The Impact of Obstructive Sleep Apnea on the Development of Refractory Nasal Symptoms After Adenoidectomy
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: Chronic rhinitis may contribute to a persistently decreased quality of life in patients undergoing surgical treatment for obstructive sleep apnea (OSA). This study aimed to characterize the role of OSA in pediatric patients with refractory chronic rhinitis after adenoidectomy.Methods: We reviewed the charts of patients <18 years of age with a history of OSA who underwent adenoidectomy at an academic medical center from October 2012 to December 2018 and that were seen in the clinic for follow-up. They were identified through the Current Procedural Terminology (CPT) codes 42830 and 42831 with the exclusion of CPT 42820 for tonsillectomy and adenoidectomy. Patients with a prior diagnosis of OSA who had refractory symptoms were compared with those who had symptoms resolution using chi-square analysis and t-tests.Results: Thirty-six (35.0%) patients with refractory symptoms following adenoidectomy and 52 (37.4%) patients without refractory symptoms had a history of OSA before surgery (<i>p</i>=0.80). In patients with refractory symptoms, the average age (3.8 years) and male sex (n=24, 66.7%) did not differ significantly from the age (4.42 years) and male sex (n=36, 69.2%) percentages of patients without refractory symptoms. The mean apnea/hypopnea-index (AHI) (<i>p</i>=0.91), completion of the sleep study (<i>p</i>=0.41), history of snoring (<i>p</i>=0.92), and tonsil size (<i>p</i>=0.42) did not differ significantly between the groups. However, patients with refractory symptoms had a significantly higher mean body mass index (BMI) (19.58) than those who did not (17.77, <i>p</i>=0.04) and completed a higher number of allergy evaluations (<i>p</i>=0.02).Conclusions: While the history and severity of OSA did not differ significantly in patients with refractory nasal symptoms after adenoidectomy, these patients had a significantly higher BMI and completion of allergy evaluation.
Abstract
Objectives: Chronic rhinitis may contribute to a persistently decreased quality of life in patients undergoing surgical treatment for obstructive sleep apnea (OSA). This study aimed to characterize the role of OSA in pediatric patients with refractory chronic rhinitis after adenoidectomy.Methods: We reviewed the charts of patients <18 years of age with a history of OSA who underwent adenoidectomy at an academic medical center from October 2012 to December 2018 and that were seen in the clinic for follow-up. They were identified through the Current Procedural Terminology (CPT) codes 42830 and 42831 with the exclusion of CPT 42820 for tonsillectomy and adenoidectomy. Patients with a prior diagnosis of OSA who had refractory symptoms were compared with those who had symptoms resolution using chi-square analysis and t-tests.Results: Thirty-six (35.0%) patients with refractory symptoms following adenoidectomy and 52 (37.4%) patients without refractory symptoms had a history of OSA before surgery (<i>p</i>=0.80). In patients with refractory symptoms, the average age (3.8 years) and male sex (n=24, 66.7%) did not differ significantly from the age (4.42 years) and male sex (n=36, 69.2%) percentages of patients without refractory symptoms. The mean apnea/hypopnea-index (AHI) (<i>p</i>=0.91), completion of the sleep study (<i>p</i>=0.41), history of snoring (<i>p</i>=0.92), and tonsil size (<i>p</i>=0.42) did not differ significantly between the groups. However, patients with refractory symptoms had a significantly higher mean body mass index (BMI) (19.58) than those who did not (17.77, <i>p</i>=0.04) and completed a higher number of allergy evaluations (<i>p</i>=0.02).Conclusions: While the history and severity of OSA did not differ significantly in patients with refractory nasal symptoms after adenoidectomy, these patients had a significantly higher BMI and completion of allergy evaluation.
참고문헌 (16)
- Doulaptsi M, "Differentiating rhinitis in the paediatric population by giving focus on medical history and clinical examination", Med Sci(Basel), 7, pp.38~ (2019)[DOI]
- Pereira L, "Prevalence of adenoid hypertrophy : a systematic review and meta-analysis", Sleep Med Rev, 38, pp.101~112 (2018)[DOI]
- Loekmanwidjaja J, "Sleep disorders in children with moderate to severe persistent allergic rhinitis", Braz J Otorhinolaryngol, 84, pp.178~184 (2018)[DOI]
- Dogru M, "Does adenoid hypertrophy affect disease severity in children with allergic rhinitis?", Eur Arch Otorhinolaryngol, 274, pp.209~213 (2017)[DOI]
- Brietzke SE, "Adenoidectomy outcomes in pediatric rhinosinusitis : a meta-analysis", Int J Pediatr Otorhinolaryngol, 72, pp.1541~1545 (2008)[DOI]
- Ehsan Z, "Pediatric obstructive sleep apnea", Otolaryngol Clin North Am, 49, pp.1449~1464 (2016)[DOI]
- Huang YS, "Pediatric obstructive sleep apnea : where do we stand?", Adv Otorhinolaryngol, 80, pp.136~144 (2017)[DOI]
- Zheng M, "Association between allergic and nonallergic rhinitis and obstructive sleep apnea", Curr Opin Allergy Clin Immunol, 18, pp.16~25 (2018)[DOI]
- Magliulo G, "Nasal pathologies in patients with obstructive sleep apnoea", Acta Otorhinolaryngol Ital, 39, pp.250~256 (2019)[DOI]
- Tagaya M, "Relationship between adenoid size and severity of obstructive sleep apnea in preschool children", Int J Pediatr Otorhinolaryngol, 76, pp.1827~1830 (2012)[DOI]
- Yalamanchali S, "Effects of endoscopic sinus surgery and nasal surgery in patients with obstructive sleep apnea", Otolaryngol Head Neck Surg, 151, pp.171~175 (2014)[DOI]
- Clarenbach CF, "Does nasal decongestion improve obstructive sleep apnea?", J Sleep Res, 17, pp.444~449 (2008)[DOI]
- Jung SY, "Role of obesity in otorhinolaryngologic diseases", Curr Allergy Asthma Rep, 19, pp.34~ (2019)[DOI]
- Lennon CJ, "Risk of failure of adenotonsillectomy for obstructive sleep apnea in obese pediatric patients", Int J Pediatr Otorhinolaryngol, 92, pp.7~10 (2017)[DOI]
- Park DY, "Association of body mass index and other factors with histamine skin reactivity in adults with allergic nasal symptoms", Am J Rhinol Allergy, 29, pp.e160~e163 (2015)[DOI]
- Bhattacharyya N, "Associations between obesity and inflammatory sinonasal disorders", Laryngoscope, 123, pp.1840~1844 (2013)[DOI]