Korean J Otorhinolaryngol-Head Neck Surg.  2020 Apr;63(4):167-171. 10.3342/kjorl-hns.2019.00339.

Comparison of Functional Outcomes after PoweredIntracapsular Tonsillectomy with Adenoidectomy andConventional Extracapsular Tonsillectomy withAdenoidectomy for Pediatric Obstructive Sleep Apnea

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea

Abstract

Background and Objectives
This study was investigated to compare the clinical outcomes and complications of powered intracapsular tonsillectomy and adenoidectomy (PITA) with those of conventional extracapsular tonsillectomy and adenoidectomy (ECTA) in treatment of pediatric obstructive sleep apnea (OSA). Subjects and Method Eighty-one children with adenotonsillar hyperplasia underwent tonsillectomy and adenoidectomy (46 PITA and 35 ECTA) from December 2016 to July 2017 for OSA. The choice of surgical procedure (PITA vs. ECTA) was determined by the number of episodes of acute tonsillitis. The quality of life measurement was performed using Korean Obstructive Sleep Apnea Survey (KOSA-18) score. Postoperative bleeding was assessed as number of revisit or readmission. Postoperative pain was evaluated by visual analog scale (VAS) at postoperative day 1, 3, and 7.
Results
PITA and ECTA significantly reduced KOSA-18 scores postoperatively (p<0.01, p<0.01, respectively) and were equally effective in pediatric OSA treatment. Postoperative bleeding was lower in the PITA group, but there was no statistical difference due to small number of cases. VAS score for postoperative pain was significantly lower in the PITA group at day 1, 3, and 7 (p=0.03, p<0.01, and p<0.01, respectively).
Conclusion
PITA is effective in pediatric OSA treatment with less morbidity, and less complications.

Keyword

Pediatrics; Postoperative complications; Sleep apnea, obstructive; Surgical procedures, operative; Tonsillectomy
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