«Атипова» аденотомія у дітей

Abstract

With the spread of adenoid vegetation into the nasal cavity, their removal and restoration of the respiratory and auditory function in full is significantly difficult. The objective: of the study was to increase the effectiveness of adenotomy in children. Materials and methods. Under our supervision in the clinic were 239 children with adenoid vegetation II-III degree, aged 2 to 15 years. In the main group, there were 175 children, in the comparison group – 64. In 10 (4.2%) patients, lymphoid tissue from the nasopharynx spread through the choana into the nasal cavity. All children were operated on under endotracheal anesthesia with endoscopic control. Atypical adenotomy was performed in 83 (47.4%) patients of the main group and in 30 (46.9%) patients of the comparison group. Results. 239 children with adenoid vegetation were operated on. In all children of the main group, physiological respiration was restored, hearing was restored or improved, and disease recurrence was not observed. In the comparison group, relapse of adenoid vegetation was detected in 4 (6.25%) cases. In 29.3% of cases, an increased density of adenoid vegetation was revealed. In 13.8% of patients, hypertrophy of the tubular and lateral ridges is observed. Blood loss when using high-frequency current decreased 4.7 times. Conclusions. 1. In 29.3% of pediatric patients, an increased density of adenoid vegetation is detected, and in 4.2%, adenoid vegetation spreads to the nasal cavity, which makes it difficult or sometimes impossible to remove Beckman’s adenotome and requires an «atypical» adenotomy. 2. Atypical location of adenoid vegetation, their increased density and the use of traditional tools for adenotomy can cause a relapse of the disease. Key words: adenoid vegetation, «atypical» adenotomy, children.