Endoscopic Evaluation after Conventional Adenoid Curettage.

IF 1 Q3 OTORHINOLARYNGOLOGY International Archives of Otorhinolaryngology Pub Date : 2024-02-16 eCollection Date: 2024-07-01 DOI:10.1055/s-0044-1779434
Ahmed Abdelfattah Bayomy Nofal, Mohamed Abdelmohsen Alnemr, Ahmed Hassan Sweed, Alsayed Abdulmageed
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Abstract

Introduction  Adenoidectomy is one of the most common procedures performed by otolaryngologists. Traditional adenoid curettage is performed blindly, which can result in inadequate removal of the adenoid and injury to the surrounding structures. Objective  To perform transnasal endoscopic examinations to assess the nasopharynx after conventional curettage adenoidectomy. Methods  The present prospective study included 100 children with a mean age of 4.2 ± 3.07 years. It is composed of two steps: conventional curettage adenoidectomy by a resident trainee; and endoscopic evaluation of the nasopharynx through a 0° telescope to assess adenoidal remnants, injury to the surgical field or adjacent structures, and bleeding points. Results  Adenoid remnants were observed in 42% of the cases after conventional adenoid curettage in multiple locations, such as the roof of the nasopharynx over the choana (24%), the tubal tonsil (12%), the posterior pharyngeal wall (4%), and the posterior end of the nasal septum (2%). Injury to the surgical field and adjacent structures was observed in 46% of the cases (posterior pharyngeal wall: 23%; lateral pharyngeal wall: 11%; Passavant ridge: 10%; and the Eustachian tube orifice: 2%). Endoscopic bleeding was observed in 29% of the cases; 13% of the cases were from adenoid remnants, 10%, from the mucosa, and 6%, from the pharyngeal muscles. Bleeding was mild in 19% of the cases, moderate in 9%, and severe in 1%. Conclusion  Endoscopic evaluation of the nasopharynx following conventional adenoid curettage provides important data regarding adenoid remnants, injury to the surgical field or nearby structures, and bleeding points, which aids in the provision of optimal care and in the achievement of a better outcome.

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传统腺样体切除术后的内窥镜评估
导言:腺样体切除术是耳鼻喉科医生最常见的手术之一。传统的腺样体刮除术是盲目进行的,可能导致腺样体切除不充分和周围结构损伤。目的 通过经鼻内窥镜检查评估传统腺样体刮除术后的鼻咽部情况。方法 本前瞻性研究包括 100 名儿童,平均年龄为 4.2 ± 3.07 岁。研究包括两个步骤:由一名住院受训者进行常规刮治腺样体切除术;通过0°望远镜对鼻咽部进行内窥镜评估,以评估腺样体残留、手术区域或邻近结构的损伤以及出血点。结果 42% 的病例在常规腺样体刮除术后多个部位观察到腺样体残留,如鼻咽顶部咽喉部(24%)、输卵管扁桃体(12%)、咽后壁(4%)和鼻中隔后端(2%)。46%的病例观察到手术区域和邻近结构受到损伤(咽后壁:23%;咽侧壁:11%; Passavant脊:5%):咽后壁:23%;咽侧壁:11%;咽嵴:10%;咽鼓管口:2%):2%).29%的病例观察到内镜下出血,其中13%来自腺样体残留物,10%来自粘膜,6%来自咽部肌肉。19%的病例为轻度出血,9%为中度出血,1%为严重出血。结论 传统腺样体刮除术后的鼻咽部内窥镜评估提供了有关腺样体残留、手术区域或附近结构损伤以及出血点的重要数据,有助于提供最佳护理和取得更好的疗效。
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来源期刊
CiteScore
2.80
自引率
0.00%
发文量
84
审稿时长
12 weeks
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