Department of Otorhinolaryngology, Head and Neck Surgery, Division of Surgery and Cancer Diseases, Turku University Hospital, POB 52, 20521, Turku, Finland.
Department of Medicine, University of Turku, Turku, Finland.
Eur Arch Otorhinolaryngol. 2022 Jul;279(7):3727-3732. doi: 10.1007/s00405-022-07350-6. Epub 2022 Mar 25.
This single-group, retrospective, pre-test-post-test study was performed to examine clinical outcomes in treating obstructive sleep apnoea (OSA) with tonsillectomy alone and had the longest follow-up periods to date.
We analysed 151 tonsillectomies in our district between the years 2004 and 2018 that had either sleep apnoea or snoring listed as a diagnosis. Twenty-one patients met our criteria and were included. Patient records were analysed for home sleep apnoea test and Epworth Sleepiness Scale (ESS) scores.
We defined success as a > 50% reduction of the Apnoea-Hypopnea Index (AHI) and a total AHI of < 20 post-surgery. The averages before surgery were an AHI of 22.3 and an ESS of 7.22. The success rate was 47.6% after tonsillectomy as the sole treatment for obstructive sleep apnoea in our adult population. Eleven patients were non-responders. The average ESS score reduction was 0.69 and did not reach statistical significance. With follow-up times ranging from 1.8 to 171 months, this study had the longest follow-up period compared to other existing studies. No patient with a follow-up longer than one year was a responder.
Our results support that tonsillectomy is an effective treatment for obstructive sleep apnoea in adults with tonsillar hypertrophy. With less severe OSA than those reported on previously, our patients also had less severe daytime sleepiness before surgery, and daytime sleepiness score reductions did not reach statistical significance. In the future, long-term results should be further analysed.
本单组回顾性预测试后研究旨在观察单纯扁桃体切除术治疗阻塞性睡眠呼吸暂停（OSA）的临床疗效，并具有迄今为止最长的随访时间。
我们分析了 2004 年至 2018 年间我们地区的 151 例扁桃体切除术，这些手术均有睡眠呼吸暂停或打鼾作为诊断。21 例患者符合我们的标准并被纳入研究。对患者的病历进行了家庭睡眠呼吸暂停试验和 Epworth 嗜睡量表（ESS）评分分析。
我们将成功定义为 AHI 减少>50%和术后总 AHI<20。手术前的平均值为 AHI 为 22.3，ESS 为 7.22。扁桃体切除术作为成人阻塞性睡眠呼吸暂停的单一治疗方法，成功率为 47.6%。11 例患者无反应。ESS 评分平均降低 0.69，但无统计学意义。随访时间从 1.8 到 171 个月不等，与其他现有研究相比，本研究的随访时间最长。在随访时间超过一年的患者中，没有一个是有反应的。
我们的结果支持扁桃体切除术是成人扁桃体肥大引起的阻塞性睡眠呼吸暂停的有效治疗方法。与以前报道的相比，我们的患者 OSA 程度较轻，手术前日间嗜睡程度也较轻，日间嗜睡评分降低无统计学意义。在未来，应进一步分析长期结果。
