Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (2): 50-54.doi: 10.6040/j.issn.1673-3770.1.2020.093

Previous Articles     Next Articles

Partial tonsillectomy for 86 cases of obstructive sleep apnea syndrome in children

LIU Shaofeng, HUANG Guiliang, HUANG Zhenyun, SUN Changzhi, LUO Renzhong   

  1. Department of Otorhinolaryngology, Guangzhou Women and Children's Medical Center, Guangzhou 510180, Guangdong, China
  • Published:2021-04-20

PDF (PC)

285

Abstract: Objective To investigate the complications of partial tonsillectomy in children with obstructive sleep apnea(OSA). Methods In this study, a total of 172 children with OSA who underwent surgery at our hospital from June 2018 to December 2018 were enrolled. The children were divided into a control group(n=86)and an observation group(n=86). The control group underwent tonsillectomy and the observation group underwent partial tonsillectomy. The effects of treatment were compared between the groups. Result There was no statistically significant difference in the occurrence of postoperative primary bleeding between the two groups(χ2=0.000, P>0.999). The proportion of secondary bleeding was higher in the control group than that in the observation group(χ2=4.317, P<0.038). The pseudomembrane shedding time in the observation group was earlier than that in the control group(t=7.393, P<0.001). The pain scores of the control group at 1 d and 3 d after operation were higher than those of the observation group(t=5.376, 8.881, P<0.001). There were no significant differences in the recurrence rate and infection rate between the two groups(χ2=0.506, 0.256, P=0.613). Conclusion Partial tonsillectomy may reduce postoperative secondary hemorrhage and postoperative pain, and promote postoperative recovery in children with OSA. It can be considered a valid alternative to conventional tonsillectomy in pediatric OSA syndrome.

Key words: Sleep apnea syndrome, Obstructive, Tonsil, Tonsillectomy, Tonsillotomy, Children

CLC Number: 

