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편도 및 아데노이드 절제술 후 잔존하는 코골이가 있는소아 환자에서 하비갑개 후방 축소술이 증상 호전에 미치는 영향

The Effect of Posterior Coblation of Inferior Turbinate on Remained Snoring and Sleep Apnea after Pediatric Tonsillectomy and Adenoidectomy

이장수|배재훈|김남국|오훈재
대한이비인후과학회 부산,울산,경남 지부회 (The Busan, Ulsan, Gyeoungnam Branch of The Korean Society of Otolaryngology)|2018.06|임상이비인후과 (Journal of Clinical Otolaryngology)|제29권 제1호|pp. 57-62|DOI 10.35420/jcohns.2018.29.1.57

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참고문헌

키워드

수면무호흡증코골이하비갑개편도아데노이드절제술코블레이션.AdenotonsillectomyㆍSnoringㆍObstructive sleep apneaㆍCoblationㆍInferior turbinate.
주제분류이비인후과학

초록

Chronic upper airway obstruction attributable to adenotonsillar hypertrophy is the most common cause of sleep disordered breathing (SDB) in children. Palatine tonsillectomy and adenoidectomy (T&A) is effective for the treatment of pediatric OSA patients. However, in some children, there are still unresolved snoring and obstructive sleep apnea after the operation. This study is aimed at evaluating the efficacy of posterior coblation of inferior turbinate with remained snoring and sleep apnea after pediatric tonsillectomy and adenoidectomy. Materials and Methods：We performed Prospective study about 41 children who had done tonsillectomy and adenoidectomy but still suffering from simple snoring and mouth breath, aged between 8 to 15 years old, from January to December in 2015. We did additional inferior coblation of inferior turbinate for 41 patients. Over the period between preoperation and 1, 3, 6, 12 months after operation, we evaluated Apnea-Hypopnea Index (AHI), oxygen saturation by polysomnography, degree of snoring by Visual Analogue Sacle (VAS) score, satisfaction for quality of sleep by Epworth Sleepiness Scale (ESS), Minimal Cross section Area (MCA) and volume of nasal cavity by acoustic rhinometry, respectively. Results：After Posterior coblation of Inferior turbinate, the volume of nasal cavity voulme and MCA increased. There were significant improvements of AHI, oxygen saturation, MCA VAS and ESS score after tonsillectomy and adenoidectomy. But Additional posterior coblation did not make meaningful changes in AHI and saturation compared with tonsillectomy and adenoidectomy. Conclusions：As for pediatric OSA surgery, the evaluation of posterior nasal cavity is an indispensable factor for improving the quality of sleep and snoring. When treating pediatric OSA patients who have nasal obstruction, Posteior Coblation of inferior turbinate should be considered.

Abstract

Chronic upper airway obstruction attributable to adenotonsillar hypertrophy is the most common cause of sleep disordered breathing (SDB) in children. Palatine tonsillectomy and adenoidectomy (T&A) is effective for the treatment of pediatric OSA patients. However, in some children, there are still unresolved snoring and obstructive sleep apnea after the operation. This study is aimed at evaluating the efficacy of posterior coblation of inferior turbinate with remained snoring and sleep apnea after pediatric tonsillectomy and adenoidectomy. Materials and Methods：We performed Prospective study about 41 children who had done tonsillectomy and adenoidectomy but still suffering from simple snoring and mouth breath, aged between 8 to 15 years old, from January to December in 2015. We did additional inferior coblation of inferior turbinate for 41 patients. Over the period between preoperation and 1, 3, 6, 12 months after operation, we evaluated Apnea-Hypopnea Index (AHI), oxygen saturation by polysomnography, degree of snoring by Visual Analogue Sacle (VAS) score, satisfaction for quality of sleep by Epworth Sleepiness Scale (ESS), Minimal Cross section Area (MCA) and volume of nasal cavity by acoustic rhinometry, respectively. Results：After Posterior coblation of Inferior turbinate, the volume of nasal cavity voulme and MCA increased. There were significant improvements of AHI, oxygen saturation, MCA VAS and ESS score after tonsillectomy and adenoidectomy. But Additional posterior coblation did not make meaningful changes in AHI and saturation compared with tonsillectomy and adenoidectomy. Conclusions：As for pediatric OSA surgery, the evaluation of posterior nasal cavity is an indispensable factor for improving the quality of sleep and snoring. When treating pediatric OSA patients who have nasal obstruction, Posteior Coblation of inferior turbinate should be considered.

참고문헌 (17)

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