Improved objective outcomes and quality of life after adenotonsillectomy with inferior turbinate reduction in pediatric obstructive sleep apnea with inferior turbinate hypertrophy

被引:46
作者
Cheng, Po-Wen [1 ,2 ]
Fang, Kai-Min [1 ]
Su, Huang-Wei [3 ]
Huang, Tsung-Wei [1 ,2 ]
机构
[1] Far Eastern Mem Hosp, Dept Otolaryngol, Taipei, Taiwan
[2] Oriental Inst Technol, Dept Hlth Care Adm, Taipei, Taiwan
[3] Tung Fang Design Univ, Dept Tourism & Leisure Management, Kaohsiung, Taiwan
关键词
Pediatric obstructive sleep apnea syndrome; adenotonsillectomy; inferior turbinate; allergic rhinitis; microdebrider; ALLERGIC RHINITIS; CHILDREN; PREVALENCE; BEHAVIOR; INFANTS;
D O I
10.1002/lary.23590
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives/Hypothesis: Whether adenotonsillectomy (AT) is sufficient for pediatric obstructive sleep apnea syndrome (OSAS) with persistent severe allergic rhinitis (PSAR) remains unclear. This study attempts to identify the role of inferior turbinate reduction in treating pediatric OSAS with PSAR. Study Design: Case series with planned data collection. Methods: Fifty-one subjects aged 3 to 12 years with OSAS and PSAR were enrolled. Among them, 23 patients underwent AT concurrent with microdebrider-assisted inferior turbinoplasty (MAIT) (group AT-MAIT) and 28 patients underwent AT alone (group AT). Before surgery and at 1 year after surgery, objective outcomes were assessed using overnight polysomnography and acoustic rhinometry. Subjective outcomes were evaluated using the Obstructive Sleep Apnea (OSA)-18 quality-of-life questionnaire (OSA-18). Results: Following surgery, the median apnea-hypopnea index, minimal oxygen saturation, and snoring index were 0.8 (/h), 94 (%), and 104 (/h) in group AT-MAIT, respectively, compared with 3.5 (/h), 93 (%), and 158 (/h) in group AT, respectively (P < .05). In group AT-MAIT, the median postoperative minimal cross-sectional area recorded by acoustic rhinometry was 0.31 cm2, significantly larger than 0.16 cm2 in group AT (P < .01). Compared with postoperative scores in group AT, those in group AT-MAIT were significantly improved in domains of physical symptoms, emotional symptoms, daytime function, caregiver concerns, and overall OSA-18 scores (P < .05). Conclusions: Analytical results suggest that AT with concurrent MAIT achieves favorable subjective and objective outcomes in pediatric OSAS with PSAR. We believe that volume reduction of the inferior turbinate plays an important role in treating pediatric OSAS with inferior turbinate hypertrophy. Laryngoscope, 2012
引用
收藏
页码:2850 / 2854
页数:5
相关论文
共 23 条
[1]   NATURAL-HISTORY OF SNORING AND RELATED BEHAVIOR PROBLEMS BETWEEN THE AGES OF 4 AND 7 YEARS [J].
ALI, NJ ;
PITSON, D ;
STRADLING, JR .
ARCHIVES OF DISEASE IN CHILDHOOD, 1994, 71 (01) :74-76
[2]   SNORING, SLEEP DISTURBANCE, AND BEHAVIOR IN 4-5 YEAR OLDS [J].
ALI, NJ ;
PITSON, DJ ;
STRADLING, JR .
ARCHIVES OF DISEASE IN CHILDHOOD, 1993, 68 (03) :360-366
[3]   Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA2LEN and AllerGen) [J].
Bousquet, J. ;
Khaltaev, N. ;
Cruz, A. A. ;
Denburg, J. ;
Fokkens, W. J. ;
Togias, A. ;
Zuberbier, T. ;
Baena-Cagnani, C. E. ;
Canonica, G. W. ;
van Weel, C. ;
Agache, I. ;
Ait-Khaled, N. ;
Bachert, C. ;
Blaiss, M. S. ;
Bonini, S. ;
Boulet, L. -P. ;
Bousquet, P. -J. ;
Camargos, P. ;
Carlsen, K. -H. ;
Chen, Y. ;
Custovic, A. ;
Dahl, R. ;
Demoly, P. ;
Douagui, H. ;
Durham, S. R. ;
van Wijk, R. Gerth ;
Kalayci, O. ;
Kaliner, M. A. ;
Kim, Y. -Y. ;
Kowalski, M. L. ;
Kuna, P. ;
Le, L. T. T. ;
Lemiere, C. ;
Li, J. ;
Lockey, R. F. ;
Mavale-Manuel, S. ;
Meltzer, E. O. ;
Mohammad, Y. ;
Mullol, J. ;
Naclerio, R. ;
Hehir, R. E. O. ;
Ohta, K. ;
Ouedraogo, S. ;
Palkonen, S. ;
Papadopoulos, N. ;
Passalacqua, G. ;
Pawankar, R. ;
Popov, T. A. ;
Rabe, K. F. ;
Rosado-Pinto, J. .
ALLERGY, 2008, 63 :8-+
[4]   OBSTRUCTIVE SLEEP-APNEA IN INFANTS AND CHILDREN [J].
BROUILLETTE, RT ;
FERNBACH, SK ;
HUNT, CE .
JOURNAL OF PEDIATRICS, 1982, 100 (01) :31-40
[5]  
Djupesland P, 2000, RHINOLOGY, P52
[6]   Anatomical basis of sleep-related breathing abnormalities in children with nasal obstruction [J].
Finkelstein, Y ;
Wexler, D ;
Berger, G ;
Nachmany, A ;
Shapiro-Feinberg, M ;
Ophir, D .
ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY, 2000, 126 (05) :593-600
[7]   Quality of life for children with obstructive sleep apnea [J].
Franco, RA ;
Rosenfeld, RM ;
Rao, M .
OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2000, 123 (01) :9-16
[8]   Clinical predictors of obstructive sleep apnea [J].
Friedman, M ;
Tanyeri, H ;
La Rosa, M ;
Landsberg, R ;
Vaidyanathan, K ;
Pieri, S ;
Caldarelli, D .
LARYNGOSCOPE, 1999, 109 (12) :1901-1907
[9]   Effect of improved nasal breathing on obstructive sleep apnea [J].
Friedman, M ;
Tanyeri, H ;
Lim, JW ;
Landsberg, R ;
Vaidyanathan, K ;
Caldarelli, D .
OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2000, 122 (01) :71-74
[10]   SNORING, APNEIC EPISODES, AND NOCTURNAL HYPOXEMIA AMONG CHILDREN 6 MONTHS TO 6 YEARS OLD - AN EPIDEMIOLOGIC-STUDY OF LOWER LIMIT OF PREVALENCE [J].
GISLASON, T ;
BENEDIKTSDOTTIR, B .
CHEST, 1995, 107 (04) :963-966