Coticchia James M, Yun Romy D, Nelson Lionel, Koempel Jeffrey
Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Arch Otolaryngol Head Neck Surg. 2006 Apr;132(4):425-30. doi: 10.1001/archotol.132.4.425.
To determine if temperature-controlled radiofrequency (TCRF) tonsil reduction and adenoidectomy (TCRF&A) and conventional tonsillectomy and adenoidectomy (T&A) are statistically similar in outcome and to compare morbidity between TCRF&A and conventional T&A.
Randomized control trial.
Tertiary care children's hospital.
The study population comprised 23 patients aged 2.6 to 12.5 years with symptoms of obstructive sleep apnea, hypertrophic tonsils with no other areas of upper airway obstruction with the exception of hypertrophic adenoids, and a body mass index (calculated as weight in kilograms divided by the square of height in meters) of less than 30.
Temperature-controlled radiofrequency tonsil reduction (mean +/- SD, 12.6 +/- 1.5 ablations per patient and 994.68 +/- 91.88 J per insertion) and adenoidectomy or traditional bovie T&A.
Primary outcomes were respiratory distress index and total volume reduction. Secondary outcomes include postoperative pain, daytime sleepiness, speech and swallowing problems, weight and diet, narcotic use, and analogue snoring scale.
The respiratory distress index difference for TCRF&A was 5.63 vs 6.56 for standard T&A. On postoperative day 1 for the 13 patients who underwent TCRF&A, 0 reported severe pain, 11 (85%) had mild to moderate pain, and 2 (15%) had no pain. In the 10 patients who underwent standard T&A, 1 (10%) had severe pain and 9 (90%) had mild to moderate pain. By postoperative week 1, all TCRF&A patients experienced mild or no pain, whereas 1 (10%) of the standard T&A patients still had moderate pain. Mean visual analogue snore scores (0-10) 4 weeks after surgery were less than 1 for both groups. The mean +/- SD weight loss at postoperative week 1 for TCRF tonsil reduction patients was 1.0 +/- 3.5 lb (0.45 +/- 1.58 kg) vs 4.6 +/- 3.9 lb (2.07 +/- 1.76 kg) for standard T&A patients. Return to normal diet at postoperative week 1 occurred in 11 TCRF&A patients (85%) and 0 standard T&A patients.
The respiratory distress indexes were similar for TCRF&A patients and standard T&A patients. In addition, there were similar analog snoring scales, decreased pain, and weight loss.
确定温控射频（TCRF）扁桃体缩小术及腺样体切除术（TCRF&A）与传统扁桃体切除术及腺样体切除术（T&A）在疗效上是否具有统计学相似性，并比较TCRF&A与传统T&A之间的发病率。
随机对照试验。
三级护理儿童医院。
研究人群包括23例年龄在2.6至12.5岁之间的患者，这些患者有阻塞性睡眠呼吸暂停症状，扁桃体肥大，除腺样体肥大外无其他上呼吸道阻塞区域，且体重指数（以千克体重除以身高米数的平方计算）小于30。
温控射频扁桃体缩小术（平均±标准差，每位患者12.6±1.5次消融，每次插入994.68±91.88焦耳）及腺样体切除术或传统电刀T&A。
主要结局为呼吸窘迫指数和总体积缩小。次要结局包括术后疼痛、日间嗜睡、言语和吞咽问题、体重和饮食、麻醉药物使用及模拟打鼾量表。
TCRF&A的呼吸窘迫指数差异为5.63，而标准T&A为6.56。在接受TCRF&A的13例患者术后第1天，0例报告有严重疼痛，11例（85%）有轻度至中度疼痛，2例（15%）无疼痛。在接受标准T&A的10例患者中，1例（10%）有严重疼痛，9例（90%）有轻度至中度疼痛。到术后第1周，所有TCRF&A患者经历轻度疼痛或无疼痛，而标准T&A患者中有1例患者仍有中度疼痛。术后4周两组的平均视觉模拟打鼾评分（0 - 10）均小于1。TCRF扁桃体缩小术患者术后第1周的平均±标准差体重减轻为1.0±3.5磅（0.45±1.58千克），而标准T&A患者为4.6±3.9磅（2.07±1.76千克）。术后第1周，11例（85%）TCRF&A患者恢复正常饮食，标准T&A患者无恢复正常饮食者。
TCRF&A患者和标准T&A患者的呼吸窘迫指数相似。此外，模拟打鼾量表、疼痛减轻和体重减轻情况也相似。
