Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up
Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up
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DOI：
10.1186/s40463-014-0026-6
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发表时间：
2014-07-27
影响因子：
3.4
通讯作者：
Hultcrantz, Elisabeth
中科院分区：
文献类型：
--
作者：
Ericsson, Elisabeth;Graf, Jonas;Hultcrantz, Elisabeth
目的：研究扁桃体切开术和扁桃体切除术对幼儿的长期效果，并与6个月后的结果进行比较。方法：将4-5岁患有睡眠呼吸障碍（SDB）和扁桃体增生的儿童随机分为TE组（32例）和TT组（35例）。TT采用射频技术（Ellman）进行。80%的病例在同一时间用冷钢进行腺样体切除术。在术前、术后6个月和24个月对患者进行评估。手术的影响进行了临床评估，通过问卷调查（一般健康/打鼾/ENT感染），生活质量（QoL），调查儿童阻塞性睡眠呼吸暂停与OSA-18，和儿童的行为与儿童行为Checklist.Results：两年后，仍然没有组之间的差异，打鼾和频率或严重程度的上呼吸道感染。TT和TE均导致短期和长期生活质量和行为的大幅改善。3名TT儿童和1名TE儿童因梗阻问题复发而再次手术，TE儿童和1名TT儿童行腺样体切除术，2名TT儿童行扁桃体切除术。三TT-儿童扁桃体组织略有突出的扁桃体袋和12 TE-儿童扁桃体袋内的小扁桃体残留物，但没有必要为surgery.Conclusion：年轻的孩子有一个小的风险，复发需要再次手术后两年内TT。对于大多数人来说，对打鼾，感染，行为和生活质量的积极影响仍然存在，并且与TE相似。
Objectives: To study the long-term effect of tonsillotomy and tonsillectomy in young children after two years in comparison to the results after six months.Method: Children, age 4-5 with Sleep Disordered Breathing (SDB) and tonsil hyperplasia, were randomized to TE (32) or TT (35). TT was performed ad modum Hultcrantz with radiofrequency technique (Ellman). An adenoidectomy with cold steel was performed in the same session for 80% of cases. The patients were assessed prior to surgery, at six and 24 months postoperatively. Effects of surgery were evaluated clinically, through questionnaire (general health/snoring/ENT-infections), Quality of Life (QoL), survey of pediatric obstructive sleep apnea with OSA-18, and children's behavior with the Child Behavior Checklist.Results: After two years there was still no difference between the groups with respect to snoring and frequency or severity of upper airway infections. Both TT and TE had resulted in large improvement in short and long term QoL and behavior. Three TT-children and one TE child had been re-operated due to recurrence of obstructive problems, the TE-child and one of the TT-children with adenoidectomy and two of the TT-children with tonsillectomy. Three of the TT-children had tonsil tissue protruding slightly out of the tonsil pouch and twelve TE-children had small tonsil remnants within the tonsil pouches, but with no need for surgery.Conclusion: Younger children have a small risk of symptom-recurrence requiring re-surgery within two years after TT. For the majority, the positive effect on snoring, infections, behavior and quality of life remain and is similar to TE.