Grundfast K M, Wittich D J
Laryngoscope. 1982 Jun;92(6 Pt 1):650-6. doi: 10.1002/lary.1982.92.6.650.
Primary care physicians have become increasingly reluctant to refer children for tonsillectomy and adenoidectomy (T and A) during the past years while antimicrobial therapy for pharyngotonsillitis and otitis media has become more common. Consequently, more children retain tonsils and adenoids throughout the childhood years. Airway compromise from adenotonsillar hypertrophy is reported in 11 cases-8 with insidious onset, 3 with acute onset. Typical symptoms occurring during sleep include snoring, snorting, enuresis and obstructive apnea. Daytime symptoms included hyponasal speech, oral respiration and morning cephalgia. Methods of assessing children with adenotonsillar hypertrophy and airway compromise included polysomnography and acoustic analysis of respiratory sounds. It appears that airway compromise from adenotonsillar hypertrophy is more common now that fewer children are undergoing T and A, is being more commonly recognized because of improved methods of assessment, or both.
在过去几年中，初级保健医生越来越不愿意将儿童转诊进行扁桃体切除术和腺样体切除术（T&A），而针对咽扁桃体炎和中耳炎的抗菌治疗则变得更为普遍。因此，更多儿童在整个童年时期都保留了扁桃体和腺样体。据报道，11例因腺样体扁桃体肥大导致气道受压，其中8例起病隐匿，3例急性起病。睡眠期间出现的典型症状包括打鼾、喷鼻声、遗尿和阻塞性呼吸暂停。白天的症状包括鼻音过重、口呼吸和晨起头痛。评估腺样体扁桃体肥大和气道受压儿童的方法包括多导睡眠图和呼吸声音的声学分析。由于接受T&A的儿童减少，腺样体扁桃体肥大导致的气道受压现在似乎更为常见，或者是因为评估方法的改进而得到了更普遍的认识，或者两者兼而有之。
