소아 수면 무호흡증에서 편도 절제 수술 방식에 따른 수술 후 경과의 차이에 대한 비교 연구 (Comparison of the Postoperative Outcome for Pediatric Obstructive Sleep Apnea According to the Type of the Tonsillectomy)

서지정보

· 발행기관 : 대한이비인후과학회
· 수록지 정보 : 대한이비인후-두경부외과학회지 / 62권 / 8호 / 448 ~ 456페이지
· 저자명 : 조경래, 손정협

초록

Background and Objectives Partial intracapsular tonsillectomy and adenoidectomy (PITA)has become a well-recognized technique for tonsillectomy in children. Several studies havereported that PITA shows better postoperative morbidity compared to the conventional technique.
However, there is still concern about the regrowth of remnant tonsil tissues. The authorsevaluated the postoperative results of PITA, combined extracapsular and intracapsulartonsillectomy, and conventional tonsillectomy.
Subjects and Method The authors studied 97 children (male: 62, female: 35) aged 2 to 13years old, who underwent tonsillectomy and adenoidectomy (PITA, combined extracapsularand intracapsular tonsillectomy, and conventional tonsillectomy). The degree of adenotonsillarhypertrophy, apnea-hypopnea index and lowest oxygen saturation was confirmed for allsubjects. Operation time, quality of life, scale for postoperative pain, frequency of postoperativebleeding, and recurrence with tonsillar regrowth were compared after surgery performedby different surgical procedures.
Results Regardless of the surgical technique, all the cases presented significant improvementin the quality of life before and after surgery. On the day of surgery and four days aftersurgery, PITA showed superior results in terms of postoperative pain level compared to theconventional technique. There were no statistically significant results with respect to the operationtime and postoperative bleeding. Six months after the surgery, the recurrence of sleepapnea due to the regrowth of remaining tonsil was not obvious.
Conclusion Tonsillectomy technique preserving tonsillar capsule may show better resultson early postoperative pain. It can be a good alternative to the conventional technique in surgicaltreatment for pediatric obstructive sleep apnea in terms of early postoperative pain control.

영어초록

Background and Objectives Partial intracapsular tonsillectomy and adenoidectomy (PITA)has become a well-recognized technique for tonsillectomy in children. Several studies havereported that PITA shows better postoperative morbidity compared to the conventional technique.
However, there is still concern about the regrowth of remnant tonsil tissues. The authorsevaluated the postoperative results of PITA, combined extracapsular and intracapsulartonsillectomy, and conventional tonsillectomy.
Subjects and Method The authors studied 97 children (male: 62, female: 35) aged 2 to 13years old, who underwent tonsillectomy and adenoidectomy (PITA, combined extracapsularand intracapsular tonsillectomy, and conventional tonsillectomy). The degree of adenotonsillarhypertrophy, apnea-hypopnea index and lowest oxygen saturation was confirmed for allsubjects. Operation time, quality of life, scale for postoperative pain, frequency of postoperativebleeding, and recurrence with tonsillar regrowth were compared after surgery performedby different surgical procedures.
Results Regardless of the surgical technique, all the cases presented significant improvementin the quality of life before and after surgery. On the day of surgery and four days aftersurgery, PITA showed superior results in terms of postoperative pain level compared to theconventional technique. There were no statistically significant results with respect to the operationtime and postoperative bleeding. Six months after the surgery, the recurrence of sleepapnea due to the regrowth of remaining tonsil was not obvious.
Conclusion Tonsillectomy technique preserving tonsillar capsule may show better resultson early postoperative pain. It can be a good alternative to the conventional technique in surgicaltreatment for pediatric obstructive sleep apnea in terms of early postoperative pain control.

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