PDF(Pubmed)
Abstract：
OBJECTIVE: Pediatric obstructive sleep apnea (OSA) caused by adenoids or an enlarged palatine tonsil has a negative impact on physical and mental growth. Surgical removal of the tissue is effective but entails a life-threatening risk of postoperative bleeding, which is up to 30 times higher in chronic pediatric disease cases. However, endoscopes and resection devices provide safe, reliable surgical methods. Here, we report the efficacy and safety of endoscopic powered intracapsular tonsillectomy and adenoidectomy (PITA) for pediatric OSA in patients with high-risk comorbidities.
METHODS: This retrospective case series included pediatric patients with OSA who underwent PITA at a single tertiary medical center between April 2017 and May 2023. Ten patients (three males and seven females; mean age 6.4 years, range 2-12 years) were included; all met the Japanese criteria for complex chronic pediatric conditions.
RESULTS: The average operative time was 61 min; a microdebrider was used in eight cases and a coblator in two cases. Although there was no postoperative bleeding, one case experienced regrowth.
CONCLUSIONS: Our data show that an endoscopic PITA approach could reduce the risk of severe bleeding and relieve the sleeping conditions of pediatric patients with complex chronic OSA.
METHODS: This retrospective case series included pediatric patients with OSA who underwent PITA at a single tertiary medical center between April 2017 and May 2023. Ten patients (three males and seven females; mean age 6.4 years, range 2-12 years) were included; all met the Japanese criteria for complex chronic pediatric conditions.
RESULTS: The average operative time was 61 min; a microdebrider was used in eight cases and a coblator in two cases. Although there was no postoperative bleeding, one case experienced regrowth.
CONCLUSIONS: Our data show that an endoscopic PITA approach could reduce the risk of severe bleeding and relieve the sleeping conditions of pediatric patients with complex chronic OSA.
摘要：
目的：由腺样体或扁桃体增大引起的小儿阻塞性睡眠呼吸暂停（OSA）对身心发育有负面影响。手术切除组织是有效的，但有危及生命的术后出血风险，在慢性儿科疾病病例中高达30倍。然而,内窥镜和切除装置提供安全，可靠的手术方法。这里,我们报告了内镜下动力囊内扁桃体和腺样体切除术(PITA)治疗儿童OSA高危合并症患者的疗效和安全性.
方法：本回顾性病例系列包括2017年4月至2023年5月在一个三级医疗中心接受PITA的OSA儿科患者。十名患者（三名男性和七名女性；平均年龄6.4岁，范围2-12年);所有符合日本复杂慢性儿科疾病的标准。
结果：平均手术时间为61分钟；8例使用了微型清创器，2例使用了吸骨器。虽然没有术后出血,一个案例经历了再生。
结论：我们的数据表明，内镜下PITA方法可以降低患有复杂慢性OSA的儿科患者严重出血的风险并缓解睡眠状况。
方法：本回顾性病例系列包括2017年4月至2023年5月在一个三级医疗中心接受PITA的OSA儿科患者。十名患者（三名男性和七名女性；平均年龄6.4岁，范围2-12年);所有符合日本复杂慢性儿科疾病的标准。
结果：平均手术时间为61分钟；8例使用了微型清创器，2例使用了吸骨器。虽然没有术后出血,一个案例经历了再生。
结论：我们的数据表明，内镜下PITA方法可以降低患有复杂慢性OSA的儿科患者严重出血的风险并缓解睡眠状况。
