Dr. Huang was supported by Far Eastern Memorial Hospital, Taipei, Taiwan.
Article first published online: 15 OCT 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 12, pages 2850–2854, December 2012
How to Cite
Cheng, P.-W., Fang, K.-M., Su, H.-W. and Huang, T.-W. (2012), Improved objective outcomes and quality of life after adenotonsillectomy with inferior turbinate reduction in pediatric obstructive sleep apnea with inferior turbinate hypertrophy. The Laryngoscope, 122: 2850–2854. doi: 10.1002/lary.23590
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 11 DEC 2012
- Article first published online: 15 OCT 2012
- Manuscript Accepted: 22 JUN 2012
- Manuscript Revised: 14 MAY 2012
- Manuscript Received: 13 MAR 2012
- Pediatric obstructive sleep apnea syndrome;
- inferior turbinate;
- allergic rhinitis;
- Level of Evidence: 2b
Whether adenotonsillectomy (AT) is sufficient for pediatric obstructive sleep apnea syndrome (OSAS) with persistent severe allergic rhinitis (PSAR) remains unclear. This study attempts to identify the role of inferior turbinate reduction in treating pediatric OSAS with PSAR.
Case series with planned data collection.
Fifty-one subjects aged 3 to 12 years with OSAS and PSAR were enrolled. Among them, 23 patients underwent AT concurrent with microdebrider-assisted inferior turbinoplasty (MAIT) (group AT-MAIT) and 28 patients underwent AT alone (group AT). Before surgery and at 1 year after surgery, objective outcomes were assessed using overnight polysomnography and acoustic rhinometry. Subjective outcomes were evaluated using the Obstructive Sleep Apnea (OSA)-18 quality-of-life questionnaire (OSA-18).
Following surgery, the median apnea-hypopnea index, minimal oxygen saturation, and snoring index were 0.8 (/h), 94 (%), and 104 (/h) in group AT-MAIT, respectively, compared with 3.5 (/h), 93 (%), and 158 (/h) in group AT, respectively (P < .05). In group AT-MAIT, the median postoperative minimal cross-sectional area recorded by acoustic rhinometry was 0.31 cm2, significantly larger than 0.16 cm2 in group AT (P < .01). Compared with postoperative scores in group AT, those in group AT-MAIT were significantly improved in domains of physical symptoms, emotional symptoms, daytime function, caregiver concerns, and overall OSA-18 scores (P < .05).
Analytical results suggest that AT with concurrent MAIT achieves favorable subjective and objective outcomes in pediatric OSAS with PSAR. We believe that volume reduction of the inferior turbinate plays an important role in treating pediatric OSAS with inferior turbinate hypertrophy. Laryngoscope, 2012