耳内镜下腺样体刮匙与电动吸割器联合应用治疗腺样体肥大

Endoscopic-guided Adenoid Curette Combined with Electric Suction Device for Adenoid Hypertrophy

目的探讨耳内镜下腺样体刮匙与电动吸割联合治疗腺样体肥大的疗效。方法由鼻腔伸入耳内镜,在显像系统监视下由口咽放入腺样体刮匙,将刮匙紧贴腺样体的顶后壁,稍用力将腺样体刮除,刮除大部分腺样体组织后,未刮除的剩余部分用反向切割器经口咽导入鼻咽部予以切除,用纱布球按压止血。结果单纯腺样体切除手术时间10～15 min,平均12.5 min;同时行扁桃体剥离切除术者手术时间35～50 min,平均43 min。46例随访1～6个月,平均2个月,术后无复发、继发性出血,无一例出现术后鼻腔粘连。结论耳内镜直视下腺样体刮匙与电动吸割联合治疗腺样体肥大具有视野清晰,操作安全,有较好的临床应用价值。

Objective To access the efficacy of endoscopic ear curette adenoidectomy combined with electric suction for the treatment of adenoid hypertrophy. Methods With a nasal endoscope in the ear to monitor the oropharynx we removed most of the hypertrophic tissues by using an adenoid curette,the residual hypertrophic tissues were then cut by a reverse-cutter.Gauze was used for compression hemostasis. Results The procedure was completed in 10 to 15 min（mean,12.5 min） for simple adenoidectomy,and in 35 to 50 min（mean,43 min） for adenoidectomy combined with tonsillectomy.The 46 cases were followed up for 1-6 months with a mean of 2 months.No patients had relapse,secondary hemorrhage or nasal adhesion. Conclusions Endoscopic-guided adenoid curette combined with electric suction device is effective and safe for adenoid hypertrophy with a clear surgical field.