PURPOSE: This study aimed at developing a critical pathway for the children undergoing tonsillectomy. METHOD: Six steps of critical pathway developmental process were used based on the literature review. The researcher reviewed 70 medical records of children who had tonsillectomy between January 4th and April 30th, 2001. They received 76 kinds of medical services during six average hospitalization days. Five of them had post-operative bleeding problem. A professional group carefully screened 67 out of 76 medical services and adopted them with five average hospitalization days as the critical pathway framework. This framework was applied to 34 children undergoing tonsillectomy during June 1st through August 21st, 2001. RESULT: The children who used the pathways with five average hospitalization days had post-operative bleeding problem. In other words, the group who utilized the critical pathway resulted in better outcomes compared to the group who did not use the tool. CONCLUSION: Since the critical pathway is an efficient care management tool, nurses need to participate more positively participate in developing and utilizing the tool for other health problem.
Child ; Critical Pathways* ; Hemorrhage ; Hospitalization ; Humans ; Medical Records ; Methods ; Tonsillectomy*

Adult ; Female ; Humans ; Male ; Tonsillectomy ; instrumentation ; methods ; Ultrasonic Therapy ; instrumentation

Child ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; physiopathology ; surgery ; Tonsillectomy ; methods

The feasibility of partial tonsillectomy was reviewed. Compared with total tonsillectomy, partial tonsillectomy has the advantages of less postoperative pain, lower postoperative bleeding rate and faster recovery. Partial tonsillectomy has a potential for tonsil regrowth and its efficacy in treating sleep-disordered breathing in children is still controversial.
Humans ; Sleep Apnea, Obstructive ; surgery ; Tonsillectomy ; adverse effects ; methods

The purpose of this study was to evaluate the effect of informational intervention on postoperative pain following tonsillectomy in children. This study was performed on 30 children, aged 5-15 years, undergoing tonsillectomy and their parents by providing informational intervention with colored figure; operation procedure and information. Pain assessment was done by Pain Questionnaire. The results from this study were as follows : 1. Children in experimental group with mean 16.07 had lower pain scores than control group with mean 14.87 at 4th hours after operation(p < 0.05). It showed "significant difference" and first hypothesis was adopted. 2. Children in experimental group with mean 20.60 had lower pain scores than control group with mean 17.27 at 8th hours after operation(p < 0.05). It showed "significant difference" and second hypothesis was adopted. 3. Children in experimental group with mean 28.80 had lower pain scores than control group with mean 25.70 at 24th hours after operation(p < 0.05). It showed "significant difference" and third hypothesis was adopted. 4. When we analyzed the time difference and difference between two groups simultaneously by repeated measure ANOVA, the significant difference was not found. And so "the experiential group with operation-related information will show the lower pain sense than the control group just as the time flows after operation", fourth hypothesis was rejected. Generally, it was found that providing information about operation to children and their parents reduced effectively postoperative pain in children, but in clinical settings there are minimum preoperative information-providing because of insufficient time and inconvenience although nursing staffs and patients know its needs. Conclusionally providing preoperative information should help children and their parents cope with Pre, Peri and Post operative events effectively.
Adenoidectomy ; Analysis of Variance ; Child* ; Humans ; Methods ; Nursing Staff ; Pain Measurement ; Pain, Postoperative* ; Parents ; Tonsillectomy* ; Child Health

Adolescent ; Child ; Child, Preschool ; Electrosurgery ; Female ; Humans ; Male ; Tonsillectomy ; instrumentation ; methods

Adult ; Female ; Humans ; Male ; Middle Aged ; Palatine Tonsil ; surgery ; Tonsillectomy ; instrumentation ; methods

