儿童扁桃体切除术的麻醉与术式探讨

目的探讨儿童扁桃体切除术的麻醉与术式选择及术后精神创伤预防.方法对720例使用剥离法或挤切法行扁桃体切除术的儿童进行回顾性研究,挤切术用表面麻醉或局部麻醉(A组),剥离术在插管全身麻醉下进行(B组).结果出血常发生在术后2～3 h,A组3%的患儿出现严重出血而需回手术室处理,B组1.19%出现严重出血;A组术后残体占17%,而B组仅0.95%;精神损伤中重度以上A组占75%,B组7.86%.结论插管全身麻醉下儿童扁桃体剥离术更安全、有效,对儿童精神创伤较轻.(中国眼耳鼻喉科杂志,2006,6:103～104)     

Jerk Seesaw Nystagmus After Posterior Cranial Fossa Decompression with Cerebellar Tonsillectomy for Chiari I Malformation

We report a case of jerk seesaw nystagmus that developed after posterior cranial fossa decompression with cerebellar tonsillectomy for Chiari I malformation. A 40-year-old female was diagnosed to be suffering from a Chiari I malformation associated with syringomyelia. Posterior cranial fossa decompression with cerebellar tonsillectomy was performed. Three months later, she developed oscillopsia and jerk seesaw nystagmus. The oscillopsia improved substantially with oral gabapentin. We conclude that oscillopsia and acquired nystagmus are rare but potentially disabling complications following posterior cranial fossa decompression. Oral gabapentin may be effective in the management of oscillopsia secondary to acquired jerk seesaw nystagmus.