Department of Otolaryngology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy; Department of Otolaryngology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Department of Otolaryngology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
Int J Pediatr Otorhinolaryngol. 2021 Jan;140:110493. doi: 10.1016/j.ijporl.2020.110493. Epub 2020 Nov 11.
Adenoid hypertrophy is a common cause of upper airway obstruction in children. However, after adenoidectomy, nasal obstructive symptoms may persist or recur, requiring surgical revision. The aim of this study is to evaluate if individual patient features can influence the efficacy of the traditional technique.
A retrospective observational study was conducted by recruiting patients from candidates for adenoidectomy. All children underwent conventional transoral curettage adenoidectomy with endoscopic control at the end of procedure, and in presence of adenoid residues, a concomitant revision adenoidectomy was performed. For each patient, the following data were collected: age, sex, weight, height, length of the soft palate and surgical technique used.
In 18% of patients (113/612), the most critical areas of the nasopharynx were not reached by standard surgery, making a complete adenoidectomy difficult. In this group, the average length of the soft palate was 3.1 cm, 5 mm more than the average of the sample, and 6 mm more than the average length of patients undergoing standard surgery alone (p < 0.001).
Our study confirms the hypothesis that a greater length of the soft palate conditions the results of the intervention. The length of the soft palate can be considered an intraoperative criterion to select the cases in which perform endoscopic control after the standard procedure.
腺样体肥大是儿童上呼吸道阻塞的常见原因。然而，腺样体切除术后，鼻部阻塞症状可能持续或复发，需要手术修正。本研究旨在评估个体患者特征是否会影响传统技术的疗效。
通过招募腺样体切除术候选患者，进行回顾性观察性研究。所有儿童均接受传统经口刮除腺样体切除术，并在内镜控制下完成手术。如果发现腺样体残留，同期行腺样体切除术。收集每位患者的以下数据：年龄、性别、体重、身高、软腭长度和手术技术。
在 18%的患者（113/612）中，标准手术无法到达鼻咽部的关键区域，难以实现完全的腺样体切除术。在这组患者中，软腭的平均长度为 3.1 厘米，比样本平均值长 5 毫米，比仅行标准手术的患者的平均长度长 6 毫米（p<0.001）。
我们的研究证实了这样一种假设，即软腭较长会影响干预的结果。软腭的长度可以被视为术中标准，用于选择在标准手术后进行内镜检查的病例。
