关键词: 腺样体, 腺样体切除术, 鼻内镜

Abstract:

Objective   To evaluate four surgical methods of adenoidectomy. Method   Clinical data 138 cases of adenoid hypertrophy were reviewed. Four different surgical methods were applied, including conventional transoral adenoidectomy with a currete(group A, 20 cases),  conventional transoral adenoidectomy with a currete plus punch forceps (group B, 63 cases),  endoscopic adenoidectomy (group C, 25 cases), and plasma ablation(group D, 30 cases). The effects, residue, complication, operation time and blood loss were evaluated  among the methods. Result   The effective rate was 90% for group A, but 100% for the other three groups. The residual rates in descending order were 60% in group A,  6.67% in group D， and zero in both group B and C. Post-op hemorrhage occurred in 4 cases (1 in group A, 2 in group B,  and 1 in group C). 6 cases presented  nasal synechia (4 in group B, 2 in group C) . Operation time of group A and group D were longer than the other two groups. There was no significant difference in  blood loss between the group A and B. The maximal loss was noted in group C, however the minimal loss was in group D. Conclusion   The conventional transoral adenoidectomy with a currete should be abandoned because of the high rate of residue. Though plasma ablation shows the advantages, including short operation time and little blood loss,  cost of this method is one big concern. It can only be applied in the patients who can afford it and give much attention to the blood loss. For the majority of patients, conventional transoral adenoidectomy plus punch forceps or endoscopic adenoidectomy are desirable , which are relatively simple and affordable.

Key words: Adenoidectomy, Adenoid, Endoscopy