Chronic snoring and obstructive sleep apnea syndrome in children

Increased upper airway resistance during sleep may lead to heavy snoring and/or obstructive sleep apnea in infants and children. Clinical symptoms will be seen with increased upper airway resistance during sleep, even without obstructive sleep apnea or significant oxygen saturation drop. It may be responsible for apparent life threatening events (ALTE). Mild cranio-facial morphometric changes are often associated with increased upper airway resistance during sleep, and there is a continuous interaction between airway patency during sleep and maxillo-mandibular growth. Nasal CPAP can be as much a diagnostic tool as a treatment procedure. Orthodontic and surgical approaches may also be combined in the treatment of this significant health problem.     

A prospective study of day case adenoidectomy

Adenoidectomy in this country is typically performed as an in-patient procedure requiring an overnight stay in hospital but experience from other countries shows that adenoidectomy can be safely performed as a day case procedure. In Leicester, a prospective study of day case adenoidectomy was initiated in 1991 under carefully monitored conditions. We report on 721 patients entered in the first 3 years. We have so far found day case adenoidectomy to be a safe procedure.     

Otitis media with effusion: benefits and harms of strategies in use for treatment and prevention

Otitis media with effusion (OME) is a common clinical condition that is associated with hearing loss. It can be diagnosed at least once in approximately 80% of preschool children: 30-40% of them have recurrent episodes, and 5-10% have chronic disease. OME, in recurrent and persistent cases, might significantly delay or impair communication skills, resulting in behavioral and educational difficulties. Several therapeutic approaches have been used to avoid these problems. Most, however, have not been adequately studied, and no definitive conclusions can be drawn. Official guidelines do not recommend the use of decongestants, antihistamines, steroids, or antibiotics. The data are too scanty to assess other interventions, although autoinflation, because it incurs neither cost nor adverse events, deserves attention. Surgical procedures (i.e., tympanostomy tube insertion and adenoidectomy as an adjuvant) can be useful in some cases. This review evaluates all the current OME treatments and preventive measures, including their possible adverse events.     

鼓膜置管联合腺样体切除治疗分泌性中耳炎疗效观察

目的:探讨治疗小儿分泌性中耳炎的合理方法。方法:回顾性分析2002~2004年我科12例鼓膜置管联合腺样体切除治疗分泌性中耳炎。结果:术后4天语言频率上升30~40dB,耳科检查:耳道干燥,鼓膜变白,置管无脱落。结论:鼓膜置管联合腺样体切除治疗分泌性中耳炎为小儿分泌性中耳炎的优选治疗方法。     

儿童腺样体肥大3种切除方式疗效分析

目的：比较传统经口腔腺样体刮除术、鼻内镜下经鼻腔腺样体切除术及鼻内镜下经口鼻腔双径路腺样体切除术的疗效。方法：回顾性分析202例接受腺样体肥大手术患儿的临床资料,比较3种术式术后患儿夜间打鼾、鼻塞、鼻漏及听力等症状的恢复和腺样体残留等情况。结果：传统经口腔腺样体刮除术后6例患儿存在腺样体残留,其他2种术式术后无腺样体残留。鼻内镜下经口鼻腔双径路腺样体切除术后患儿打鼾、鼻塞症状改善明显。结论：腺样体肥大的理想手术方法为鼻内镜下经口鼻腔双径路腺样体切除术。     

鼻内镜下切除扁桃体及腺样体的临床探索

目的 比较鼻内镜下低温等离子切除扁桃体及腺样体与鼻内镜下扁桃体电切术和腺样体吸切术的临床疗效.方法 选取该院因扁桃体及腺样体肥大需要手术的患儿80例.其中,实验组(n=40)为鼻内镜下低温等离子切除扁桃体及腺样体,对照组(n=40)为鼻内镜下电切扁桃体与腺样体吸切,比较两组患儿术中和术后相关指标的差异.结果 实验组手术...     

扁桃体腺样体切除对儿童阻塞性睡眠呼吸暂停低通气综合征术后免疫功能的影响

儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OS-AHS)是一种在儿童中较为常见的呼吸道阻塞性疾病,常常会影响儿童的智力以及体格发育。对于伴有扁桃体反复发炎以及夜间睡眠呼吸暂停的OSAHS患儿,扁桃体和腺样体切除术是最有效的