Chirurgie im Rachen – Adenotomie, Tonsillektomie, Tonsillotomie und Eingriffe bei obstruktivem Schlafapnoe-Syndrom

Abstract

Surgery in the pharynx belongs to the most frequent otorhinolaryngological procedures. Adenoidectomy and tonsillectomy are amongst the most frequent surgeries at all and belong to the first procedures which are performed by otorhinolaryngology residents during their specialist training. Therefore, it is essential to study early during the specialist training the most frequent pharyngeal procedures, surgical techniques, complications and outcome. A series of excellent clinical trials and meta-analyses have been published in the recent year demonstrating that adenoidectomy is an important therapy element in pediatric otorhinolaryngology. In particular due to the developments in the field of laser surgery, tonsillotomy could experience a revival in the recent years. The indication spectrum is still widening. There are many fields where clinical trials are needed to proof if tonsillotomy is as effective as tonsillectomy but with the advantage of lower morbidity. There are manifold pharyngeal surgical procedures to treat patients with obstructive sleep apnea. These surgical techniques have proved valuable especially as alternative to conservative therapy and in case of treatment failure under airway pressure therapy. As the obstruction during this type of sleep-related respiratory disorder is often not located at one anatomical site, an individual combination of several pharyngeal and other surgeries are needed for an effective treatment of the patient. The present article gives an overview of the most important pharyngeal surgeries for future otorhinolaryngologists under specialist training.

Verändert die Einführung eines präoperativen Gerinnungsbogens die Nachblutungsrate nach Adenotomie?

“…Die Adenotomie (AT) stellt einen der häufigsten operativen Eingriffe im Kindesalter dar [1]. Das perioperative Risiko einer Nachblutung ist gering, und die Nachblutungsraten schwanken je nach Literaturangaben zwischen 0,1 und 8,1 % [2,3,4].…”

Age-related changes of the innate immune system of the palatine tonsil in a healthy cohort

“…The highest prevalence of tonsillectomies is seen in the age group of less than 18 years (2) and decreases with higher age (3). Most of these surgeries are indicated to treat tonsil hyperplasia, recurrent acute tonsillitis, or a peritonsillar abscess (2).…”

Kommentar der Schriftleitung

“…Die Autoren schlussfolgern, dass die endonasale endoskopische Resektion von Choanalatresien mit Erweiterung der Choane Richtung Schädelbasis, Reduktion des Nasenbodens und Abtragen der hinteren Septumanteile eine schonende und erfolgreiche Therapieoption darstellt. Die Arbeit ist eine gute Ergänzung zu bereits vorliegenden Übersichten, siehe [10,11]. Schließlich wird das seltene Krankheitsbild der nekrotisierenden zervikalen Lymphadenopathie mit unklaren Hautläsionen erörtert und besprochen [12].…”