BACKGROUND AND OBJECTIVES: Adenotonsillectomy is a highly effective treatment for obstructive sleep apnea symptoms in children. In this study, to investigate the effects of adenotonsillectomy on snoring in children, we analyzed and compared snoring sounds recorded using a smartphone before and after adenotonsillectomy. We also determined whether it is possible to use acoustic analysis to monitor snoring in children. SUBJECTS AND METHOD: A total of 20 children diagnosed with snoring and had undergone adenotonsillectomy performed by the same surgeon were enrolled for the study. Snoring was recorded by patients' caregivers using smartphones before and after the surgery (mean of 8.5 days) and analyzed. Questionnaires were conducted by telephone survey at 3 months and 12 months after the surgery to determine snoring status. RESULTS: Snoring completely ceased in 25% of patients and decreased in the remaining 75% during the immediate follow-up period (mean of 8.5 days; from 58.07±9.35 dB to 42.59±7.89 dB, p<0.001), and disappeared in all of the patients by 3 months after adenotonsillectomy. Snoring recurred only in one patient after 1 year. A frequency analysis offered no evident statistically significant changes during the immediate follow-up period, indicating that although snoring volume had decreased, no anatomical change had developed in the patient. Spectrography was useful in investigating the snoring patterns before and after adenotonsillectomy. CONCLUSION: The results showed that acoustic analysis of snoring sounds obtained using a smartphone may be useful for monitoring snoring during follow-up after adenotonsillectomy in pediatric snoring patients.
Acoustics* ; Caregivers ; Child* ; Follow-Up Studies ; Humans ; Methods ; Sleep Apnea, Obstructive ; Smartphone* ; Snoring* ; Telephone ; Tonsillectomy

BACKGROUND AND OBJECTIVES: This study was performed to evaluate the long-term effect of adenotonsillectomy on childhood growth by examining preoperative growth status and presenting symptoms. SUBJECTS AND METHOD: One hundred and four patients who underwent adenotonsillectomy from January to December 2009 were enrolled in this study. Clinical data were collected from medical record reviews and through the administered questionnaire. We investigated symptoms and growth changes during 5 years following the surgery. RESULTS: The mean age of patients was 6.0±1.94 years (range, 3–10), with the male to female ratio of 62:42. Pre-operative symptoms were significantly improved after the surgery. The mean pre-operative height and weight percentiles were 53.6±27.4 and 59.6±29.2 at initial evaluation, and 67.1±26.4 and 59.6±28.6 at 5 years post adenotonsillectomy (p < 0.001, p=0.989), respectively. An increase in height percentile was more prominent in patients whose pre-operative height percentile was less than 50 compared to those with a percentile of 50 or more (p < 0.001). Weight percentile was significantly increased in those with the pre-operative weight percentile of less than 50 and decreased in patients with a percentile of 50 or more. CONCLUSION: Adenotonsillectomy has a positive effect on height growth in children with adenotonsillar hypertrophy, especially in patients whose height percentile is less than 50. Weight gain also can be expected in preoperative low-weight children.
Adenoidectomy ; Child ; Female ; Humans ; Hypertrophy ; Male ; Medical Records ; Methods ; Tonsillectomy ; Weight Gain

BACKGROUND AND OBJECTIVES: Pediatric obstructive sleep apnea (OSA) can have an effect on the quality of life (QOL) such as behavior, school performance, emotional distress and daytime function. We aim to verify changes in sleep disordered breathing based on polysomnographic findings and disease specific health related QOL before and after adenotonsillectomy in Korean children with OSA. SUBJECTS AND METHOD: A total 20 children aged 3 through 13 years old (mean age=6.7 years old and male/female=14/6) with OSA were included. We evaluated respiratory disturbances in patients using the standard polysomnography and the OSA-specific health related QOL based on Korean Obstructive Sleep Apnea-18 Survey (KOSA-18). RESULTS: There were significant improvements in apnea-hypopnea index (from 9.4±7.4 to 1.1±0.8 events/hour, p<0.001) and total score of KOSA-18 (71.3±26.0 to 33.6±10.7, p<0.001) after adenotonsillectomy. CONCLUSION: Sleep disordered breathing and QOL improve significantly after adenotonsillectomy in Korean OSA children.
Adenoidectomy ; Child ; Humans ; Methods ; Polysomnography ; Quality of Life* ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive* ; Tonsillectomy