Base of Tongue Surgery and Pediatric Obstructive Sleep Apnea.

Autor: Williamson A; Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA., McArdle EH; Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA., Morrow VR; School of Medicine, West Virginia University, Morgantown, West Virginia, USA., Zalzal HG; Department of Otolaryngology-Head and Neck Surgery, Children's National Hospital, Washington, DC, USA., Carr MM; Department of Otolaryngology-Head Neck Surgery, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York, USA., Coutras SW; Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2023 Apr; Vol. 168 (4), pp. 839-847. Date of Electronic Publication: 2023 Feb 05.
DOI: 10.1177/01945998221094211
Abstrakt: Objective: Drug-induced sleep endoscopy-directed lingual tonsillectomy and midline posterior glossectomy have been employed for the treatment of obstructive sleep apnea in children. The purpose of this study is to evaluate outcomes in children undergoing lingual tonsillectomy, midline posterior glossectomy, or combined base of tongue reduction procedures for obstructive sleep apnea.
Study Design: Case series with chart review.
Setting: Tertiary care academic medical center.
Methods: A case series was performed with chart review of pediatric patients with obstructive sleep apnea who underwent base of tongue surgery as directed by drug-induced sleep endoscopy. Pre- and postoperative obstructive apnea-hypopnea index (oAHI) was compared. Age, sex, body mass index z score, and medical history were also evaluated.
Results: A total of 168 children were included, with a mean ± SD age of 8.3 ± 3.6 years. Of these patients, 101 underwent lingual tonsillectomy alone; 25, midline posterior glossectomy alone; and 42, both. Their mean oAHI improvement was 3.52 ± 8.39, 2.55 ± 5.59, and 3.70 ± 6.07, respectively. Each surgical group experienced significant improvement in sleep apnea when pre- and postoperative oAHI was compared (P < .01). Overall surgical success, as defined by oAHI <1 (or <5 without clinical symptoms), was 75% (126 patients).
Conclusion: When guided by drug-induced sleep endoscopy, pediatric tongue base surgery can significantly improve oAHI and thus demonstrates promising success in treating pediatric obstructive sleep apnea.
(© 2022 American Academy of Otolaryngology-Head and Neck Surgery Foundation.)
Databáze: MEDLINE
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