Problemi correnti
Fibro-endoscopia dell’ostruzione del cavo rino-faringeo da iupertrofia adenoidea
FIBERENDOSCOPIC ASSESSMENT OF RHINOPHARYNGEAL OBSTRUCTION DUE TO ADENOIDAL HYPERTROPHY
PASQUALE CASSANO, MATTEO GELARDI
Clinica Otorinolaringoiatrica, Università di Bari
Aprile 2000 - pagg. 239 -244
Abstract
Transnasal fiberendoscopy of the nasopharinx is the easiest and most effective way to assess
adenoidal hypertrophy in children. On this basis, the Authors proposed a 4-stage
classification to guide the case management: the first two stages are characterized by moderate
or discrete adenoidal hypertrophy, and adenoidectomy is not necessary; in 4th stage
obstruction adenoidectomy is mandatory. The most important therapeutic problems are
present in 3rd grade obstruction, characterized by hypertrophic adenoids taking up about
3/4 of the rhinopharynx. In this group, which includes the largest number of hypertrophic
adenoids, the therapeutic strategy must take into account the existance of obstructed
breathing and of frequent complications such as recurrent otites, sinusites, sleep apnea etc.
The Authors conclude that when transnasal fiberendoscopy shows important though incomplete
obstruction, the decision about treatment must be based on complementary investigations
to assess the presence and severity of complications.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
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8. Zwillich CW, Pickett C, Hanson FN, Weil YV. Disturbed sleep and prolanged apnea during nasal obstruction in normal men. Am Rev Respir Dis 1981;124:158-60.
9. Cantarella G, De Berti G. Valutazione dell’ostruzione respiratoria nasale cronica del bambino mediante rinofaringoscopia a fibre ottiche e rinomanometria. Acta Otorhinol Ital 1990;10:59-72.
10. Fabbri F, Vicini C, Amaretti B, Pieri F, Arbelli F. La fibroendoscopia delle VADS nella pratica ambulatoriale. Atti delle Sedute Scientifiche LXXVI Congresso Nazionale SIO, Rieti, 24-27 maggio 1989.
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12. Vicini C. L’endoscopia nasale con ottica flessibile. Atti del XVII Convegno Nazionale di Aggiornamento A.O.O.I. su “La diagnostica endoscopica in Otorinolaringoiatria oggi. pagg.41-53; Sanreno 15-17 ottobre 1993.
13. Gattes GA, Muntz HR, Gaylis B. Adenoidectomy and otitis media. Ann Otol Rhinol Laryngol 1991;2 4-32(Suppl 155)1.
2. Cole P, Haight JSJ. Mechanism of nasal obstruction in sleep. Laryngoscope 1984;94: 1557-9.
3. Dayal VS, Phillipson EA. Nasal surgery in the management of sleep apnea. Ann Otol 1985;94:550-4.
4. Lavie P, Gertner R, Zomer Y, Podoshin L. Breathing disorders in sleep associated with “microarousals” in patients with allergic rhinitis. Acta Otolaryngol 1981;92:529-33.
5. Lavie P, Zomer J, Eliaschar I, Jochim Z, Halpern E, Rubin AH, Arroy G. Excessive daytime sleepiness and insomnie. Arch Otolaryngol 1982;108:373-7.
6. Levy AM, Tabakin BS, Harrison YS. Hypertrophied adenoids causing hypertension and severe congestive failure. N Engl J Med 1967;277: 506-11.
7. Olsen RD, Kern EB, Westbrook PR. Sleep and breathing disturbances secondary to nasal obstruction. Otolarryngol Head Neck Surg 1981;89:804-10.
8. Zwillich CW, Pickett C, Hanson FN, Weil YV. Disturbed sleep and prolanged apnea during nasal obstruction in normal men. Am Rev Respir Dis 1981;124:158-60.
9. Cantarella G, De Berti G. Valutazione dell’ostruzione respiratoria nasale cronica del bambino mediante rinofaringoscopia a fibre ottiche e rinomanometria. Acta Otorhinol Ital 1990;10:59-72.
10. Fabbri F, Vicini C, Amaretti B, Pieri F, Arbelli F. La fibroendoscopia delle VADS nella pratica ambulatoriale. Atti delle Sedute Scientifiche LXXVI Congresso Nazionale SIO, Rieti, 24-27 maggio 1989.
11. Grimaldi M., La Rosa R.: Semeiotica endoscopica rinofaringea. Atti del XVII Convegno Nazionale di Aggiornamento A.O.O.I. su “La diagnostica endoscopica in Otorinolaringoiatria oggi, pagg. 55-66; Sanreno 15-17 ottobre 1993.
12. Vicini C. L’endoscopia nasale con ottica flessibile. Atti del XVII Convegno Nazionale di Aggiornamento A.O.O.I. su “La diagnostica endoscopica in Otorinolaringoiatria oggi. pagg.41-53; Sanreno 15-17 ottobre 1993.
13. Gattes GA, Muntz HR, Gaylis B. Adenoidectomy and otitis media. Ann Otol Rhinol Laryngol 1991;2 4-32(Suppl 155)1.