  • R766.7
[1] Odhagen E, Stalfors J, Sunnergren O. Morbidity after pediatric tonsillotomy versus tonsillectomy: a population-based cohort study[J]. Laryngoscope, 2019, 129(11): 2619-2626. doi:10.1002/lary.27665.
[2] 田莉, 林镝. 儿童扁桃体切除术后继发性出血的危险因素分析[J]. 临床耳鼻咽喉头颈外科杂志, 2018,32(23): 1813-1816. doi:10.13201/j.issn.1001-1781.2018.23.011. TIAN Li, LIN Di. Risk factor analysis of secondary post-tonsillectomy hemorrhage in children[J]. J Clin Otorhinolaryngol Head Neck Surg, 2018,32(23): 1813-1816. doi:10.13201/j.issn.1001-1781.2018.23.011.
[3] Lee E, Tong JY, Pasick LJ, et al. Complications associated with PlasmaBlade TnA during tonsillectomy and adenoidectomy from 2010 to 2020: a MAUDE study[J]. Am J Otolaryngol, 2021, 42(1): 102826. doi:10.1016/j.amjoto.2020.102826.
[4] Hizli O, Kayabasi S, Cengiz B, et al. A novel proposal for classifying pediatric tonsillectomy complications: modified clavien classification[J]. Cureus, 2020, 12(6): e8701. doi:10.7759/cureus.8701.
[5] Coté CJ, Posner KL, Domino KB. Death or neurologic injury after tonsillectomy in children with a focus on obstructive sleep apnea: Houston, we have a problem![J]. Anesth Analg, 2014, 118(6): 1276-1283. doi:10.1213/ANE.0b013e318294fc47.
[6] 中华耳鼻咽喉头颈外科杂志编委会, 中华医学会耳鼻咽喉科学分会. 儿童阻塞性睡眠呼吸暂停低通气综合征诊疗指南草案(乌鲁木齐)[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(2): 83-84. doi:10.3760/j.issn: 1673-0860.2007.02.002. Editorial Board of Chinese Journal of Otorhinolary, Chinese Otorhinolaryngology of Chinese Medical Ass. Draft of guidelines for the diagnosis and treatment of pediatric sleep apnea hypopnea syndrome(Urumqi)[J]. Chin J Otorhinolaryngol Head Neck Surg, 2007, 42(2): 83-84. doi:10.3760/j.issn: 1673-0860.2007.02.002.
[7] 侯东明, 杨军, 曹荣萍, 等. 低温等离子射频扁桃体部分切除术与传统扁桃体剥离术治疗儿童OSAHS的比较分析[J]. 山东大学耳鼻喉眼学报, 2010, 24(6): 47-49. HOU Dongming, YANG Jun, CAO Rongping, et al. Comparison of radiofrequency ablation tonsillotomy versus standard tonsillectomy for OSAHS child patients[J]. J Otolaryngol Ophthalmol Shandong Univ, 2010, 24(6): 47-49.
[8] 陈曦, 李进让. 部分或整体扁桃体等离子射频切除术治疗儿童阻塞性睡眠呼吸暂停低通气综合征疗效对比[J]. 山东大学耳鼻喉眼学报, 2013, 27(3): 1-3. doi:10.6040/j.issn.1673-3770.0.2012.339. CHEN Xi, LI Jinrang. Partial radiofrequency ablation tonsillectomy for children with OSAHS[J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(3): 1-3. doi:10.6040/j.issn.1673-3770.0.2012.339.
[9] Parikh SR, Archer S, Ishman SL, et al. Why is there No statement regarding partial intracapsular tonsillectomy(tonsillotomy)in the new guidelines?[J]. Otolaryngol Head Neck Surg, 2019, 160(2): 213-214. doi:10.1177/0194599818810507.
[10] Mitchell RB, Archer SM, Ishman SL, et al. Clinical practice guideline: tonsillectomy in children(update)-executive summary[J]. Otolaryngol Head Neck Surg, 2019, 160(2): 187-205. doi:10.1177/0194599818807917.
[11] Zhang LY, Zhong L, David M, et al. Tonsillectomy or tonsillotomy? A systematic review for paediatric sleep-disordered breathing[J]. Int J Pediatr Otorhinolaryngol, 2017, 103: 41-50. doi:10.1016/j.ijporl.2017.10.008.
[12] Junaid M, Sood S, Walijee H, et al. Pain scores and recovery post tonsillectomy: intracapsular versus extracapsular coblation[J]. J Laryngol Otol, 2019: 1-7. doi:10.1017/S0022215119001610.
[13] Koltai PJ, Solares CA, Koempel JA, et al. Intracapsular tonsillar reduction(partial tonsillectomy): reviving a historical procedure for obstructive sleep disordered breathing in children[J]. Otolaryngol Head Neck Surg, 2003, 129(5): 532-538. doi:10.1016/s0194-5998(03)00727-7.
[14] Lee HS, Yoon HY, Jin HJ, et al. The safety and efficacy of powered intracapsular tonsillectomy in children: a meta-analysis[J]. Laryngoscope, 2018, 128(3): 732-744. doi:10.1002/lary.26886.
[15] Kim JS, Kwon SH, Lee EJ, et al. Can intracapsular tonsillectomy be an alternative to classical tonsillectomy? A meta-analysis[J]. Otolaryngol Head Neck Surg, 2017, 157(2): 178-189. doi:10.1177/0194599817700374.
[16] Borgström A, Nerfeldt P, Friberg D. Postoperative pain and bleeding after adenotonsillectomy versus adenotonsillotomy in pediatric obstructive sleep apnea: an RCT[J]. Eur Arch Otorhinolaryngol, 2019, 276(11): 3231-3238. doi:10.1007/s00405-019-05571-w.
[17] Ericsson E, Graf J, Lundeborg-Hammarstrom I, et al. Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up[J]. J Rhino Laryngol, 2014, 43(1): 26. doi:10.1186/s40463-014-0026-6.
[18] Celenk F, Bayazit YA, Yilmaz M, et al. Tonsillar regrowth following partial tonsillectomy with radiofrequency[J]. Int J Pediatr Otorhinolaryngol, 2008, 72(1): 19-22. doi:10.1016/j.ijporl.2007.09.007.
[19] Hizli O, Kayabasi S, Cengiz B, et al. A novel proposal for classifying pediatric tonsillectomy complications: modified clavien classification[J]. Cureus, 2020, 12(6): e8701. doi:10.7759/cureus.8701.
[20] Chaidas KS, Kaditis AG, Papadakis CE, et al. Tonsilloplasty versus tonsillectomy in children with sleep-disordered breathing: short- and long-term outcomes[J]. Laryngoscope, 2013, 123(5): 1294-1299. doi:10.1002/lary.23860.
