아데노이드 재절제술의 임상양상 분석

Abstract

Adenoidectomy is one of the most common surgery performed on children. However, after successful surgery, some may develop symptoms suggestive of adenoid regrowth. Purpose of this study is to analyze clinical aspects and postoperative outcomes of patients who had revision adenoidectomy. Methods：A retrospective study was performed on 2,191 patients who underwent adenoidectomy or adeno-tonsillectomy from January, 2009 through December, 2015 in single tertiary medical care center. Clinical history and data, such as sex, age, symptoms of initial and revision surgery, postoperative complications were collected from medical records. To evaluate the degree of adenoid hypertrophy, adenoidal-nasopharyngeal ratio was measured from PNS X-ray lateral view. Results：Among 2,191 patients who had adenoidectomy or adeno-tonsillectomy during this period, 35 patients had revision adenoidectomy. In total 35 patients, 20 (57.1%) were male, 15 (42.9%) were female patients. Average age when patients had initial surgery was 8.6, revision surgery was 13. Comparing chief complaints of revision surgery with initial surgery, snoring with sleep disorder, postnasal drip (PND), rhinorrhea seem to increase significantly (p＜0.05). There was no significant difference in hospital days, operation time and postoperative complication such as bleeding, pain, Eustachian tube dysfunction and velopharyngeal insufficiency. Also, there was no significant difference in adenoidal-nasopharyngeal ratio, between the time of initial and revision surgery. Conclusions：Revision adenoidectomy showed no difference of safety compared with initial surgery. However, in revision cases, patients showed significantly increased inflammatory symptoms such as rhinorrhea and PND which is commonly seen in sinusitis and rhinitis. Also, sizable proportion of patients show comorbid nasal inflammatory disease. Therefore, those with chronic inflammatory disease in nasal cavity after initial adenoidectomy are recommended for careful management and follow up.