Clinical Analysis Of The Effect Of Adenoid And Tonsil Surgery On Nasal Ventilation Function In Children

Objective:To investigate the relationship between children’s OSA-18 scale questionnaire and children with obstructive sleep apnea Hypopnea syndrome and adenoid size,and to investigate the effect of adenoid and tonsil surgery on nasal ventilation in children and the study of the improvement of symptoms in children.Methods:58 children who were hospitalized with adenoid and tonsil hypertrophy were examined for preoperative polysomnography monitoring(PSG),and 2 weeks before and after operation,nasal and nasal resistance examination,OSA-18 scale Questionnaire survey,and SPSS 21.0 statistical software were used to carry out statistical analysis of data.Results:1.50 children met the standard into the study group,age 3-12 years old,median age 7years old.Among them,36 cases and 14 female cases.In 10 children with adenoid hypertrophy,there were 40 cases of adenoid complicated with tonsil hypertrophy.2.the total resistance of preoperative inhalation and the total score of preoperative OSA-18 scale were not statistically significant,there was no statistical significance between the total resistance of preoperative exhalation and the total score of preoperative OSA-18scale,and there was no correlation between preoperative nasal resistance and the total score of preoperative OSA-18 scale.3.the relationship between the total score of the preoperative OSA-18 scale and the degree of adenoid hypertrophy,by single factor variance analysis,F=0.543,p=0.585>0.05,the difference is not statistically significant,it can be considered that the total score of the preoperative OSA-18 scale is not correlated with the degree of adenoid hypertrophy.4.The correlation between the results of PSG and the degree of adenoid hypertrophy was tested by X~2,X~2=2.019,p=0.364>0.05,that is,there was no difference in the results of PSG between different adenoid degrees.5.After the single factor variance analysis,the total resistance of preoperative inhalation and the total resistance of preoperative exhalation in the adenoid score between the P value is greater than 0.05,that is,the difference is not statistically significant,it can be considered that the preoperative nasal resistance and adenoid hypertrophy degree is not correlated.6.There was no statistically significant difference in the total resistance between the glandular hypertrophy group and the Adenoid hypertrophy group before operation,and there was no statistically significant difference in the total resistance before operation,and it can be concluded that the anterior nasal resistance was not related to the hypertrophy of the tonsils.7.preoperative and postoperative 2 weeks of the total score of the OSA-18 scale by pairing T test,t=19.757,p=0.000<0.05,the difference is statistically significant.8,compared with before the operation,after Adenoid,tonsillectomy,the children’s NPV increased,NMCA increased,DCAN forward,NAR decreased,and the contrast between surgery is statistically significant(P<0.05).Conclusion:Adenoid and tonsillectomy can effectively improve the subjective symptoms and nasal ventilation function in children with adenoid and tonsil hypertrophy.The OSA-18scale can reflect the subjective symptoms of the child,but is not related to the size of the adenoid.Children with adenoid hypertrophy do not necessarily meet the clinical diagnostic criteria for child OSAHS,and PSG cannot be used to evaluate adenoid size.Tonsil hypertrophy is not a factor that causes the increase of nasal resistance value.Children over 4years of age are better suited for nasal reflex and nasal resistance examination.Nasal acoustic reflex can be used to evaluate the degree of adenoid hypertrophy by accurately measuring the volume of nasopharyngeal cavity,and as a routine screening method for adenoid hypertrophy in children in clinic.Nasal resistance does not reflect the size of adenoids,but can be used to evaluate the efficacy of adenoid hypertrophy surgery.In a word,nasal reflex and nasal resistance examination have the advantages of no trauma,simple and fast,less cost,objective results,good repeatability,good compliance with children,etc.,which can gradually replace the traditional examination methods such as nasopharyngeal lateral tablets and electronic nasopharyngeal microscopy,for the diagnosis of adenoid and tonsil hypertrophy in children,The choice of treatment plan and the evaluation of surgical efficacy have important clinical value.