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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.
摘要：
介绍腺样体切除术是耳鼻喉科医师最常见的手术之一。传统的腺样体刮治是盲目进行的，这可能导致腺样体的去除不足和对周围结构的损伤。目的对腺样体清扫术后鼻咽部进行经鼻内镜检查。方法本前瞻性研究包括100名儿童，平均年龄为4.2±3.07岁。它由两个步骤组成：由住院医师进行常规刮刮术腺样体切除术；通过0°望远镜对鼻咽进行内窥镜评估，以评估腺样体残留物，损伤手术区域或邻近结构，和出血点。结果42％的病例在多个部位行常规腺样体刮除后出现腺样体残留,例如鼻咽部的顶部（24％），输卵管扁桃体（12%），咽后壁（4%），和鼻中隔的后端（2％）。在46％的病例中观察到手术区域和邻近结构的损伤（咽后壁：23％；咽侧壁：11％；帕萨万特脊：10％；咽鼓管口：2％）。在29％的病例中观察到内窥镜出血；13％的病例来自腺样体残留物，10%,从粘膜，6%,从咽部肌肉。19%的病例出血轻微,中等在9%，严重的是1%。结论常规腺样体刮除后鼻咽的内镜评估提供了有关腺样体残留物的重要数据。损伤手术区域或附近结构，和出血点，这有助于提供最佳护理和实现更好的结果。
