Premium
Can pillar suturing promote efficacy of adenotonsillectomy for pediatric osas? A prospective randomized controlled trial
Author(s) -
Chiu PoHan,
Ramar Kannan,
Chen KuangChao,
Tsai YihJeng,
Lin ChiaMo,
Chiang YuhChyun,
Lu ChiaYing,
Chiang Rayleigh PingYing
Publication year - 2013
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24011
Subject(s) - medicine , obstructive sleep apnea , tonsillectomy , randomized controlled trial , adenoidectomy , prospective cohort study , pillar , polysomnography , apnea–hypopnea index , apnea , pediatrics , anesthesia , surgery , structural engineering , engineering
Objectives/Hypothesis Pediatric obstructive sleep apnea syndrome ( OSAS ) is a common disorder with serious clinical implications if left untreated. The recommended initial treatment for pediatric patients with obstructive sleep apnea syndrome ( OSAS ) is adenotonsillectomy. However, recent reports have shown variable surgical results with adenotonsillectomy in the treatment of pediatric OSAS . Study Design Prospective, controlled study. Methods From April 2007 to August 2010, 24 participants were assigned alternatively to either adenotonsillectomy with pillar suturing (intervention group) or adenotonsillectomy alone (control group). Result The average improvement in apnea hypopnea index ( AHI ) was 42.6% in the control group and 79.9% in the intervention group ( P =0.037). The success rate was 50% in the control group and 91.6% in the intervention group ( P =0.034). Six patients (50%) in the intervention group achieved complete resolution of pediatric OSAS , as defined by an AHI <1/hour, compared to 2 patients (16.7%) in the control group ( P =0.097). Conclusion Adenotonsillectomy with pillar suturing showed significant improvement in treating pediatric patients with OSAS compared to adenotonsillectomy alone. The procedure is simple and safe. Level of Evidence 4. Laryngoscope , 123:2574–2578, 2013