90度成人鼻内镜下口腔进路低温等离子消融治疗腺样体肥大

目的通过应用90度成人鼻窦内窥镜下口腔进路低温等离子消融腺样体，探索治疗腺样体肥大的最佳途径。方法选择2009年1月至2011年10月确诊为腺样体肥大者368例，应用鼻内镜下低温等离子切除腺样体，对伴有分泌性中耳炎者行鼓膜穿刺术。结果368例明确诊断为腺样体肥大的患儿应用90度成人鼻窦内窥镜下口腔进路低温等离子消融配合术后鼻腔喷入雷诺考特治疗效果显著，术后没有明显疼痛和出血，基本不影响进食，鼻塞、张口呼吸等症状消失。同期对31例37耳伴有分泌性中耳炎者行鼓膜穿刺术治疗后症状消除，听力得到改善，随访1～6个月，总有效率97．2％。结论90度成人鼻窦内窥镜下口腔进路低温等离子消融腺样体是治疗腺样体肥大的有效途径，同时鼓膜穿刺可一次性将小儿分泌性中耳炎治愈，有效防止复发。

90 adult nasal endoscopic oral route of low-temperature plasma ablation for the treatment of adenoid hypertrophy

Objective Through the application of nasal endoscope in low-temperature plasma ablation for the treatment of adenoid hypertrophy,looking for the best of adenoid hypertrophy therapeutic approaches.Methods From 2009 January to 2011 October in our hospital diagnosed adenoid hypertrophy in 368 cases,application of low temperature plasma under nasal endoscope in adenoidectomy,achieved good therapeutic effect,with secretory otitis media underwent tympanocentesis,treatment after listening.Results Three hundred and sixty-eight cases of adenoid hypertrophy in children with nasal endoscope in low-temperature plasma ablation therapy,significant effect,no obvious postoperative pain and bleeding,do not affect eating.At the same time in 31 cases of 37 ears with otitis media with effusion or tympanic membrane puncture,after treatment,elimination of symptoms,hearing improved,follow-up of 1 months to 6 months,the total efficiency of 97.2 %.Conclusions Nasal endoscope in adenoidectomy low-temperature plasma ablation is the treatment of adenoid hypertrophy in an effective way,and tympanic membrane puncture can make children with secretory otitis media cure,prevent recurrence.