Leiberman Alberto, Stiller-Timor Liran, Tarasiuk Ariel, Tal Asher
Department of Otolaryngology, Head & Neck Surgery, Soroka University Medical Center, PO Box 151, Beer-Sheva 84101, Israel.
Int J Pediatr Otorhinolaryngol. 2006 Oct;70(10):1675-82. doi: 10.1016/j.ijporl.2006.06.002. Epub 2006 Jul 18.
To present the Negev perspective in recent decades as to the effect of adenotonsillectomy regarding clinical and polysomnographic features, cardiopulmonary morbidity, growth, neurocognitive function, health care services utilization, and enuresis by reviewing current related literature.
All relevant published data by the Soroka University Medical Center and related community medical services were reviewed and compared to MEDLINE linked literature regarding aspects of childhood obstructive sleep apnea published through November 2005.
Published data support a significant effect of adenotonsillectomy on the associated co morbidities: adenotonsillectomy resulted in the reduction of pulmonary hypertension, improved growth as a result of an increase in growth hormone secretion, improvement of neurocognitive function to the normal range, reduction in nocturnal enuresis, as well as reducing general morbidities, as reflected by the reduction in health care utilization. However, there are still uncertainties relating to major aspects. There is no specific definition for OSAS grading, or for generating a guideline for surgical treatment and refinement of the indications of T&A.
Adenotonsillectomy has a beneficial effect on children with OSAS, however, further research is required before recommendations for the treatment of OSAS in children can be formulated.
通过回顾当前相关文献，呈现内盖夫地区近几十年来关于腺样体扁桃体切除术对临床和多导睡眠图特征、心肺发病率、生长发育、神经认知功能、医疗服务利用及遗尿症影响的观点。
回顾了索罗卡大学医学中心及相关社区医疗服务机构所有已发表的相关数据，并与截至2005年11月发表的关于儿童阻塞性睡眠呼吸暂停各方面的MEDLINE链接文献进行比较。
已发表的数据支持腺样体扁桃体切除术对相关合并症有显著影响：腺样体扁桃体切除术可降低肺动脉高压，因生长激素分泌增加而促进生长发育，将神经认知功能改善至正常范围，减少夜间遗尿症，还可减少总体发病率，这体现在医疗服务利用的减少上。然而，在一些主要方面仍存在不确定性。对于阻塞性睡眠呼吸暂停综合征（OSAS）分级没有具体定义，也没有制定手术治疗指南及完善扁桃体和腺样体切除术（T&A）的指征。
腺样体扁桃体切除术对患有OSAS的儿童有有益影响，然而，在能够制定儿童OSAS治疗建议之前，还需要进一步研究。
