儿童腺样体肥大和分泌性中耳炎的发病关系及鼻内镜手术治疗

Treatment and relationship between adenoid vegetation and secretory otitis media in children under nasal endoscopy

目的探讨儿童腺样体肥大、扁桃体肥大和分泌性中耳炎的发病关系以及在鼻内镜下的手术方法和疗效。方法216例采用气管插管全身麻醉,使用3mm0°鼻内镜实施腺样体或/和扁桃体切除术,125例合并分泌性中耳炎者,在鼻内镜下一并实施鼓膜置管术或切开术。结果术后随访3～6个月,183例(85%)睡眠张口呼吸、打鼾等症状消失或明显改善,125例合并分泌性中耳炎者,术后91%(114例)听力获明显改善,纯音听阈恢复或接近正常,声导抗测试为A形图,声反射引出。结论腺样体肥大是儿童分泌性中耳炎发病的重要因素;鼻内镜下手术治疗儿童腺样体肥大和分泌性中耳炎方法简便,疗效确切。

[Objective] To explore relationship between the adenoid vegetation, the tonsil hypertrophy and secretory otitis media in children and surgical operation method with curative effect under the nasal endoscope. [Methotis] 216 adoptions windpipe puts the tube anaesthesia, using 3 mm 0° nasal endoscope to put into practice adenoidectomy, among them merges secretory otifis media 125 examples, to put into practice myringotomy with tube insertion or myringotomy under the nasal endoscope. Chronic tonsillitis or tonsil hypertrophy in companion 171 example, put into practice tonsillectomy along together. [Results] After operation with visit during 3 and 6 months, 183 examples （85%） sleep with gape breath and snore etc.symptom disappears or obvious improvement. Merges to secretory otitis media of 125 examples, after operation 91% （114 example） hearing acquire obvious improvement, pure tone hearing threshold recover or near to normal, tympanogram show the A type diagram, acoustic stapedius reflex is deriven. [Condusionl Adenoid vegetation is an important factor that children secretory otitis media to be taken place; Treatment adenoid vegetation with secretory otitis media in children under nosal endoscope surgical operation, the method is simple, the curative effect is accurate.