수면호흡장애와 관련한 편도 절제술 적응증의 변화
Changes of Indication in Tonsillectomy Associated with Sleep-Disordered Breathing
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9년 동안 15세 이하의 소아의 경우, 편도 적출술의 적응증은 남녀 모두 감염과 수면호흡장애가 함께 적응증이 되는 비율이 가장 높았으며 두시기간 유의한 차이는 없었다. 성인의 경우, 특히 남성에서 수면호흡장애의 치료로써 편도 적출술을 시행 받는 비율이 유의하게 증가했음을 알 수있었다. 전세계적으로 비만인구가 증가하는 추세인 요즘 수면호흡질환의 진단과 치료의 중요성이 날로 증가하고 있다. 본연구의 결과 또한 이러한 실상을 잘 반영하고 있으며, 향후 편도질환의 수술적 치료가 수면호흡장애의 적극적인 치료의 한 부분으로 활용되어야 할 것으로 사료된다.
Abstract
With patients increasingly interested in snoring and sleep apnea, sleep-disordered breathing (SDB) patients are frequently encountered in the otolarygologic office. Tonsillectomy is one of the frequently used technique, among surgical procedure of SDB. Retrospective analysis was done about patients who underwent tonsilletomy to find change of incidence in tonsillectomy as a treatment of SDB. Materials and Methods：From January 1998 to December 1999, retrospective chart analysis of indication of tonsillcetomy was done about 2 groups divided by age under fifteen and over sixteen. Same chart review was done from January 2007 to December 2008. Indication of tonsillectomy was divided as infection group, SDB group and mixed group. Results：Under age of fifteen, From January 1998 to December 1999, tonsillectomy indication were mixed group, infection group and SDB group, in the order of frequency. From January 2007 to December 2008, the order had changed as mixed group, SDB group and infection group. There was no statistical significance these change. In other hands, At that time, SDB group had been incresed from 28.3% to 59.5% in adult male group. (p=0.002) Conclusion：Proportion of tonsillecetomy as a treatment of SDB has beeen increased in male adult. Recently, frequency of tonsillectomy realated with SDB has been incresed. Surgical treatment of tonsil is considered as an active solution of SDB.
참고문헌 (18)
- Discolo CM, "Infectious indications for tonsillectomy", Pediatr Clin North Am, 50(2), pp.445~458 (2003)
- Darrow DH, "Indications for tonsillectomy and adenoidectomy", Laryngoscope, 112(8), pp.6~10 (2002)
- "Ambulatory and inpatient procedures in the United States, 1996. National Center for Health Statistics. Vital Health Stat 13 (139)" (1998)[URL]
- Deutsch ES, "Tonsillectomy and adenoidectomy: changing indications", Pediatr Clin N Am, 43(6), pp.1319~1338 (1996)
- Young T, "The occurrence of sleep-disordered breathing among middle- aged adults", N Engl J Med, 328(17), pp.1230~1235 (1993)
- Hudgel DW, "Variable site of airway narrowing among obstructive sleep apnea patients", J Appl Physio, 61(4), pp.1403~1409 (1986)
- Kezirian EJ, "Drug-induced sleep endoscopy: the VOTE classification", Eur Arch Otorhinolaryngol, 268(8), pp.1233~1236 (2011)
- Rosenfeld RM, "Tonsillectomy and adenoidectomy: changing trends", Ann Otol Rhinol Laryngol, 99(3), pp.187~191 (1990)
- Brunetti L, "Prevalence of obstructive sleep apnea syndrome in a cohort of 1,207 children of southern Italy", Chest, 120(6), pp.1930~1935 (2001)
- Erickson BK, "Changes in incidence and indications of tonsillectomy and adenotonsillectomy, 1970-2005", Otolaryngol Head Neck Surg, 140(6), pp.894~901 (2009)
- Jin YW, "Changing trends of indications in adenotonsillectomy", Korean J Bronchoesophagol, 6(1), pp.72~79 (2000)
- Parker NP, "Trends in the indications for pediatric tonsillectomy or adenotonsillectomy", Int J Pediatr Otorhinolaryngol, 75(2), pp.282~285 (2011)
- Veasey SC, "Medical therapy for obstructive sleep apnea: a review by the Medical Therapy for Obstructive Sleep Apnea Task Force of the Standards of Practice Committee of the American Academy of Sleep Medicine", Sleep, 29(8), pp.1036~1044 (2006)
- Sullivan CE, "Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares", Lancet, 1(8225), pp.862~865 (1981)
- Kaneko Y, "Cardiovascular effects of continuous positive airway pressure in patients with heart failure and obstructive sleep apnea", N Engl J Med, 348(13), pp.1233~1241 (2003)
- Marin JM, "Long-term cardiovascular outcomes in men with obstructive sleep apnoeahypopnoea with or without treatment with continuous positive airway pressure: an observational study", Lancet, 365(9464), pp.1046~1053 (2005)
- Kapsimalis F, "Gender and obstructive sleep apnea syndrome, part 2: mechanisms", Sleep, 25(5), pp.499~506 (2002)
- Guilleminault C, "Women and the obstructive sleep apnea syndrome", Chest, 93(1), pp.104~109 (1988)