| Objective:To investigate the changes of eustachian tube function in early stage after low temperature plasma adenoidectomy.To investigate the changes of nasopharyngeal volume at early stage after low temperature plasma adenoidectomy.To evaluate the effect of acoustic rhinometry after adenoidectomy.Methods:From May 2019 to September 2019,56 children(112 ears)who were treated in our hospital due to "Chronic tonsillitis with Adenoidal hypertrophy"were given nasopharyngoscopy,acoustic rhinometry examination,and acoustic impedance.After the examination,low-temperature plasma adenoidectomy and bilateral tonsillectomy were performed.bilateral tonsillectomy examination and acoustic impedance examination were performed on the first day,the fifth day,and one month after the operation.And another nasopharyngeal endoscopic examination were performed on one month after the operation.In addition,in order to further explore the function of the eustachian tube,the groups were grouped according to the acoustic impedance test results:group A:adenoid hypertrophy alone and group B:adenoid hypertrophy combined with abnormal tympanic pressure.SPSS 22.0 statistical software was used for statistical analysis of the data results.Results:1.The function of eustachian tube in early stage changed obviously after low temperature plasma adenoidectomy.There were 15 cases,65 cases,55 cases and 1 case with eustachian tube dysfunction before surgery,the first day,the fifth day,and one month after the surgery.Postoperative day 1,shown as the ear of the eustachian tube dysfunction were increased significantly compared with before surgery(chi-square=62.500,P<0.05),postoperative day 5,performance for the ear of the eustachian tube dysfunction were no obvious difference compared with the postoperative day 1(chi-square=2.209,P=0.137),and postoperative 1 month except 1 case of ear of C type figure,more than check ear acoustic immittance results are shown as type A figure.Between A and B two groups of early postoperative eustachian tube function were no significant differences(postoperative day 1 and 5 days respectively:chi square=0.15,P>0.05,chi-square=0.107,P>0.05),It can be seen that the eustachian tube will have obvious dysfunction in the early stage after low-temperature plasma adenoidectomy,and this temporary dysfunction lasts at least until the 5th day after operation,and can basically return to normal after 1 month.In addition,the early effects of low-temperature plasma adenoidectomy on eustachian tube function have nothing to do with whether the tympanic pressure is normal before surgery.2.The nasopharyngeal volume was significantly changed in the early stage after low-temperature plasma adenoidectomy.The nasopharyngeal volume measured by acoustic rhinometry before,on the 1st day,on the 5th day after the operation,and after 1 month after the operation were:20.166 ±0.960cm3,15.930 ±0.802 cm3,18.875 ± 0.869 cm3,and 29.575± 0.669 cm3.The nasopharyngeal volume on the first day after surgery was significantly lower than that before the operation(P=0.000),and the nasopharyngeal volume on the fifth day after the operation was basically the same as that before the operation(P=0.593).The overall elevation was preoperatively,and the elevation of the nasopharyngeal curve was the most significant(P=0.000).In addition,there was a significant statistically negative correlation between adenoid size and nasopharyngeal volume under preoperative nasopharyngoscopy(r=-0.402,P<0.05).acoustic rhinometry assessment of the nasopharyngeal volume is accurate and sensitive,which can be used as an inspection method to evaluate adenoid postoperative follow-up and efficacy evaluation.3.Correlation analysis was performed between nasopharyngeal volume and eustachian tube function.There was no significant statistical correlation between nasopharyngeal volume and acoustic impedance:postoperative day 1:r=-0.177,P=0.274,the 5th day after operation:r=0.033,P=0.838.It can be seen that the volume change of nasopharyngeal cavity in the early postoperative period does not directly affect the function of the eustachian tube.Conclusions:1.Both low-temperature plasma adenoidectomy and traditional adenoidectomy can affect the eustachian tube function in the early postoperative period,but the degree of influence is not exactly the same.And this effect is mainly caused by adenoidectomy itself,and there is no absolute correlation with preoperative tympanic pressure.With the disappearance of edema in the operating cavity and the recovery of mucosal function and ventilation function,the eustachian tube function can gradually return to normal.This change can provide strong guidance for the formulation of postoperative clinical work and communication with the family members of patients.2.The nasopharyngeal volumey will decrease significantly in the early stage after low-temperature plasma adenoidectomy,and the nasopharyngeal mucosa will return to normal under nasopharyngoscope one month after the operation,and the nasopharyngeal volume will also increase significantly compared with that before operation.acoustic rhinometry can not only objectively record the postoperative change of nasopharyngeal volume,and clarify the influence of low-temperature plasma adenoidectomy on the early postoperative nasopharyngeal cavity,but also be used as a method of follow-up and efficacy evaluation after adenoidectomy in clinical practice.3.There was no significant correlation between the nasopharyngeal volume and the results of acoustic impedance after adenoid surgery,and the nasopharyngeal volume could not directly affect the function of the eustachian tube in the early postoperative period.The effect of adenoidectomy on the function of the eustachian tube is not only related to the surgical method,nasopharyngeal cavity ventilation,nasopharyngeal cavity infection control and mucosal recovery,but also related to the duration of the disease in the history and whether there is repeated upper respiratory tract infection,which should not be neglected in clinical treatment. |
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