Korean J Otorhinolaryngol-Head Neck Surg.  2019 Aug;62(8):448-456. 10.3342/kjorl-hns.2018.00899.

Comparison of the Postoperative Outcome for Pediatric Obstructive Sleep Apnea According to the Type of the Tonsillectomy

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea. entsohn@gmail.com

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.

Keyword

Obstructive sleep apnea; Pediatrics; Postoperative pain; Tonsillectomy

MeSH Terms

Adenoidectomy
Child
Female
Hemorrhage
Humans
Hypertrophy
Methods
Oxygen
Pain, Postoperative
Palatine Tonsil
Pediatrics
Quality of Life
Recurrence
Sleep Apnea Syndromes
Sleep Apnea, Obstructive*
Tonsillectomy*
Oxygen
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