Comparison of the Postoperative Outcome for Pediatric Obstructive Sleep Apnea According to the Type of the Tonsillectomy
10.3342/kjorl-hns.2018.00899
- Author:
Kyoung Rai CHO
1
;
Jung Heob SOHN
Author Information
1. Department of Otorhinolaryngology-Head and Neck Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea. entsohn@gmail.com
- Publication Type:Original Article
- Keywords:
Obstructive sleep apnea;
Pediatrics;
Postoperative pain;
Tonsillectomy
- MeSH:
Adenoidectomy;
Child;
Female;
Hemorrhage;
Humans;
Hypertrophy;
Methods;
Oxygen;
Pain, Postoperative;
Palatine Tonsil;
Pediatrics;
Quality of Life;
Recurrence;
Sleep Apnea Syndromes;
Sleep Apnea, Obstructive;
Tonsillectomy
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
2019;62(8):448-456
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Partial intracapsular tonsillectomy and adenoidectomy (PITA) has become a well-recognized technique for tonsillectomy in children. Several studies have reported that PITA shows better postoperative morbidity compared to the conventional technique. However, there is still concern about the regrowth of remnant tonsil tissues. The authors evaluated the postoperative results of PITA, combined extracapsular and intracapsular tonsillectomy, and conventional tonsillectomy. SUBJECTS AND METHOD: The authors studied 97 children (male: 62, female: 35) aged 2 to 13 years old, who underwent tonsillectomy and adenoidectomy (PITA, combined extracapsular and intracapsular tonsillectomy, and conventional tonsillectomy). The degree of adenotonsillar hypertrophy, apnea-hypopnea index and lowest oxygen saturation was confirmed for all subjects. Operation time, quality of life, scale for postoperative pain, frequency of postoperative bleeding, and recurrence with tonsillar regrowth were compared after surgery performed by different surgical procedures. RESULTS: Regardless of the surgical technique, all the cases presented significant improvement in the quality of life before and after surgery. On the day of surgery and four days after surgery, PITA showed superior results in terms of postoperative pain level compared to the conventional technique. There were no statistically significant results with respect to the operation time and postoperative bleeding. Six months after the surgery, the recurrence of sleep apnea due to the regrowth of remaining tonsil was not obvious. CONCLUSION: Tonsillectomy technique preserving tonsillar capsule may show better results on early postoperative pain. It can be a good alternative to the conventional technique in surgical treatment for pediatric obstructive sleep apnea in terms of early postoperative pain control.
