Improved objective outcomes and quality of life after adenotonsillectomy with inferior turbinate reduction in pediatric obstructive sleep apnea with inferior turbinate hypertrophy

Abstract

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.

Complications of turbinate reduction surgery in combination with tonsillectomy in pediatric patients

“…6 Another recent study documented objective improvements in physical and emotional symptoms, daytime performance, caregiver concerns, and overall OSA scores when microdebrider-assisted inferior turbinoplasty was performed in conjunction with T&A. 7 Finally, the safety of pediatric turbinoplasty with or without adenoidectomy was documented in a recent study. 8 Given the potential benefit of turbinoplasty in select pediatric patients with OSDB, but the concern for posttonsillectomy complications, the question arises as to whether or not T&A should be performed alone or if it can be performed safely with turbinoplasty procedures.…”

“…Aside from adenotonsillar hypertrophy, turbinate hypertrophy (TH) has also been implicated as a source of upper airway obstruction in some patients with obstructive sleep apnea (OSA) . One study of 25 adult patients found TH alone as the source of polysomnography‐confirmed primary snoring or mild OSA .…”

“…A recent pediatric study suggested turbinoplasty may be a useful adjunct to T&A in patients with turbinate hypertrophy because pediatric snoring is associated with increasing body mass index, palatal obstruction, and subjective turbinate size as opposed to adult palatal‐flutter based snoring . Another recent study documented objective improvements in physical and emotional symptoms, daytime performance, caregiver concerns, and overall OSA scores when microdebrider‐assisted inferior turbinoplasty was performed in conjunction with T&A . Finally, the safety of pediatric turbinoplasty with or without adenoidectomy was documented in a recent study…”

“…3,4 Aside from adenotonsillar hypertrophy, turbinate hypertrophy (TH) has also been implicated as a source of upper airway obstruction in some patients with obstructive sleep apnea (OSA). [5][6][7] One study of 25 adult patients found TH alone as the source of polysomnography-confirmed primary snoring or mild OSA. 5 In this small cohort of patients, their OSA was relieved with mouth breathing, indicating that TH alone can be a source of OSA in select patients.…”

The prediction of treatment failure of the continuous positive airways pressure

“…If CPAP fails, bi-level positive airway pressure (BiPAP) is the next step of treatment. Surgical treatment is an option depending on specifi c situations where the effect of PAP is limited by the obstruction of the upper airways (16,17,18) or when conservative therapy for severe obstructive SAS fails (19,20,21,22,23).…”