Cantarella Giovanna, Viglione Silvia, Forti Stella, Minetti Andrea, Pignataro Lorenzo
Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Auris Nasus Larynx. 2012 Aug;39(4):407-10. doi: 10.1016/j.anl.2011.10.012. Epub 2011 Nov 25.
To evaluate postoperative quality of life in patients undergoing microdebrider intracapsular tonsillotomy and adenoidectomy (PITA) in comparison with traditional adenotonsillectomy (AT) and to assess PITA's efficacy in solving upper-airway obstructive symptoms.
29 children with adenotonsillar hyperplasia referred for AT were included. Patients were divided into two groups: Group 1 (underwent PITA) included 14 children (age 5.1±1.8 years) affected by night-time airway obstruction without a relevant history of recurrent tonsillitis; Group 2 (underwent AT) included 15 children (age 5.2±1.7 years) with a history of upper-airway obstruction during sleep and recurrent acute tonsillitis. Outcomes measures included the number of administered pain medications, time before returning to a full diet, Obstructive Sleep Apnea survey (OSA-18), parent's postoperative pain measure questionnaire (PPPM) and Wong-Baker Faces Pain Rating Scale (WBFPRS).
Postoperative pain was significantly lower in the PITA group, as demonstrated by PPPM and WBFPRS scores and by a lower number of pain medications used. PITA group also resumed a regular diet earlier (P<0.001). OSA-18 scores proved that both PITA and AT were equally effective in curing upper-airway obstructive symptoms.
PITA reduces post-tonsil ablation morbidity and can be a valid alternative to AT for treating upper-airway obstruction due to adenotonsillar hyperplasia.
评估与传统腺样体扁桃体切除术(AT)相比,接受微切割器囊内扁桃体切除术和腺样体切除术(PITA)患者的术后生活质量,并评估PITA解决上气道阻塞症状的疗效。
纳入29例因腺样体扁桃体增生而转诊接受AT的儿童。患者分为两组:第1组(接受PITA)包括14名儿童(年龄5.1±1.8岁),有夜间气道阻塞但无复发性扁桃体炎相关病史;第2组(接受AT)包括15名儿童(年龄5.2±1.7岁),有睡眠期间上气道阻塞和复发性急性扁桃体炎病史。观察指标包括使用的止痛药物数量、恢复正常饮食前的时间、阻塞性睡眠呼吸暂停调查问卷(OSA-18)、家长术后疼痛测量问卷(PPPM)和面部表情疼痛评分量表(WBFPRS)。
PPPM和WBFPRS评分以及使用的止痛药物数量均表明,PITA组术后疼痛明显较低。PITA组恢复正常饮食也更早(P<0.001)。OSA-18评分证明,PITA和AT在治疗上气道阻塞症状方面同样有效。
PITA可降低扁桃体切除术后的发病率,对于治疗因腺样体扁桃体增生引起的上气道阻塞,它可以成为AT的有效替代方法。