腭扁桃体切除术后舌扁桃体肥大的临床病例分析

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。 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月期间收治的10例腭扁桃体切除术后舌扁桃肥大患者的临床资料。 结果：10例患者中男性7例，女性3例，（所有患者既往均有腭扁桃体切除病史，其中4例患者既往行双侧腭扁桃体切除术；2例患者既往行腭咽成形+双侧腭扁桃体切除术；3例患者既往行双侧腭扁桃体+腺样体切除术；1例患者行单侧腭扁桃体切除术。术前2例无明显咽喉部不适症状；其余患者均有咽部异物感，其中2例患者说话含糊、含球音，2例患者伴有打鼾伴憋气，1例患者伴呛咳）均于全麻下行舌扁桃体切除术，术后患者恢复良好，仅1例患者术后5天出现出血，术后随访1-14年，症状改善明显。 结论：双侧扁桃体切除术后，可部分出现舌扁桃体肥大，应引起重视。

Abstract:

Abstract Objective:To analyze clinical cases of lingual tonsillar hypertrophy in patients after palatine tonsillectomy. Methods:Clinical data of 10 patients diagnosed with lingual tonsil hypertrophy following palatine tonsillectomy admitted to the Department of Otorhinolaryngology Head and Neck Surgery, the Sixth Medical Center of Chinese PLA General Hospital from May 2012 to May 2025 were retrospectively analyzed. Results:Among the 10 patients, there were 7 males and 3 females. All patients had a prior history of palatine tonsillectomy, including 4 cases of simple 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. Two patients presented without obvious pharyngeal discomfort preoperatively; the rest complained of foreign body sensation in the pharynx, among whom 2 had muffled speech with globus sensation, 2 suffered from snoring accompanied by apnea, and 1 presented with choking cough. All patients underwent lingual tonsillectomy under general anesthesia. Postoperative recovery was uneventful except for one case of hemorrhage on the 5th postoperative day. The follow-up period ranged from 1 to 14 years，and remarkable relief of symptoms was observed in all patients. Conclusion:Lingual tonsil hypertrophy may occur after bilateral tonsillectomy, which deserves sufficient clinical attention.