Sweeya V Raj, Kelly L Vittetoe, Emily L Mace, Daniel Larson, Amy S Whigham
{"title":"咽成形术并发腺扁桃体切除术治疗儿童阻塞性睡眠呼吸暂停的疗效。","authors":"Sweeya V Raj, Kelly L Vittetoe, Emily L Mace, Daniel Larson, Amy S Whigham","doi":"10.1016/j.ijporl.2025.112571","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study assesses whether surgical procedures to address pharyngeal anatomy performed concurrently with adenotonsillectomy (AT) lead to improved postoperative polysomnogram (PSG) outcomes in children with obstructive sleep apnea (OSA) compared to AT alone.</p><p><strong>Study design/setting: </strong>This is a retrospective cohort study conducted at a tertiary care children's hospital in the southeastern United States.</p><p><strong>Methods: </strong>Patients were identified using Current Procedural Terminology (CPT) codes for pharyngoplasty and AT. Retrospective chart review was conducted to obtain clinical data. Patients were matched by age, body mass index (BMI), and preoperative apnea hypopnea index (AHI) to children who underwent AT alone.</p><p><strong>Results: </strong>Forty-six children who underwent AT with concomitant pharyngoplasty were identified along with 187 patients who underwent AT alone. Age, BMI, and preoperative AHI were significantly higher in the pharyngoplasty + AT group. The pharyngoplasty + AT group demonstrated significantly greater improvement in AHI, REM AHI, and obstructive AHI (oAHI) postoperatively; however, multivariable regression showed that BMI predicted postoperative change in AHI. Twenty children in each group were therefore matched by age, BMI, and preoperative AHI. Subsequent analysis of matched cases revealed no significant difference in surgical outcomes between groups.</p><p><strong>Conclusion: </strong>After controlling for age, BMI, and preoperative AHI, there was no difference between AT with concurrent pharyngoplasty and AT alone with respect to change in AHI or oxygen saturation nadir postoperatively. Ultimately, children who undergo pharyngoplasty in combination with AT are a clinically distinct group, and further randomized controlled trials within this population are necessary to define the role of pharyngoplasty concurrent with AT.</p>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"112571"},"PeriodicalIF":1.3000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Utility of concurrent pharyngoplasty with adenotonsillectomy to treat pediatric obstructive sleep apnea.\",\"authors\":\"Sweeya V Raj, Kelly L Vittetoe, Emily L Mace, Daniel Larson, Amy S Whigham\",\"doi\":\"10.1016/j.ijporl.2025.112571\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study assesses whether surgical procedures to address pharyngeal anatomy performed concurrently with adenotonsillectomy (AT) lead to improved postoperative polysomnogram (PSG) outcomes in children with obstructive sleep apnea (OSA) compared to AT alone.</p><p><strong>Study design/setting: </strong>This is a retrospective cohort study conducted at a tertiary care children's hospital in the southeastern United States.</p><p><strong>Methods: </strong>Patients were identified using Current Procedural Terminology (CPT) codes for pharyngoplasty and AT. Retrospective chart review was conducted to obtain clinical data. Patients were matched by age, body mass index (BMI), and preoperative apnea hypopnea index (AHI) to children who underwent AT alone.</p><p><strong>Results: </strong>Forty-six children who underwent AT with concomitant pharyngoplasty were identified along with 187 patients who underwent AT alone. Age, BMI, and preoperative AHI were significantly higher in the pharyngoplasty + AT group. The pharyngoplasty + AT group demonstrated significantly greater improvement in AHI, REM AHI, and obstructive AHI (oAHI) postoperatively; however, multivariable regression showed that BMI predicted postoperative change in AHI. Twenty children in each group were therefore matched by age, BMI, and preoperative AHI. Subsequent analysis of matched cases revealed no significant difference in surgical outcomes between groups.</p><p><strong>Conclusion: </strong>After controlling for age, BMI, and preoperative AHI, there was no difference between AT with concurrent pharyngoplasty and AT alone with respect to change in AHI or oxygen saturation nadir postoperatively. Ultimately, children who undergo pharyngoplasty in combination with AT are a clinically distinct group, and further randomized controlled trials within this population are necessary to define the role of pharyngoplasty concurrent with AT.</p>\",\"PeriodicalId\":14388,\"journal\":{\"name\":\"International journal of pediatric otorhinolaryngology\",\"volume\":\"198 \",\"pages\":\"112571\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of pediatric otorhinolaryngology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ijporl.2025.112571\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of pediatric otorhinolaryngology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ijporl.2025.112571","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
Utility of concurrent pharyngoplasty with adenotonsillectomy to treat pediatric obstructive sleep apnea.
Objective: This study assesses whether surgical procedures to address pharyngeal anatomy performed concurrently with adenotonsillectomy (AT) lead to improved postoperative polysomnogram (PSG) outcomes in children with obstructive sleep apnea (OSA) compared to AT alone.
Study design/setting: This is a retrospective cohort study conducted at a tertiary care children's hospital in the southeastern United States.
Methods: Patients were identified using Current Procedural Terminology (CPT) codes for pharyngoplasty and AT. Retrospective chart review was conducted to obtain clinical data. Patients were matched by age, body mass index (BMI), and preoperative apnea hypopnea index (AHI) to children who underwent AT alone.
Results: Forty-six children who underwent AT with concomitant pharyngoplasty were identified along with 187 patients who underwent AT alone. Age, BMI, and preoperative AHI were significantly higher in the pharyngoplasty + AT group. The pharyngoplasty + AT group demonstrated significantly greater improvement in AHI, REM AHI, and obstructive AHI (oAHI) postoperatively; however, multivariable regression showed that BMI predicted postoperative change in AHI. Twenty children in each group were therefore matched by age, BMI, and preoperative AHI. Subsequent analysis of matched cases revealed no significant difference in surgical outcomes between groups.
Conclusion: After controlling for age, BMI, and preoperative AHI, there was no difference between AT with concurrent pharyngoplasty and AT alone with respect to change in AHI or oxygen saturation nadir postoperatively. Ultimately, children who undergo pharyngoplasty in combination with AT are a clinically distinct group, and further randomized controlled trials within this population are necessary to define the role of pharyngoplasty concurrent with AT.
期刊介绍:
The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.