The Application Value Of Ultrasound In Children With Hypertrophy Of Tonsil

Objective To investigate the accuracy of ultrasound in tonsillar display rate and volume estimation,and to further study the application value of ultrasound in children with snoring and even obstructive sleep apnea syndrome.Methods(1)hundreds of students in a primary school were initially questioned,and were divided into the control group and the experimental group according to the parents’ description of whether there were nasal obstruction,dyspnea and snoring,etc.Facial deformity and obesity made it impossible to measure the amygdala and those with previous tonsillar extraction were excluded,131 in the control group and 121 in the experimental group.(2)according to the 2011 American children tonsil resection of clinical practice guidelines(abstract)and the Chinese medical association otolaryngology head and neck surgery branch in urumqi,the diagnosis and treatment guidelines,with no conditions for polysomnography or can’t cooperate with children,can be inquired about their medical history,signs,always auxiliary examination results,overall judgment whether surgery is needed.(3)121 snoring students were scored on the osa-18 scale(see the following figure).The same medical staff instructed the guardian to fill in the osa-18 scale.The total score ranged from 18 to 126,with < 60 being mild,60-80 moderate,and > 80 severe.(4)30 children who met the requirements of surgery were successively excised from bilateral tonsils,and the volume of bilateral tonsils was measured and calculated.(5)the height and weight of 252 students were measured.(6)a total of 252 students had their bilateral tonsils measured by ultrasound.The left and right diameters of the tonsils,the anterior and posterior diameters,the longitudinal maximum oblique diameters and the distance between the medial and medial sides of the tonsils were measured,and the tonsil volume was calculated.(7)statistical analysis of the dataobtained.Results 1.The detection rate of tonsil by ultrasound was 95.5%(235/246);2.Statistical analysis was conducted on the data such as age,gender,height and weight.There was no statistical difference between the above data in the operation group and the non-operation group.3.The tonsil volume was estimated by ultrasound to be(1.78±0.93)ml in 131 patients with unobtrusional expirations,and(2.96±1.17)ml in 121 patients with dyspnea.4.60 tonsils of 30 patients were measured,and the actual volume and the estimated volume were(3.90±1.33)ml and(3.60 ± 1.58)ml,respectively,with no statistically significant difference(t=0.741,P=0.462).5,collected with breathing disorders symptoms before and after about 121 children tonsil of diameter,diameter,vertical oblique biggest diameter and the distance between the left and right sides of the tonsils inside,ROC statistical analysis,compare the four degree of sensitivity and specific measurements,it is concluded that the tonsils around inside diameter and spacing of the cutoff value limited sensitivity and the highest specific degree,clinical significance,diameter about spacing cutoff value about the left side of the diameter of 15.95 mm,about the right diameter 16.75 mm,within the limit of spacing of10.85 mm;6.The range of the amygdala in the amygdala was between 11.0mm-13.9mm,and there was little difference between the number of tonsillar enlargement of degree I and degree II in the group.After the range of amygdala in the group was ≥ 14 mm,the number of tonsillar enlargement of degree I in the group was far more than that of degree II,suggesting that the range was greater than 14 mm.7.According to binary Logistic regression analysis,the image prediction model was obtained: Ln{pre/(1-pre)}= 0.339 x mean diameter + spacing x(-0.308)-2.367(mean OR =1.404,spacing OR =0.735,P < 0.005),Ln{pre/(1-pre)}= 0.496 x mean tonsil volume-2.132(mean OR =1.642,P < 0.05),,respectively,it was concluded that when pre > 41.3% could be recommended for surgery.Conclusion 1.High detection rate of tonsil by ultrasound;2.Tonsil volume less than(1.78±0.93)ml did not affect respiratory patency,while tonsil volume greater than(2.96±1.17)ml did not affect respiratory patency.3.The accuracy of preoperative ultrasound evaluation of tonsil volume was very high,and there was a positive correlation between ultrasound and the actual measurement of tonsil volume(r2=0.853,P < 0.005).4.Ultrasonic measurement oftonsil volume ≥(3.60 ± 1.58)ml,combined with clinical symptoms,surgery can be recommended;5.The truncation values of the left and right diameters of the amygdala and the interval between the left and right diameters were the most clinically significant.The truncation values of the left and right diameters were 15.95 mm,16.75 mm,and 10.85 mm respectively.6.If the tonsil volume is larger than(2.96 ± 1.17)ml,the tonsil enlargement degree is less than I degree by oropharyngeal examination,and the interval between the limits of tonsil enlargement is ≥14mm by oropharyngeal examination,it can be inferred that this type of tonsil belongs to the embedded tonsil.7.The left and right diameters,spacing and volume of the amygdala are good indicators for evaluating snoring caused by enlarged amygdala.8,the image binary Logistic regression analysis forecasting model: Ln {pre/(1-pre)} the mean diameter = 0.339 x x + spacing(0.308)to 2.367(average diameter about the OR = 1.404,the distance between the OR = 0.735,and P < 0.005),Ln {pre/(1-pre)} = 0.496 x tonsil volume average 2.132(the mean volume OR value = 1.642,P < 0.05),the two calculated separately,come to the conclusion that when the pre > 41.3% can be recommended surgery.;9.Ultrasonic examination of children’s tonsil volume is a relatively ideal objective method.Preoperative ultrasonic evaluation of the anatomy and size of the tonsil has a good guiding significance for tonsil surgery.