腺样体切除术治疗阻塞性睡眠呼吸暂停伴腺样体肥大复发/残留患儿的多导睡眠监测结果。
Polysomnographic outcomes of revision adenoidectomy in children with obstructive sleep apnea and recurrent/residual adenoidal hypertrophy.
机构信息
Department of Pediatrics, University of Louisville and Norton Children Medical Group, 9880 Angies Way Suite, Louisville, KY, 300, USA.
Norton Children's Research Institute, affiliated with University of Louisville School of Medicine, Louisville, KY, USA.
出版信息
Sleep Breath. 2024 May;28(2):887-893. doi: 10.1007/s11325-023-02951-9. Epub 2023 Nov 29.
INTRODUCTION
Recurrent/residual adenoidal hypertrophy after adenotonsillectomy in children can result in obstructive sleep apnea (OSA). We aimed to assess the polysomnographic (PSG) outcomes of revision adenoidectomy in children with recurrent/residual adenoidal hypertrophy and OSA.
METHODS
This was a single-center retrospective study that included children with sleep studies that confirmed OSA and known history of adenotonsillectomy who were diagnosed with adenoidal hypertrophy and subsequently underwent revision adenoidectomy. Pre- and postoperative PSG variables of revision adenoidectomy were included in the analysis.
RESULTS
A total of 20 children were included in the study. The cohort included 13 males and 7 females with a mean age of 7.8 years (± 3.6 years). The mean BMI z score was 1.96 [1.31, 2.43]. The median duration from adenotonsillectomy performance was 2.3 years [1.4, 4.0]. Overall, revision adenoidectomy resulted in significant improvements in multiple respiratory parameters, including AHI 6.6 [1.4, 13. 7] vs 14.8 [7.4, 20.7], p = 0.02; oxygen desaturations nadir 88.0 [84.0, 93.0] vs 80.0 [72.2, 88.9], p = 0.01; supine AHI 8.6 [1.5, 14.3] vs 17.6 [8.3, 30.2], p = 0.02; and arousal index 12.2 [9.6, 15.7] vs 18.9 [13.4, 24.9], p = 0.04.
CONCLUSIONS
Children with recurrent/residual adenoidal hypertrophy after adenotonsillectomy who undergo revision adenoidectomy experience improvements in respiratory event, gas exchange, and arousal index.
介绍
儿童腺样体扁桃体切除术后腺样体残留或复发可导致阻塞性睡眠呼吸暂停（OSA）。我们旨在评估腺样体切除术治疗腺样体残留或复发且伴有 OSA 的儿童的多导睡眠图（PSG）结果。
方法
这是一项单中心回顾性研究，纳入了睡眠研究证实 OSA 且有腺样体扁桃体切除术病史的儿童，这些儿童被诊断为腺样体肥大，并随后接受了腺样体切除术。分析了腺样体切除术前后的 PSG 变量。
结果
共纳入 20 例儿童。该队列包括 13 名男性和 7 名女性，平均年龄为 7.8 岁（±3.6 岁）。平均 BMI z 评分 1.96[1.31，2.43]。从腺样体扁桃体切除术到腺样体切除术的中位时间为 2.3 年[1.4，4.0]。总体而言，腺样体切除术显著改善了多项呼吸参数，包括 AHI 6.6[1.4，13.7]与 14.8[7.4，20.7]，p=0.02；氧饱和度最低值 88.0[84.0，93.0]与 80.0[72.2，88.9]，p=0.01；仰卧位 AHI 8.6[1.5，14.3]与 17.6[8.3，30.2]，p=0.02；觉醒指数 12.2[9.6，15.7]与 18.9[13.4，24.9]，p=0.04。
结论
腺样体扁桃体切除术后腺样体残留或复发的儿童行腺样体切除术可改善呼吸事件、气体交换和觉醒指数。
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