Deutsch E S
Department of Pediatric Otolaryngology, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA.
Pediatr Clin North Am. 1996 Dec;43(6):1319-38. doi: 10.1016/s0031-3955(05)70521-6.
Obstructive sleep apnea and upper airway obstruction (even without complete apnea) from adenotonsillar hypertrophy is either occurring more frequently or is becoming better recognized. Tonsillectomy or adenoidectomy is indicated for these children. Most patients who would benefit from surgery can be identified by a thorough history and physical examination. Occasionally, additional methods of evaluation, such as lateral neck radiographs or polysomnograms, are helpful. The indications for tonsillectomy and adenoidectomy are varied. No review can cogently encompass all clinical scenarios. Tonsillectomy and adenoidectomy remain valuable procedures for carefully selected patients.
腺样体扁桃体肥大导致的阻塞性睡眠呼吸暂停和上气道阻塞(即使无完全性呼吸暂停),其发生率要么正变得更高,要么正得到更好的认识。对于这些儿童,建议行扁桃体切除术或腺样体切除术。大多数能从手术中获益的患者可通过全面的病史采集和体格检查得以识别。偶尔,额外的评估方法,如颈部侧位X线片或多导睡眠图,会有所帮助。扁桃体切除术和腺样体切除术的适应证多种多样。没有哪篇综述能令人信服地涵盖所有临床情况。对于精心挑选的患者,扁桃体切除术和腺样体切除术仍然是有价值的手术。