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

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] ZHAO Chunrong, YANG Sen, LI Chunyan, WANG Donghai, YANG Yu, YANG Xiaoying. Effects of continuous positive airway pressure on olfactory and cognitive functions in patients with moderate-to-severe obstructive sleep apnea-hypopnea syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(3): 68-73.
[2] ZHU Xiqian, WANG Jia, SUN Zuxian, FENG Jianxiu, ZHANG Mengjia, ZHAO Ying, WANG Hong, JIANG Minmin. Refractive status of school-aged children aged 6-9 years in Yangpu District, Shanghai, 2022-2024: a cohort study [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(3): 102-109.
[3] ZHANG Xin, LIU Yajie, LI Fei, HUANG Chunmei, ZHANG Huixin, ZHU Jiabin. Correlation between hemodynamic parameters of the ophthalmic artery and central retinal artery in patients with severe OSA with AHI and LSaQ2 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(2): 87-94.
[4] SONG Yanling, SI Yuanyuan, CUI Yan. Minimal quantity vitrectomy for laser-pointer induced full-thickness macular hole in a child: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 144-147.
[5] XIONG Qin, ZHANG Yan, WU Rina, LI Feng, TANG Lixing. Application of intranasal corticosteroids in pediatrics [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 160-167.
[6] LIU Nanxian, YANG Zeyin, HAN Lin, ZHANG Aiying, ZHAO Yuliang, XUE Jing, SUN Yijun, SHAO Yongliang. Significance of video-EEG in the diagnosis of recurrent vertigo in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 20-25.
[7] HUANG Huan, HUA Hongli, DENG Yuqin, JIANG Chengyang, WANG Yuwei, YANG Xinghai. Correlation of allergic rhinitis, tonsil adenoid hypertrophy, and sinusitis in children and analysis of its clinical guiding value [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 34-41.
[8] FU Lijun, WANG Haiyang, WANG Yuqi, ZOU Yuhao, ZOU Jian. Immune mechanism and clinical application of the intranasal vaccine in nasopharyngeal-associated lymphoid tissues [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 93-99.
[9] LIU Di, WANG Zhenzhen, GUAN Bing, ZHU Bing. The effect of environmental and meteorological factors on the outbreak of acute epiglottitis and tonsillitis in downtown Yangzhou [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 142-150.
[10] WANG Hua, ZHANG Fengzhen, LONG Ting, ZHAO Jing, LI Hongbin, WANG Shengcai, WANG Guixiang. Analysis of the reasons and prognostic outcomes for tracheostomy in pediatric patients following posterior fossa tumor resection [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 168-173.
[11] YUE Bingyan, ZOU Jian, LEI Lei, WEN Qiao, QIAN Yingxue. Tonsillar microbiota of children, immune regulation and diseases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(4): 193-200.
[12] WEI Zhicheng, PENG Yu, LI Lilin, SHEN Hangdong, LI Xinyi, XU Huajun, GUAN Jian. Kynurenine mediates liver injury induced by obstructive sleep apnea: a cross-sectional study [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 38-44.
[13] WANG Yao, CHEN Jingyi, YANG Yingchao, SU Kaiming. Adenotonsillectomy in a child with congenital fibrinogen deficiency and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 77-80.
[14] MA Xin, DONG Lingkang, WU Hongmin, YI Hongliang, ZOU Jianyin. Modifications and applications of lateral expansion abduction suspension suture technique in the treatment of obstructive sleep apnea [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 81-88.
[15] LI Lilin, LI Xinyi, GUAN Jian. Research progress on the mechanism of comorbidity between obstructive sleep apnea and depression [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(3): 89-96.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!