例行扁桃体切除术的患者，对照组包括 30 例行腹股沟疝和包皮环切术的患者。对每位患者进行两次颏下冠状平面舌超声检查。在扁桃体切除术组中，第一次检查舌面积（TA）是在插管后但放置扁桃体牵开器前进行的。第二次检查（TA）是在扁桃体切除术结束后、移除扁桃体牵开器但在拔管前进行的。在对照组中，第一次检查（TA）是在插管后立即进行的，第二次检查（TA）是在手术结束前、拔管前进行的。将这些结果与对照组进行比较。
两组在人口统计学和插管时间方面相似。两组在 TA 方面无显著差异（ =.212），但在 TA 方面有显著差异（ =.000）。在定义为 TA - TA 的舌肿胀方面，两组也有显著差异（ =.000）。
扁桃体牵开器确实会导致扁桃体切除术中的舌肿胀。这种舌肿胀似乎是扁桃体牵开器施加的压力所致。本研究首次证明了超声检查在确定小儿患者扁桃体牵开器引起的舌肿胀中的可能作用。
