小儿重度和极重度阻塞性睡眠呼吸暂停在全扁桃体切除术与囊内扁桃体切除术后的预后

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2025-09-13 DOI:10.1002/lio2.70255

Jordyn A. Hurly, Anna Christina Clements, Marisa A. Ryan, Megan Ballard, Carolyn Jenks, David E. Tunkel, Jonathan M. Walsh

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引用次数: 0

摘要

目的扁桃体囊内切除术可减少术后疼痛，缩短恢复时间，降低出血风险。没有研究专门调查其在重度或极重度阻塞性睡眠呼吸暂停综合征（OSAS）患者中的应用。我们的研究旨在报告严重OSAS患儿在囊内（IT）和全扁桃体切除术（TT）后的严重OSAS结果。方法：我们进行了一项回顾性研究，纳入了2018年6月至2022年6月在三级保健中心接受腺扁桃体切除术或扁桃体切除术的≤18岁的患者。术前将患者分为严重OSAS （OAHI≥10）和非常严重OSAS （OAHI≥30）。主要结局包括术后多导睡眠图测量的阻塞性呼吸暂停低通气指数（OAHI）、氧饱和度最低点、高碳血症的存在和呼吸障碍指数（RDI），以及需要CPAP的残余OSAS。结果本组57例患者平均年龄为4.5（±2.9）岁，男性占59.7%。两组患者术后残余OSAS结果均无显著差异，随访多导睡眠图平均时间为237（范围：24-885）天。结论：我们的研究表明，对于重度OSAS和极重度OSAS，术后OAHI的主要结局在手术技术方面没有差异；然而，长期的术后结果仍然是需要的。证据级别4。

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Pediatric Outcomes for Severe and Very Severe Obstructive Sleep Apnea After Total vs. Intracapsular Tonsillectomy

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Pediatric Outcomes for Severe and Very Severe Obstructive Sleep Apnea After Total vs. Intracapsular Tonsillectomy

Objectives

Intracapsular tonsillectomy is associated with decreased postoperative pain, shortened recovery, and decreased bleeding risk. No study has specifically investigated its use in patients with exclusively severe or very severe obstructive sleep apnea syndrome (OSAS). Our study aimed to report severe OSAS outcomes following intracapsular (IT) compared to total tonsillectomy (TT) in pediatric patients with severe and very severe OSAS.

Methods

We conducted a retrospective study including patients ≤ 18 years of age who underwent adenotonsillectomy or tonsillectomy between June 2018 and June 2022 at a tertiary care center. Patients were categorized preoperatively as having severe OSAS (OAHI ≥ 10) or very severe OSAS (OAHI ≥ 30). Primary outcomes included obstructive apnea-hypopnea index (OAHI), oxygen saturation nadir, presence of hypercarbia, and respiratory disturbance index (RDI) as measured on postoperative polysomnography, as well as residual OSAS requiring CPAP.

Results

Of 57 patients in this study, the mean age was 4.5 (±2.9) and 59.7% were male. There was no significant difference in postoperative residual OSAS outcomes following surgery for patients in either severity group, with a mean time to follow up polysomnogram of 237 (range: 24–885) days.

Conclusion

Our study reveals that for both severe OSAS and very severe OSAS, there is no difference in the primary outcome of postoperative OAHI with regard to surgical technique; however, long-term postoperative outcomes are still needed.