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Tonsillotomy of OSAS treatment confirmed by polysomnography in childhood

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ONDROVÁ Martina RYZÍ Michal MÁCHALOVÁ Michaela KRAUS Jaroslav FLORIANOVÁ Linda

Rok publikování 2012
Druh Konferenční abstrakty
Fakulta / Pracoviště MU

Lékařská fakulta

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Popis Obstructive sleep apnea syndrome (OSAS) in childhood is often caused by hypertrophy of the palatine tonsils. The only objective examination is polysomnography. Objectives Recommended method of treatment for hypertrophy of the palatine tonsils with symptoms of OSAS is a tonsillectomy. The goal is to prove that an adequate method of the treatment of OSAS in children with tonsils hypertrophy is a both side tonsillotomy. The study was controled by polysomnography before and after surgery treatment. Determine the effectiveness of the tonsillotomy to apnea pauses and other symptoms caused by this hypertrophy. Methods In the period 2006-2012 were examined 50 patients in age from 2 to 10 years old at Pediatric ENT Clinic in University Hospital in Brno and ENT Department in Benešov. All patients have tonsillar hypertrophy more than 50 percent of the pharyngeal space. Positive anamnestic symptoms were apnea and snoring. Overnight polysomnography test of all children had to realized at Pediatric Neurology Clinic in University Hospital in Brno. OSAS were confirmed in 33 patients. The value of AHI were in the range of 1.2 to 42. 17 patients were confirmed only ronchopathy with AHI < 1. Both side tonsillotomy was made in the group of 26 patient. The control polysomnography was performed between 6 weeks and 3 months after healing. Results The group to polysomnographic examination before and after tonsillotomy included 33 patients. 7 patients had AHI =0 after tonsillectomy. AHI value was zero after tonsillotomy in 25 children. Only 1 patient was found AHI of 0,9 (before surgery was AHI 42). No recurrent tonsillitis were found. No recurrent hypertrophy was found. Conclusion Therapeutic effect of tonsillotomy (success rate 94.4%) is comparable with tonsillectomy (success rate in literature 70-90%). Reduction radikality does not change the effect of OSAS treatment , while maintaining the functional part of the palatine tonsils in children age is importance for the development of the immune system and it is the positive effect of tonsillotomy.

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