수면호흡장애 소아에서 편도 및 아데노이드 절제술과 비갑개 후방축소술동반 시행 시 효용성에 대한 고찰 (The Efficacy of Posterior Turbinoplasty in Combination with Tonsillectomy and Adenoidectomy in Pediatric Sleep Disordered Breathing Patients)

서지정보

· 발행기관 : 대한이비인후과학회
· 수록지 정보 : 대한이비인후-두경부외과학회지 / 63권 / 5호 / 216 ~ 222페이지
· 저자명 : 배재훈, 이장수, 김남국

초록

Background and Objectives Tonsillectomy and adenoidectomy (T&A) are effective for thetreatment of pediatric sleep disorder breathing. However, in some pediatric patients, there remainunresolved snoring and mouth breathing problems after the operation. This study isaimed at evaluating the efficacy of coblation of hypertrophic posterior turbinate in combinationwith tonsillectomy and adenoidectomy.
Subjects and Method We analyzed data from 50 children aged between 5 to 13 years oldwho were scheduled to undergo T&A operation from June 2018 to December in 2018. We randomlydivided them into two groups. The first group consisted of 25 patients who were scheduledto perform only tonsillectomy and adenoidectomy. The second group was 21 patientswho were scheduled to perform posterior turbinoplasty in combination with tonsillectomy andadenoidectomy. We evaluated preoperative and postoperative polysomnogram [Apnea-HypopneaIndex (AHI), O2 saturation], acoustic rhinometry (minimal cross section area, nasalvolume), and Korean Obstructive Sleep Apnea-18 Survey (KOSA-18) score.
Results After additional turbinoplasty (coblation of hypertrophic posterior turbinate), the rate ofsnoring and mouth breathing remaining was decreased. There were significant improvements inAHI, oxygen saturation, Visual Analog Scale and Epworth Sleepiness Scale in two groups. Symptoms(snoring and mouth breath) remaining postoperatively was much more decreased in the posteriorturbinoplasty combined with T&A group than in the single T&A group in terms of KOSA-18.
Conclusion When it comes to pediatric sleep disorder breathing surgery, nasal cavity evaluationis an important factor for patient’s postoperative satisfaction for sleeping and snoring.
For pediatric sleep disorder breathing patients with hypertrophic posterior turbinate, who arescheduled to do tonsillectomy and adenoidectomy, an additional coblation of posterior turbinateshould be considered.

영어초록

Background and Objectives Tonsillectomy and adenoidectomy (T&A) are effective for thetreatment of pediatric sleep disorder breathing. However, in some pediatric patients, there remainunresolved snoring and mouth breathing problems after the operation. This study isaimed at evaluating the efficacy of coblation of hypertrophic posterior turbinate in combinationwith tonsillectomy and adenoidectomy.
Subjects and Method We analyzed data from 50 children aged between 5 to 13 years oldwho were scheduled to undergo T&A operation from June 2018 to December in 2018. We randomlydivided them into two groups. The first group consisted of 25 patients who were scheduledto perform only tonsillectomy and adenoidectomy. The second group was 21 patientswho were scheduled to perform posterior turbinoplasty in combination with tonsillectomy andadenoidectomy. We evaluated preoperative and postoperative polysomnogram [Apnea-HypopneaIndex (AHI), O2 saturation], acoustic rhinometry (minimal cross section area, nasalvolume), and Korean Obstructive Sleep Apnea-18 Survey (KOSA-18) score.
Results After additional turbinoplasty (coblation of hypertrophic posterior turbinate), the rate ofsnoring and mouth breathing remaining was decreased. There were significant improvements inAHI, oxygen saturation, Visual Analog Scale and Epworth Sleepiness Scale in two groups. Symptoms(snoring and mouth breath) remaining postoperatively was much more decreased in the posteriorturbinoplasty combined with T&A group than in the single T&A group in terms of KOSA-18.
Conclusion When it comes to pediatric sleep disorder breathing surgery, nasal cavity evaluationis an important factor for patient’s postoperative satisfaction for sleeping and snoring.
For pediatric sleep disorder breathing patients with hypertrophic posterior turbinate, who arescheduled to do tonsillectomy and adenoidectomy, an additional coblation of posterior turbinateshould be considered.

참고자료

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