Safety and efficacy of lingual tonsillectomy in multilevel airway surgery for pediatric obstructive sleep apnea.

Autor:	Williamson A; Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia., Morrow VR; Department of Orthopaedics, West Virginia University, Morgantown, West Virginia., Carr MM; Department of Otolaryngology-Head Neck Surgery, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York., Coutras SW; Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia.
Jazyk:	angličtina
Zdroj:	Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2024 Feb 01; Vol. 20 (2), pp. 189-199.
DOI:	10.5664/jcsm.10816
Abstrakt:	Study Objectives: Prior studies have demonstrated the efficacy of lingual tonsillectomy in treating pediatric obstructive sleep apnea. The goal of this study is to describe the postoperative outcomes following lingual tonsillectomy as a part of drug-induced sleep endoscopy-directed multilevel sleep surgery. Methods: A retrospective review was performed for pediatric patients with obstructive sleep apnea who underwent lingual tonsillectomy as a part of drug-induced sleep endoscopy-directed sleep surgery. Data collected included age, sex assigned at birth, body mass index z-score, polysomnography results, past medical and surgical history, and postoperative outcomes. Results: A total of 174 patients were included in the study with a mean age of 8.29 ± 3.49 years (range 1.89-15.62) and mean preoperative apnea-hypopnea index of 7.88 ± 13.42 (range 1.10-123.40). Complications occurred in 26 patients (14.9%) including 14 patients (8.0%) requiring emergency department visit or readmission and 12 patients (6.9%) experiencing postoperative bleeding. Asthma ( P = .033) and developmental delay ( P = .016) correlated with postoperative complications. For patients with preoperative and postoperative polysomnography data (n = 145; 83.3%), there was significant improvement ( P < .001) in apnea-hypopnea index with a mean postoperative apnea-hypopnea index of 4.02 ± 7.81 (range 0.00-54.46). Surgical failure, defined as postoperative apnea-hypopnea index ≥ 5, was identified in 25 patients (17.2%). Surgical failure was associated with body mass index z-score > 2 ( P = .025) and Trisomy 21 ( P = .005). Conclusions: This study highlights the promising surgical success rate of drug-induced sleep endoscopy-directed lingual tonsillectomy in multilevel sleep surgery (82.8%) and infrequent complications including postoperative bleeding (6.9%) and readmission (2.3%). Citation: Williamson A, Morrow VR, Carr MM, Coutras SW. Safety and efficacy of lingual tonsillectomy in multilevel airway surgery for pediatric obstructive sleep apnea. J Clin Sleep Med . 2024;20(2):189-199. (© 2024 American Academy of Sleep Medicine.)
Databáze:	MEDLINE
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