アデノイド口蓋扁桃摘出、アデノイド口蓋扁桃摘出術

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/09/04 00:04:22」(JST)

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Location of the adenoid

Adenoiditis is the inflammation of the adenoid tissue, usually caused by an infection. Adenoiditis is treated using medication (antibiotics and/or steroids) or surgical intervention.

Adenoiditis may present with cold like symptoms. However, adenoiditis symptoms often persist for ten or more days, and often include pus like discharge from nose.

The infection cause is usually viral. However, if the adenoiditis is caused by a bacterial infection, antibiotics may be prescribed for treatment. A steroidal nasal spray may also be prescribed in order to reduce nasal congestion. Severe or recurring adenoiditis may require surgical removal of the adenoids (adenotonsillectomy).

Signs and symptoms

Acute adenoiditis is characterized by fever, runny nose, nasal airway obstruction resulting in predominantly oral breathing, snoring and sleep apnea, rhinorrhea with serous secretion in viral forms and mucous-purulent secretion in bacterial forms. In cases due to viral infection symptoms usually recede spontaneously after 48 hours, symptoms of bacterial adenoiditis typically persist up to a week. Adenoiditis is sometimes accompanied by tonsillitis. Repeated adenoiditis may lead to enlarged adenoids.

Complications

Complications of acute adenoiditis can occur due to extension of inflammation to the neighboring organs.

Etiology

Viruses that may cause adenoiditis include adenovirus, rhinovirus and paramyxovirus. Bacterial causes include Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis and various species of Staphylococcus including Staphylococcus aureus.

Diagnosis

Optical fiber endoscopy can confirm the diagnosis in case of doubt, directly visualizing the inflamed adenoid.

Treatment

In cases of viral adenoiditis, treatment with analgesics or antipyretics is often sufficient. Bacterial adenoiditis may be treated with antibiotics, such as amoxicillin - clavulanic acid or a cephalosporin. In case of adenoid hypertrophy, adenoidectomy may be performed to remove the adenoid.

Epidemiology

Adenoiditis occurs mainly in childhood, often associated with acute tonsillitis. Incidence decreases with age, with adenoiditis being rare in children over 15 years due to physiological atrophy of the adenoid tissue.

External links

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1. 小児における扁桃摘出およびアデノイド切除 tonsillectomy and adenoidectomy in children
2. 小児における閉塞性睡眠時無呼吸の管理 management of obstructive sleep apnea in children
3. 小児における急性中耳炎：再発予防 acute otitis media in children prevention of recurrence
4. 小児における夢遊およびその他の錯眠 sleepwalking and other parasomnias in children
5. 成人における扁桃摘出：適応 tonsillectomy in adults indications

English Journal

The effect of adenotonsillectomy on serum insulin like growth factors and the adenoid/nasopharynx ratio in pediatric patients: A blind, prospective clinical study.

Tatlıpınar A, Atalay S, Esen E, Yılmaz G, Köksal S, Gökçeer T.SourceHaydarpasa Numune Research and Training Hospital, 1st ENT Clinic, Uskudar, Istanbul, Turkey.
International journal of pediatric otorhinolaryngology.Int J Pediatr Otorhinolaryngol.2012 Feb;76(2):248-52. Epub 2011 Dec 10.
OBJECTIVES: Obstructive adenoid and tonsillar hyperplasia may present with retardation of growth. An adenoid-nasopharynx (A/N) ratio determined by means of lateral cephalometric radiographs has long been used as a diagnostic tool in the assessment of adenoid size. This study was designed to investig
PMID 22155086

Incidence of laryngospasm and bronchospasm in pediatric adenotonsillectomy.

Orestes MI, Lander L, Verghese S, Shah RK.SourceNational Capitol Consortium Otolaryngology Residency Training Program, Walter Reed Army Medical Center, Washington, D.C.
The Laryngoscope.Laryngoscope.2012 Feb;122(2):425-8. doi: 10.1002/lary.22423. Epub 2012 Jan 17.
OBJECTIVES/HYPOTHESIS: To evaluate and describe airway complications in pediatric adenotonsillectomy.STUDY DESIGN: Retrospective case-control study.METHODS: A chart review of patients that underwent adenotonsillectomy between 2006 and 2010 was performed. Perioperative complications, patient characte
PMID 22252947

Japanese Journal

喉頭横隔膜症を合併した小児症例のアデノイド・口蓋扁桃摘出術に対する麻酔管理

山本知裕,河野達郎
麻酔 60(2), 214-216, 2011-02
NAID 40018714064

乳幼児OSAHSに対する手術治療の安全性に関する臨床的検討

能田淳平,濱田昌史,松本昇,宋碩柱,兵頭政光
頭頸部外科 = Journal of Japan Society for Head and Neck Surgery 20(1), 57-61, 2010-06-30
幼齢の閉塞性睡眠時無呼吸低呼吸症候群（以下OSAHS）症例に対する外科的治療の安全性を検討するため，2004年4月より2008年12月までに当科にて治療をした147例を年少群（0〜3歳）と年長群（4〜6歳）に分けて比較検討した。検討項目は口蓋扁桃摘出術及びアデノイド切除術の手術時間，術中出血量，術後肺野異常陰影の出現，後出血の有無，術後在院日数である。その結果，年少群のアデノイド切除術において有意 …
NAID 10029078647