Can pillar suturing promote efficacy of adenotonsillectomy for pediatric osas? A prospective randomized controlled trial

Authors

  • Po-Han Chiu MD,

    1. Department of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
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  • Kannan Ramar MD,

    1. Division of Pulmonary, Sleep & Critical Care Medicine, Mayo Clinic, Center for Sleep Medicine, Rochester, Minnesota, U.S.A.
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  • Kuang-Chao Chen MD,

    1. Department of Otolaryngology, Cheng Hsin General Hospital, Taipei, Taiwan
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  • Yih-Jeng Tsai MD, MSc,

    1. Department of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
    2. Department of Otolaryngology Head and Neck Surgery, School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
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  • Chia-Mo Lin MD,

    1. Sleep Center and Department of Pulmonology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
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  • Yuh-Chyun Chiang MD, MSc,

    1. Department of Otolaryngology, Taiwan Adventist Hospital, Taipei, Taiwan
    2. Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei, Taiwan
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  • Chia-Ying Lu MPA,

    1. Department of Public Administration, National Chengchi University, Taipei, Taiwan
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  • Rayleigh Ping-Ying Chiang MD, MMS

    Corresponding author
    1. Department of Otolaryngology Head and Neck Surgery, School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
    2. Sleep Technology Special Interest Group, INSIGHT Center, National Taiwan University, Taipei, Taiwan
    • Department of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Send correspondence to Rayleigh Ping-Ying Chiang, MD, MMS, Department of Otorhinolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, No.95, Wen-Chang Rd., Shih-lin Dist., Taipei City 111, Taiwan (R.O.C.). E-mail: rayleighchiang@ntu.edu.tw

Abstract

Objectives/Hypothesis

Pediatric obstructive sleep apnea syndrome (OSAS) is a common disorder with serious clinical implications if left untreated. The recommended initial treatment for pediatric patients with obstructive sleep apnea syndrome (OSAS) is adenotonsillectomy. However, recent reports have shown variable surgical results with adenotonsillectomy in the treatment of pediatric OSAS.

Study Design

Prospective, controlled study.

Methods

From April 2007 to August 2010, 24 participants were assigned alternatively to either adenotonsillectomy with pillar suturing (intervention group) or adenotonsillectomy alone (control group).

Result

The average improvement in apnea hypopnea index (AHI) was 42.6% in the control group and 79.9% in the intervention group (P=0.037). The success rate was 50% in the control group and 91.6% in the intervention group (P=0.034). Six patients (50%) in the intervention group achieved complete resolution of pediatric OSAS, as defined by an AHI <1/hour, compared to 2 patients (16.7%) in the control group (P=0.097).

Conclusion

Adenotonsillectomy with pillar suturing showed significant improvement in treating pediatric patients with OSAS compared to adenotonsillectomy alone. The procedure is simple and safe.

Level of Evidence

4. Laryngoscope, 123:2574–2578, 2013

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