腺样体肥大3种不同手术方式的比较

Comparison among the three different approaches in the management of adenoid hypertrophy

目的:比较经鼻内镜腺样体切除术(TEA)、内镜辅助经口腺样体切除术(ETA)及传统的经口腔腺样体刮除术(TCA)的优缺点.方法:分析130例接受腺样体肥大手术患者的临床资料,比较3种术式的术后听力、夜间打鼾、鼻塞、鼻漏等症状恢复和腺样体残留等情况.结果:术后随访6～44个月,平均21.4个月.TCA术后鼻塞改善有效率显著低于ETA(P＜0.05).TCA术式中,有20例患者存在腺样体残留,其他两种术式无腺样体残留.结论:腺样体肥大的最佳手术方法为ETA,伴有鼻腔、鼻窦疾病者可行TEA.

Objective:To compare the advantage and disadvantage among Transnasal Endoscopic Adenoidectomy (TEA), Endoscopic-assisted Transnasal Adenoidectomy (ETA) and traditional Transoral Curette Adenoidectomy (TCA).Method:Clinical data of 130 cases who received adenoidectomy were studied and the effective rate of hearing, snoring, nasal obstruction, rhinorrhea and residual of adenoid were compared among the three groups after operation. There were 82 male and 48 female with average age of 7.58 years (range 3~29 years). Of 130 cases, there were 79 cases in TCA group, 24 cases in TEA group and 27 in ETA group.Result:The effective rate of nasal obstruction in ETA group was significantly higher than that in TCA group ( P <0.05) with average following-up 21.4 months (range 6~44 months). Residual adenoid was found in 20 cases in TCA group and none in the other two groups.Conclusion:Endoscopic-assisted transnasal adenoidectomy using power system is the best approach of choice in the management of adenoid hypertrophy. Transnasal endoscopic adenoidectomy has benefit when another endoscopic sinonasal procedure is planned.