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European Archives of Oto-Rhino-Laryngology

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Open Access 01-10-2020 | Sleep Apnea | Laryngology

Postoperative morbidity after adenotonsillectomy versus adenopharyngoplasty in young children with obstructive sleep apnea: an RCT

Authors: Johan Fehrm, Anna Borgström, Pia Nerfeldt, Danielle Friberg

Published in: European Archives of Oto-Rhino-Laryngology | Issue 10/2020

Abstract

Purpose

In our previous randomized controlled trial (RCT), comparing adenotonsillectomy (ATE) with adenopharyngoplasty (APP) in children with severe obstructive sleep apnea (OSA), there were no differences in respiratory sleep parameters or quality of life. The purpose of the present report was to evaluate postoperative morbidity from this RCT.

Methods

The study was a blinded RCT in 83 children (ATE = 47; APP = 36), 2–4 years of age, with an obstructive apnea–hypopnea index of ≥ 10. Pain was assessed from the first until the tenth day after surgery with a logbook that reported pain by child (FPS-R, Faces Pain Scale-Revised) and caregiver (visual analogue scale), analgesic use, return to normal diet, and weight change. Bleeding, infection, satisfaction with treatment, speech, and swallowing were assessed with a questionnaire and medical records 6 months after surgery.

Results

Sixty-four children (77%) returned the logbook and 65 (78%) answered the questionnaire. The median (interquartile range) day the children graded themselves as pain free (FPS-R = 0) was 7 (6–10) after ATE, compared with 9 (7 to > 10) after APP (p = 0.018). There were no other significant differences between the groups regarding any other pain-related outcomes, bleeding, infection, satisfaction, swallowing, or speech, but three children (11%) reported impaired speech after APP compared to none after ATE (p = 0.067).

Conclusion

The results regarding postoperative morbidity were in favor of ATE and the results from our previous report showed no advantages of APP. Therefore, APP should not be recommended in young, otherwise healthy children with OSA.

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Title: Postoperative morbidity after adenotonsillectomy versus adenopharyngoplasty in young children with obstructive sleep apnea: an RCT
Authors: Johan Fehrm
Anna Borgström
Pia Nerfeldt
Danielle Friberg
Publication date: 01-10-2020
Publisher: Springer Berlin Heidelberg
Keywords: Sleep Apnea
Tonsillectomy
Pharyngoplasty
Published in: European Archives of Oto-Rhino-Laryngology / Issue 10/2020
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06035-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Postoperative morbidity after adenotonsillectomy versus adenopharyngoplasty in young children with obstructive sleep apnea: an RCT

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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