Hurly Jordyn A, Clements Anna Christina, Ryan Marisa A, Ballard Megan, Jenks Carolyn, Tunkel David E, Walsh Jonathan M
Johns Hopkins University School of Medicine Baltimore Maryland USA.
Department of Otolaryngology-Head and Neck Surgery University of Washington Seattle WA USA.
Laryngoscope Investig Otolaryngol. 2025 Sep 13;10(5):e70255. doi: 10.1002/lio2.70255. eCollection 2025 Oct.
Intracapsular tonsillectomy is associated with decreased postoperative pain, shortened recovery, and decreased bleeding risk. No study has specifically investigated its use in patients with exclusively severe or very severe obstructive sleep apnea syndrome (OSAS). Our study aimed to report severe OSAS outcomes following intracapsular (IT) compared to total tonsillectomy (TT) in pediatric patients with severe and very severe OSAS.
We conducted a retrospective study including patients ≤ 18 years of age who underwent adenotonsillectomy or tonsillectomy between June 2018 and June 2022 at a tertiary care center. Patients were categorized preoperatively as having severe OSAS (OAHI ≥ 10) or very severe OSAS (OAHI ≥ 30). Primary outcomes included obstructive apnea-hypopnea index (OAHI), oxygen saturation nadir, presence of hypercarbia, and respiratory disturbance index (RDI) as measured on postoperative polysomnography, as well as residual OSAS requiring CPAP.
Of 57 patients in this study, the mean age was 4.5 (±2.9) and 59.7% were male. There was no significant difference in postoperative residual OSAS outcomes following surgery for patients in either severity group, with a mean time to follow up polysomnogram of 237 (range: 24-885) days.
Our study reveals that for both severe OSAS and very severe OSAS, there is no difference in the primary outcome of postoperative OAHI with regard to surgical technique; however, long-term postoperative outcomes are still needed.
囊内扁桃体切除术与术后疼痛减轻、恢复时间缩短和出血风险降低相关。尚无研究专门调查其在单纯重度或极重度阻塞性睡眠呼吸暂停综合征（OSAS）患者中的应用。我们的研究旨在报告在患有重度和极重度OSAS的儿科患者中，与全扁桃体切除术（TT）相比，囊内扁桃体切除术（IT）后的重度OSAS结局。
我们进行了一项回顾性研究，纳入了2018年6月至2022年6月在一家三级医疗中心接受腺样体扁桃体切除术或扁桃体切除术的18岁及以下患者。术前将患者分类为患有重度OSAS（阻塞性呼吸暂停低通气指数[OAHI]≥10）或极重度OSAS（OAHI≥30）。主要结局包括术后多导睡眠图测量的阻塞性呼吸暂停低通气指数（OAHI）、最低氧饱和度、高碳酸血症的存在以及呼吸紊乱指数（RDI），以及需要持续气道正压通气（CPAP）的残余OSAS。
本研究中的57例患者，平均年龄为4.5（±2.9）岁，59.7%为男性。两个严重程度组的患者术后残余OSAS结局无显著差异，随访多导睡眠图的平均时间为237天（范围：24 - 885天）。
我们的研究表明，对于重度OSAS和极重度OSAS，手术技术在术后OAHI主要结局方面没有差异；然而，仍需要长期术后结局。
4级。
