Department of Otolaryngology, Children's Hospital of Patras "Karamandaneio", 26331, Patras, Greece.
Department of Otolaryngology, Children's Hospital of Patras "Karamandaneio", 26331, Patras, Greece.
Int J Pediatr Otorhinolaryngol. 2022 Jul;158:111169. doi: 10.1016/j.ijporl.2022.111169. Epub 2022 May 7.
In the COVID-19 era, extreme measures of social distancing have contained the spread of common viral respiratory infections, which are involved in the pathogenesis of Adenotonsillar Hypertrophy (ATH), and Chronic Otitis Media with Effusion (COME), the two commonest chronic ENT diseases of childhood. This study examines the lockdown effect on the number of procedures performed for these two conditions.
The consecutive charts of 650 and 195 children being operated respectively for ATH and COME during the quarantine (05/2020-02/2021) and unrestrained (05/2019-02/2020) periods were retrospectively reviewed. Surgical treatment of ankyloglossia, performed in 103 patients during the same periods was employed as a control procedure.
Adenotonsillectomies and tympanostomies significantly decreased in the lockdown phase by 52% (P < 0.001) and 74% (P < 0.001), respectively, whereas control procedure counts increased by 25%. In terms of seasonal variation, ATH-related surgeries were significantly reduced during the winter season of the pandemic by 73% (P < 0.001), in comparison with the corresponding months of the unrestrained period. School-aged children received significantly fewer operations for ATH (-59%) than preschoolers (-42%), as a result of the lockdown (P = 0.044).
When the child's exposure to respiratory pathogens is minimal, as in the case of lockdown, a noticeable decline occurs in the incidence of ATH and COME indicated for surgical treatment. Chronic low-grade inflammation, boosted by repetitive viral infections seems to underlie both conditions. Timely, effective isolation measures might reverse the disease process and keep the child away from the Operating Room.
在 COVID-19 时代，极端的社交距离措施遏制了常见病毒性呼吸道感染的传播，这些感染与腺样体肥大（ATH）和分泌性中耳炎（COME）的发病机制有关，这两种疾病是儿童最常见的慢性耳鼻喉疾病。本研究检查了封锁措施对这两种疾病手术数量的影响。
回顾性分析了分别在隔离（2020 年 5 月至 2021 年 2 月）和无限制（2019 年 5 月至 2020 年 2 月）期间接受腺样体切除术和鼓室切开术治疗的 650 例和 195 例儿童的连续图表，同时将同期进行的 103 例舌系带切开术作为对照手术。
在封锁期间，腺样体切除术和鼓室切开术分别显著减少了 52%（P<0.001）和 74%（P<0.001），而对照手术数量增加了 25%。就季节性变化而言，ATH 相关手术在疫情冬季显著减少了 73%（P<0.001），与无限制期的相应月份相比。由于封锁，学龄儿童接受 ATH 手术的次数明显减少（-59%），而学龄前儿童减少（-42%）（P=0.044）。
当儿童接触呼吸道病原体的机会最小，如在封锁期间，需要手术治疗的 ATH 和 COME 的发病率明显下降。慢性低度炎症，由反复的病毒感染引起，似乎是这两种疾病的基础。及时、有效的隔离措施可能会逆转疾病进程，使儿童远离手术室。
