Postoperative characteristics of combined pharyngoplasty and tonsillectomy versus tonsillectomy in children with obstructive sleep apnea syndrome

Shu, Yan; Yao, Hongbing; Yang, Dazhi; Wang, Bing

doi:10.5546/aap.2018.eng.316

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…Velopharyngeal insufficiency may occur when the upper airway is structurally modified by excessive manipulation, which affects the position and height of the palate, including the uvula. 24 Genc et al had shown a higher incidence of velopharyngeal insufficiency in the pillar suture group than in the control group. 7 However, our summated results showed no statistical significance in velopharyngeal insufficiency.…”

Section: Discussionmentioning

confidence: 95%

Efficacy of pillar suture for post-tonsillectomy morbidity in children: a meta-analysis

Kim

et al. 2021

Brazilian Journal of Otorhinolaryngology

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Section: Discussionmentioning

confidence: 95%

Efficacy of pillar suture for post-tonsillectomy morbidity in children: a meta-analysis

Kim

et al. 2021

Brazilian Journal of Otorhinolaryngology

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“…The study qualities ranged between 4 and 9, that is, overall moderate or high quality (Table 1 ). 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 …”

Section: Resultsmentioning

confidence: 99%

“…29 White pseudomembranes in the non‐suturing group would take longer to slough off. 23 Infection or the sloughing of fibrin clots might expose and erode the small vessels. Therefore, we considered the existence of a suture might protect against secondary hemorrhage caused by blood vessels or mucosa.…”

Section: Discussionmentioning

confidence: 99%

Can intraoperative suturing reduce the incidence of posttonsillectomy hemorrhage? A systematic review and meta‐analysis

Wang

et al. 2022

Laryngoscope Investig Oto

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Objective This study was to compare tonsillectomy with intraoperative suturing (TIS) and tonsillectomy without intraoperative suturing (TsIS) in preventing postoperative tonsillectomy hemorrhage (PTH). Methods The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines was followed. Articles compare TIS and TsIS in preventing PTH were included. The quality of eligible studies was assessed with the Newcastle‐Ottawa Scale (NOS) by two independent investigators. Random effect models were used to determine odds ratio (OR) with 95% CIs. Results A total of 15 studies were analyzed. The pooled results showed the PTH rate was lower in the TIS group (OR = 0.64; 95% CI, 0.47–0.88). The TIS group had a lower primary and secondary PTH rate than the TsIS group with OR values of 0.44 (95% CI, 0.30–0.64) and 0.70 (95% CI, 0.54–0.90), respectively. However, suturing did not show an advantage in reducing the risk of returning to the operation room for hemostasis (OR = 0.57; 95% CI, 0.13–2.47). Adults might benefit from the intraoperative suturing procedure (OR = 0.31; 95% CI, 0.16–0.60). Patients with more than three stitches on each side had a lower PTH rate (OR: 0.44; 95% CI, 0.32–0.60). Suturing the tonsillar fossa and pillars simultaneously could reduce the PTH rate (OR = 0.47; 95% CI, 0.34–0.64). Conclusions Intraoperative suturing is a good strategy for preventing PTH. More multicenter randomized controlled studies should be conducted to demonstrate the efficacy of this procedure. Level of Evidence 5.

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“…Shallow anesthesia may induce laryngeal spasms, but the incidence of laryngeal spasms was the same among the three groups observed in this study, which may be related to the fact that there were 46-56 patients in the three groups of samples selected in this study and that intraoperative cold incision had less damage to blood vessels and nerves, light wound bleeding and edema, and lower risk of blood aspiration to the respiratory tract. With the increase in the depth of anesthesia, children might also experience hypoxemia that might induce trauma to children, despite an increase in analgesic effect, which was not conducive to their postoperative rehabilitation (20). Under a certain anesthesia depth index interval, extubation can effectively avoid sudden awakening caused by shallow anesthesia depth (21,22).…”

Section: Discussionmentioning

confidence: 99%

Tracheal extubation under Narcotrend EEG monitoring at different depths of anesthesia after tonsillectomy in children: a prospective randomized controlled study

An,

Zhang,

Chen

2024

Front. Pediatr.

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ObjectiveThis study aims to investigate whether tracheal extubation at different depths of anesthesia using Narcotrend EEG (NT value) can influence the recovery quality from anesthesia and cognitive function of children who underwent tonsillotomy.MethodsThe study enrolled 152 children who underwent tonsillotomy and were anesthetized with endotracheal intubation in our hospital from September 2019 to March 2022. These patients were divided into Group A (conscious group, NT range of 95–100), Group B (light sedation group, NT range of 80–94), and Group C (conventional sedation group, NT range of 65–79). A neonatal pain assessment tool, namely, face, legs, activity, cry, and consolability (FLACC), was used to compare the pain scores of the three groups as the primary end point. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scales were used to evaluate the cognitive function of children in the three groups before and after surgery as the secondary end points.ResultsDifferences were observed in the awakening time and FLACC scores after awakening among the three groups (P < 0.05). Among them, Group A exhibited a significantly shorter awakening time and higher FLACC score after awakening than those in Groups B and C (both P < 0.05). The total incidence of adverse reactions in Group B was significantly lower than that in Groups A and C (P < 0.05). No significant difference was observed in MMSE and MoCA scores before the operation and at 7 days after the operation among the three groups (P > 0.05), but a significant difference was found in MMSE and MoCA scores at 1 day and 3 days after the operation among the three groups (P < 0.05). In addition, MMSE and MoCA scores of the three groups decreased significantly at 1 day and 3 days after the operation than those at 1 day before the operation (P < 0.05).ConclusionWhen the NT value of tonsillectomy is between 80 and 94, tracheal catheter removal can effectively improve the recovery quality and postoperative cognitive dysfunction of children.

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Postoperative characteristics of combined pharyngoplasty and tonsillectomy versus tonsillectomy in children with obstructive sleep apnea syndrome

Cited by 5 publications

References 17 publications

Efficacy of pillar suture for post-tonsillectomy morbidity in children: a meta-analysis

Efficacy of pillar suture for post-tonsillectomy morbidity in children: a meta-analysis

Can intraoperative suturing reduce the incidence of posttonsillectomy hemorrhage? A systematic review and meta‐analysis

Tracheal extubation under Narcotrend EEG monitoring at different depths of anesthesia after tonsillectomy in children: a prospective randomized controlled study

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