Varadharajan Kiran, Caton Nadine, Faulkner Jack, Khemani Sameer
ENT ST7 Royal Surrey NHS Foundation Trust, UK.
ENT ST7 Maidstone and Tunbridge Wells NHS Trust, UK.
Int J Pediatr Otorhinolaryngol. 2020 Aug;135:110113. doi: 10.1016/j.ijporl.2020.110113. Epub 2020 May 16.
The use of Coblation® intracapsular tonsillectomy for the treatment of sleep disordered breathing (SDB)/obstructive sleep apnoea (OSA) has an increasing evidence base. However, the results for tonsillitis as the predominant indication for surgery are not as clear. We present our initial results from 80 paediatric cases undergoing Coblation® intracapsular tonsillectomy for infective indications.
Prospective case series within the secondary care environment, January 2016-July 2018, all with completed follow-up. We utilised the validated T14 tonsil symptom questionnaire pre- and postoperatively and also collected data regarding postoperative complications.
80 consecutive patients (age range 2-16 years and mean 7.2 years) undergoing Coblation® intracapsular tonsillectomy (with or without adenoidectomy) predominantly for infective reasons although some also had concomitant adenoidectomy for snoring/sleep disordered breathing were included. Mean follow-up was at 13 months postoperatively. 38 children had tonsillitis (with or without snoring) and 42 children had SDB in combination with tonsillitis. The mean over-all total T14 score was 32.7 preoperatively and 2.7 postoperatively (p < 0.0001). The mean infective score was 22.1 preoperatively and 1.5 postoperatively (p < 0.0001). The mean SDB score was 10.6 preoperatively and 1.5 postoperatively (p < 0.0001). There were no cases of haemorrhage, re-admission or regrowth noted.
Coblation® intracapsular tonsillectomy is a safe and effective technique for treating children with recurrent tonsillitis. Future studies should incorporate longer term follow-up.
使用低温等离子刀囊内扁桃体切除术治疗睡眠呼吸障碍（SDB）/阻塞性睡眠呼吸暂停（OSA）的证据基础日益增多。然而，以扁桃体炎作为主要手术指征的治疗结果尚不清楚。我们展示了80例因感染指征接受低温等离子刀囊内扁桃体切除术的儿科病例的初步结果。
2016年1月至2018年7月在二级医疗环境中的前瞻性病例系列研究，所有病例均完成随访。我们在术前和术后使用经过验证的T14扁桃体症状问卷，并收集术后并发症的数据。
纳入80例连续患者（年龄范围2 - 16岁，平均7.2岁），主要因感染原因接受低温等离子刀囊内扁桃体切除术（有或无腺样体切除术），尽管有些患者也因打鼾/睡眠呼吸障碍同时进行了腺样体切除术。平均随访时间为术后13个月。38名儿童患有扁桃体炎（有或无打鼾），42名儿童患有扁桃体炎合并SDB。术前总体T14评分平均为32.7，术后为2.7（p < 0.0001）。感染评分术前平均为22.1，术后为1.5（p < 0.0001）。SDB评分术前平均为10.6，术后为1.5（p < 0.0001）。未发现出血、再次入院或复发的病例。
低温等离子刀囊内扁桃体切除术是治疗复发性扁桃体炎患儿的一种安全有效的技术。未来的研究应纳入长期随访。
