Sarmah Utpal, Mandal Shantanu, Roy Manaswita
Department of Otorhinolaryngology, Vardhman Mahavir Medical College and Safdarjung Hospital, Arjun Nagar, Safdarjung Enclave, New Delhi, 110029 India.
Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):221-229. doi: 10.1007/s12070-018-01569-8. Epub 2019 Jan 4.
Adenotonsillectomy is a widely practiced surgical intervention to manage obstructive sleep apnoea syndrome (OSAS) in the paediatric age group. We conducted a prospective, non randomised, interventional study among 40 patients in paediatric age group (2-18 years) suffering from adenotonsillar hypertrophy with an indication of adenotonsillectomy based on American Academy of Otolaryngology-Head and Neck Surgery criteria. Care givers completed the obstructive sleep apnoea 18 (OSA 18) quality of life (QoL) survey and Rutter Children's Behaviour Questionnaire (RCBQ) before adenotonsillectomy as well as 6 months after surgery. We found that mean score of OSA 18 and total RCBQ decreased significantly 6 months after surgery. The mean score of OSA 18 (4.12 ± 1.4) and total RCBQ score (20.5 ± 2) significantly reduced to 1.19 ± 0.12 and 7.4 ± 2.55 ( < 0.0001), respectively, after surgery. There was significant improvement in all the domains of OSA 18 score after intervention including sleep disturbance (mean score change 2.56, < 0.0001), physical suffering (2.99, < 0.0001), emotional distress (2.71, < 0.0001), daytime problems (2.56, < 0.0001), caregiver concerns (3.76, < 0.0001). We also observed that QoL as well as behaviour was independent of age and gender of patients. This study demonstrates significant score changes across all questionnaire domains, comparing pre and post operative data indicating an improvement in their quality of life and behaviour. Hence, we advocate that adenotonsillectomy may be considered as an effective treatment in properly selected patients with OSAS.
腺样体扁桃体切除术是治疗小儿阻塞性睡眠呼吸暂停综合征(OSAS)的一种广泛应用的外科手术。我们对40名2至18岁患有腺样体扁桃体肥大且符合美国耳鼻咽喉头颈外科学会标准、有腺样体扁桃体切除指征的儿童患者进行了一项前瞻性、非随机干预性研究。在腺样体扁桃体切除术前以及术后6个月,护理人员完成了阻塞性睡眠呼吸暂停18项(OSA 18)生活质量(QoL)调查和鲁特儿童行为问卷(RCBQ)。我们发现,术后6个月,OSA 18的平均得分和RCBQ总分显著下降。术后,OSA 18的平均得分(4.12±1.4)和RCBQ总分(20.5±2)分别显著降至1.19±0.12和7.4±2.55(P<0.0001)。干预后,OSA 18得分的所有领域均有显著改善,包括睡眠障碍(平均得分变化2.56,P<0.0001)、身体痛苦(2.99,P<0.0001)、情绪困扰(2.71,P<0.0001)、日间问题(2.56,P<0.0001)、护理人员担忧(3.76,P<0.0001)。我们还观察到,生活质量和行为与患者的年龄和性别无关。本研究比较了术前和术后数据,显示所有问卷领域的得分均有显著变化,表明患者的生活质量和行为有所改善。因此,我们主张,对于经过适当选择的OSAS患者,腺样体扁桃体切除术可被视为一种有效的治疗方法。