Objective To evaluate the efficacy of tonsils and adenoid ablation by plasma-mediated temperature-controlled radiofrequency for obstructive sleep apnea hypopnea syndrome (OSAHS) in children. Methods From August 2005 to May 2007,43 cases with OSAHS received tonsillectomy and adenoid radical resection with Evac70 tool bit using a plasma-mediated temperature-controlled system. The clinical data of the patients were reviewed. Results The mean operation time was 16 minutes,ranged from 10 to 20 minutes. During the operation,the patients had a mean of 3 ml hemorrhage (1 to 10 ml). Compared with the preoperative examination,the patients showed significantly lowered AHI [(14.6?4.6) times/h vs (4.2?2.7) times/h,t=8.563,P=0.000] and OAI [(6.9?3.5) times/h vs (3.3?1.4) times/h,t=5.443,P=0.000] and increased minimum blood oxygen saturation [(85.7?4.4)% vs (99.7?0.2)%,t=-6.687,P=0.000]. Conclusions The ablation of the tonsil and adenoid using plasma-mediated temperature-controlled radiofrequency is effective and safe for children with OSAHS.

OBJECTIVE: To compare the effect of the medical and surgical treatment of pediatric chronic rhinosinusitis (CRS). METHOD: Seventy-two cases of pediatric CRS were randomly divided into medical group (35 cases) and surgical group (37 cases). The patients in medical group received a 12-week course of clarithromycin, alkaline nasal douche and intranasal mometasone furoate. The patients in surgical group underwent adenoidectomy or (and) tonsillectomy or ESS. All patients underwent pre- and post-treatment assessments of visual analogue score (VAS) and nasal endoscopy. The assessments of CT were arranged before starting the treatment and post-treatment in 12-month. RESULT: Both groups of pediatric CRS significantly improved in VAS and endoscopic parameters of CRS in all stages. There were no significant difference between two groups in 1-month (P > 0.05). The surgical group demonstrated greater change than medical group in 3-month, 6-month and 12-month (P < 0.01). In surgical group, 37 cases underwent three different styles of operation: adenoidectomy (n = 19), adenoidectomy and tonsillectomy (n = 10) and ESS (n = 8). VAS and endoscopic parameters were not significantly different among three groups in all stages except in 1-month. CONCLUSION The results of this study warrant further that both medical and surgical treatment of pediatric CRS significantly improve in VAS and endoscopic parameters of CRS. The mainstay of management is medical treatment. Long-term, low-dose macrolide is an effective therapy and a valid alternative in pediatric CRS. Surgical intervention is necessary for cases that do not respond to prolonged course medical treatment. Adenoidectomy or (and) tonsillectomy seems to be a recommended surgical procedure for children with adenoid or (and) tonsil hypertrophy.
Adenoidectomy ; Adolescent ; Child ; Chronic Disease ; Clarithromycin ; therapeutic use ; Female ; Humans ; Male ; Mometasone Furoate ; Pregnadienediols ; therapeutic use ; Sinusitis ; drug therapy ; surgery ; Tonsillectomy ; Treatment Outcome

Objective:To study the clinical effects of modified surgical method with H-uvulopalatopharyngoplasty(H-UPPP)and traditional surgical method in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)in children.Methods:The clini-cal data of 364 pediatric patients with OSAHS were retrospectively analyzed.The patients were divided into 2 groups and treated by low-temperature plasma knife radio frequency ablation for bilateral tonsil removal combined with H-UPPP(group A,n=204)and low-temperature plasma knife radio frequency ablation only(group B,n=160)respectively.The operative time,intraoperative bleed-ing,postoperative secondary bleeding,VAS of pain following operation,postoperative traumatic white film shedding time,OAH1,LSaO2,ESS scores and complications of the 2 groups were compared.Results:In group A the operative time,intraoperative bleed-ing,VAS,OAHI and ESS scores were lower than those in group B(P＜0.05),wile postoperative traumatic white film detachment time and LSaO2 were higher(P＜0.05).No statistically significant difference in terms of the number of cases of postoperative seconda-ry bleeding and complications was observed between the 2 groups(P＞0.05).Conclusion:The combination of low-temperature plas-ma radio frequency ablation and H-UPPP for the treatment of OSAHS may provide clear intraoperative view,and may improve the treatment effects.

OBJECTIVE: To investigate the change of serum leptin levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after surgery. METHOD: The cases were divided into effective (n=44) and non-effective (n=13) groups according to PSG. The effective cases were divided into decreased (> or = 5%, n=25) and non-decreased(<5%, n=19) BMI. The level of serum leptin was detected by radioimmunoassay. RESULT: The level of serum leptin after treatment (9.1 +/- 2.6 microg/L) was as high as before treatment (9.3 +/- 2.3 microg/L) in 13 non-effective cases. The level of serum leptin after treatment (7.15 +/- 1.23 microg/L) was significantly decreased than before treatment (12.79 +/- 2.98 microg/L) in 25 cases of decreased BMI (> or = 5%). The level of serum leptin after treatment (7.15 +/- 1.23 microg/L) was significantly decreased than before treatment (12.79 +/- 2.98 microg/L) in 19 cases of non-decreased BMI (<5%). Leptin level of all cases showed a positive correlation with AHI (P < 0.01). CONCLUSION The level of serum leptin in patients with OSAHS are increased. The serum leptin level of effective patients with OSAHS after treatment was significantly decreased. The level of serum leptin reflects the degree of AHI in patients with OSAHS.
Adult ; Aged ; Humans ; Intraoperative Period ; Leptin ; blood ; Middle Aged ; Sleep Apnea, Obstructive ; blood ; surgery