[21] Park A, Proctor MD, Alder S, et al. Subtotal bipolar tonsillectomy does not decrease postoperative pain compared to total monopolar tonsillectomy[J]. Int J Pediatr Otorhinolaryngol, 2007, 71(8): 1205-1210. doi:10.1016/j.ijporl.2007.04.010.
[1] WANG Xingxin, YANG Xinyu, ZHENG Xiaojun, DING Lin, SHENG Yawen, BI Xiaoyun, YANG Jiguo. Acupoint application therapy for adenoid hypertrophy in children: a case report [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 122-124.
[2] ZHANG Keren, LEI Chunyan, ZHANG Meixia. Floppy eyelid syndrome associated with obstructive sleep apnea: a case report [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 125-128.
[3] ZHANG Fengzhen, WANG Guixiang, WEI Yunyun, ZHANG Yamei, ZHAO Jing, WANG Hua, LI Hongbin, LI Xiaodan, ZHANG Jie. Perioperative management of children with mild bleeding disorders undergoing adenotonsillectomy procedures [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 66-72.
[4] HAN Jibo, DONG Jie, MING Wei, WANG Yan, LUO Zhihong. The utility of different values of average oxygen saturation and minimum oxygen saturation between different sleep stages for predicting the uvulopalatopharyngoplastysurgery effect [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 73-78.
[5] LU Weili, JIANG Tao, LI Xianhua. Analysis of sIgE in polysensitized children with allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 260-265.
[6] JIN Xiaoxue, HAN Yingying, GUO Ruixiang, NI Shoujie, ZOU Juanjuan, WANG Yan, LI Yanzhong. Correlation between allergy factors and maxillofacial malformation in children with tonsil and adenoid hypertrophy in denture replacement period [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 45-50.
[7] HAN Yingying,LI Yanzhong. Obstructive sleep apnea hypopnea syndrome and subclinical arteriosclerosis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 126-132.
[8] YANG Yang, WANG Xiaoxu, ZHANG Jie. Progress on diagnosis and treatment of middle ear cholesteatoma in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 1-6.
[9] GAO Xinzhong, LING Zongtong, SHEN Ling, LIU Pingfang, LIN Xin, XU Yangyang. Analysis of the efficacy of balloon eustachian tuboplasty combined with adenoidectomy in the treatment of otitis media with effusion in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 7-12.
[10] HU Chunyan, DANG Panhong, ZHANG Rui, FAN Mengyun. Analysis of audiological and imaging characteristics of 149 children with unilateral sensorineural hearing loss [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 31-36.
[11] DANG Panhong, ZHANG Rui, HU Chunyan, WANG Jie, FAN Mengyun. Clinical analysis of facial nerve decompression via an external transmastoid-subtemporal labyrinth approach in eight children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 37-42.
[12] LIU Shanshan, HAN Shujing, WANG Xiaoxu, LI Yanhong, NI Xin, ZHANG Jie. Hearing loss in children after bacterial meningitis: a systematic review and meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 48-54.
[13] JIAO Xuemei, YANG Yang, LI Chunfeng, ZHANG Xiaolin. Effect of tympanic membrane insertion on the function of eustachian tube in children with secretory otitis media [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 60-63.
[14] WANG Pengpeng, GE Wentong, TANG Lixing, YANG Xiaojian, ZHANG Wei, XIAO Xiao, HAN Yang. Four cases of open rhinoplasty approach for congenital nasal dermoid and sinus cysts in children and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 64-69.
[15] LI Menghui, ZHI Lili, QI Kaiwen, WANG Shanshan, GAO Qian, BU Meiling,. Clinical research of subcutaneous immunotherapy on children with allergic asthma caused by dust mites and combined with mold allergen [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 75-80.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(2): 116 -118 .
[2] ZHOU Bin,LI Bin . Endoscopic sinus surgery for 75 patients with chronic sinusitis and nasal polyps[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 24 -26 .
[3] XU Sainan,YANG Lei . Apoptosis of epithelial cells in nasal polyps promoted by erythromycin[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 27 -29 .
[4] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 94 -95 .
[5] LIU Lian-he . Treatment of deep neck abscess in 37 cases[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(2): 180 -181 .
[6] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 200 -203 .
[7] QIAO Yi,NI Guan-sen,CHEN Wen-wen . Effect of H-UPPP and nasal operations on obstructive sleep apnea syndrome in 38 cases
[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 206 -208 .
[8] WANG Xiao-feng,LIN Chang,CHENG Jin-mei . Expression of ABAD in inner ears and its clinical significance in different age mice[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 207 -211 .
[9] FAN Qi-jun,HUANG Zhi-wu,MEI Ling,XIAO Bo-kui . Expression of the heat shock protein 27 in rat cochlea induced by sodium salicylate injection by the FQ-PCR technique[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 212 -214 .
[10] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 227 -227 .
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd