Roy Ravi, Banger Sween, Singh S K, Swami Himanshu, Gupta D K, Goyal Sunil, Chugh Rajeev, Yadav Sneha, Patel Bhaumik, Mahesh R
Department of ENT HNS, Army Hospital Research and Referral, New Delhi, 110010 India.
Department of ENT HNS, Military Hospital, Jhansi, India.
Indian J Otolaryngol Head Neck Surg. 2023 Apr;75(Suppl 1):822-827. doi: 10.1007/s12070-022-03453-y. Epub 2022 Dec 31.
The aim of the study was to determine the post surgical outcomes in pediatric adenotonsillar hypertrophy with OSA using portable polysomnography (PSG), OSA 18 Questionnaire and Quality of life (QoL) scores. Secondly to correlate the subjective outcomes with objective scores of polysomonography. A prospective, single-arm, nonrandomized, single center study was performed at a tertiary care centre on children aged 3-12 years (n = 30) with adenoid hypertrophy/ tonsillar hypertrophy/adenotonsillar hypertrophy and symptoms suggestive of OSA. All subjects underwent appropriate surgical intervention. A portable PSG and OSA 18 questionnaire evaluation was performed pre surgery and 06 weeks post surgery to assess objective and clinical assessment for OSA. The mean age of children enrolled in the study was 8.68 ± 3 years. The mean pre treatment AHI was 12.56 ± 13.16 which improved to 1.72 ± 1.53 post surgery and was statistically significant ( < 0.05, Wilcoxon signed rank test). There was a statistically significant improvement in other PSG indices such as RDI and ODI post surgery also. The mean total symptom score (TSS) and QoL score also showed a statistically significant improvement post treatment ( < 0.05). However there was no correlation between the PSG and OSA 18 questionnaire scores pre and post surgery. Children with OSA like symptoms can undergo a portable polysomnography pre and post surgery to demonstrate severity of OSA and objectively monitor improvement in OSA post treatment. In the absence of availability of PSG, OSA 18 questionnaire is a suitable alternative to monitor disease severity and outcomes. Further studies may plan to include impact of paediatric OSA on other function such as the cardiac, dentition & malocclusion and neurocognitive function.
本研究的目的是使用便携式多导睡眠监测（PSG）、OSA 18问卷和生活质量（QoL）评分来确定小儿腺样体扁桃体肥大伴阻塞性睡眠呼吸暂停（OSA）的术后结果。其次是将主观结果与多导睡眠监测的客观评分相关联。在一家三级医疗中心对3至12岁（n = 30）患有腺样体肥大/扁桃体肥大/腺样体扁桃体肥大且有OSA症状的儿童进行了一项前瞻性、单臂、非随机、单中心研究。所有受试者均接受了适当的手术干预。术前和术后6周进行了便携式PSG和OSA 18问卷评估，以评估OSA的客观和临床评估。纳入研究的儿童平均年龄为8.68±3岁。治疗前平均呼吸暂停低通气指数（AHI）为12.56±13.16，术后改善至1.72±1.53，差异有统计学意义（<0.05，Wilcoxon符号秩检验）。术后其他PSG指标如呼吸紊乱指数（RDI）和氧减指数（ODI）也有统计学意义的改善。平均总症状评分（TSS）和QoL评分在治疗后也有统计学意义的改善（<0.05）。然而，术前和术后PSG与OSA 18问卷评分之间没有相关性。有OSA样症状的儿童可在术前和术后进行便携式多导睡眠监测，以证明OSA的严重程度并客观监测治疗后OSA的改善情况。在没有PSG的情况下，OSA 18问卷是监测疾病严重程度和结果的合适替代方法。进一步的研究可能计划纳入小儿OSA对其他功能如心脏、牙列和错牙合以及神经认知功能的影响。
