Comparison of Functional Outcomes after Powered Intracapsular Tonsillectomy with Adenoidectomy and Conventional Extracapsular Tonsillectomy with Adenoidectomy for Pediatric Obstructive Sleep Apnea
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Background and Objectives This study was investigated to compare the clinical outcomesand complications of powered intracapsular tonsillectomy and adenoidectomy (PITA) withthose of conventional extracapsular tonsillectomy and adenoidectomy (ECTA) in treatment ofpediatric obstructive sleep apnea (OSA). Subjects and Method Eighty-one children with adenotonsillar hyperplasia underwent tonsillectomyand adenoidectomy (46 PITA and 35 ECTA) from December 2016 to July 2017 forOSA. The choice of surgical procedure (PITA vs. ECTA) was determined by the number ofepisodes of acute tonsillitis. The quality of life measurement was performed using KoreanObstructive Sleep Apnea Survey (KOSA-18) score. Postoperative bleeding was assessed asnumber of revisit or readmission. Postoperative pain was evaluated by visual analog scale(VAS) at postoperative day 1, 3, and 7. Results PITA and ECTA significantly reduced KOSA-18 scores postoperatively (p＜0.01, p＜0.01,respectively) and were equally effective in pediatric OSA treatment. Postoperative bleeding waslower in the PITA group, but there was no statistical difference due to small number of cases. VASscore for postoperative pain was significantly lower in the PITA group at day 1, 3, and 7 (p=0.03,p＜0.01, and p＜0.01, respectively). Conclusion PITA is effective in pediatric OSA treatment with less morbidity, and less complications.
Abstract
Background and Objectives This study was investigated to compare the clinical outcomesand complications of powered intracapsular tonsillectomy and adenoidectomy (PITA) withthose of conventional extracapsular tonsillectomy and adenoidectomy (ECTA) in treatment ofpediatric obstructive sleep apnea (OSA). Subjects and Method Eighty-one children with adenotonsillar hyperplasia underwent tonsillectomyand adenoidectomy (46 PITA and 35 ECTA) from December 2016 to July 2017 forOSA. The choice of surgical procedure (PITA vs. ECTA) was determined by the number ofepisodes of acute tonsillitis. The quality of life measurement was performed using KoreanObstructive Sleep Apnea Survey (KOSA-18) score. Postoperative bleeding was assessed asnumber of revisit or readmission. Postoperative pain was evaluated by visual analog scale(VAS) at postoperative day 1, 3, and 7. Results PITA and ECTA significantly reduced KOSA-18 scores postoperatively (p＜0.01, p＜0.01,respectively) and were equally effective in pediatric OSA treatment. Postoperative bleeding waslower in the PITA group, but there was no statistical difference due to small number of cases. VASscore for postoperative pain was significantly lower in the PITA group at day 1, 3, and 7 (p=0.03,p＜0.01, and p＜0.01, respectively). Conclusion PITA is effective in pediatric OSA treatment with less morbidity, and less complications.
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