腭扁桃体切除术后舌扁桃体肥大的临床分析

Clinical case analysis of lingual tonsillar hypertrophy following palatine tonsillectomy

摘要:

目的 分析腭扁桃体切除术后舌扁桃体肥大的临床病例资料，探讨腭扁桃体切除术后患者远期并发舌扁桃体肥大的临床特点与临床意义，为临床诊疗及术后随访提供参考依据。方法 回顾性分析解放军总医院第六医学中心耳鼻咽喉头颈外科2012年5月—2025年5月收治的 10例腭扁桃体切除术后并发舌扁桃体肥大患者的临床资料,其中男7例，女3例。所有患者既往均有腭扁桃体切除病史，其中4例患者行双侧腭扁桃体切除术，2例患者行腭咽成形术联合双侧腭扁桃体切除术，3例患者行双侧腭扁桃体联合腺样体切除术，1例患者行单侧腭扁桃体切除术。2例患者无明显咽喉部不适症状，其余患者均存在咽部异物感，其中2例伴有说话含糊、含球音，2例合并睡眠打鼾伴憋气，1例伴呛咳症状。所有患者均在全麻下行舌扁桃体切除术。结果 10例患者手术均顺利完成，术后患者恢复良好，仅1例患者术后5 d出现术区出血，经对症处理后痊愈。患者术后随访1~13年，咽喉异物感、打鼾憋气、言语异常及呛咳等不适症状均得到明显改善。结论 腭扁桃体切除术后，部分患者并发舌扁桃体肥大，临床需引起重视，加强术后定期随访，对出现典型症状的患者及时干预，改善患者预后及生活质量。

Abstract:

Objective To analyze clinical case data of lingual tonsil hypertrophy following palatine tonsillectomy to explore the clinical characteristics and significance of lingual tonsil hypertrophy as a long-term complication after palatine tonsillectomy, providing reference for clinical diagnosis, treatment, and postoperative follow-up.Methods Clinical data of 10 patients diagnosed with lingual tonsil hypertrophy following palatine tonsillectomy admitted to the Department of Otolaryngology Head and Neck Surgery, the Sixth Medical Center of Chinese PLA General Hospital from May 2012 to May 2025 were retrospectively analyzed. Among the 10 patients, 7 were male and 3 were female. All patients had a prior history of palatine tonsillectomy, including 4 cases of bilateral palatine tonsillectomy, 2 cases of uvulopalatopharyngoplasty combined with bilateral palatine tonsillectomy, 3 cases of bilateral palatine tonsillectomy plus adenoidectomy, and 1 case of unilateral palatine tonsillectomy. Of them, 2 patients had no obvious symptoms of pharyngeal discomfort. The remaining patients all reported a sensation of foreign body in the pharynx, including 2 with muffled speech and globus sensation, 2 with snoring and apnea, and 1 with choking cough. All patients underwent lingual tonsillectomy under general anesthesia.Results All the 10 patients underwent successful surgery with good overall postoperative recovery. Only one patient experienced surgical site bleeding on the 5^th postoperative day, which resolved completely after appropriate treatment. All patients were followed up for 1 to 13 years postoperatively, during which symptoms such as foreign body sensation in the pharynx, snoring and apnea, speech abnormalities, and choking cough showed significant improvement, confirming the effectiveness of the treatment.Conclusions Lingual tonsil hypertrophy may occur as a complication after tonsillectomy, which deserves clinical attention. Regular postoperative follow-up should be strengthened, and timely intervention should be provided for patients presenting typical symptoms to improve prognosis and quality of life.