Case Control Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2020; 8(4): 679-688
Published online Feb 26, 2020. doi: 10.12998/wjcc.v8.i4.679
Clinical observation of soft palate-pharyngoplasty in the treatment of obstructive sleep apnea hypopnea syndrome in children
Xiao-Xu Ding, Lan-Qing Zhao, Xiang-Guo Cui, Yang Yin, Huai-An Yang
Xiao-Xu Ding, Lan-Qing Zhao, Xiang-Guo Cui, Yang Yin, Huai-An Yang, Department of Otolaryngology Head and Neck Surgery, Department of The Sleep Medicine Center, Shengjing Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Ding XX performed the majority of the experiments and wrote the manuscript; Yang HA designed the study and revised the manuscript; Zhao LQ, Cui XG, and Yin Y participated collecting the human material.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of China Medical University Shengjing Hospital.
Informed consent statement: All study participants or their legal guardian written informed consent.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data.
STROBE statement: The manuscript was checked and revised according to the STROBE checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Huai-An Yang, PhD, Doctor, Department of Otolaryngology Head and Neck Surgery, Department of The Sleep Medicine Center, Shengjing Hospital of China Medical University, No. 39 Huaxiang Road, Tiexi District, Shenyang 110001, Liaoning Province, China. 13840082796@163.com
Received: September 29, 2019
Peer-review started: September 29, 2019
First decision: November 21, 2019
Revised: December 21, 2019
Accepted: January 14, 2020
Article in press: January 14, 2020
Published online: February 26, 2020
Abstract
BACKGROUND

Childhood obstructive sleep apnea hypopnea syndrome (OSAHS) is a common clinical disease that can cause serious complications if not treated in time. The preferred treatment for OSAHS in children is surgery.

AIM

To observe the effects of soft palate-pharyngoplasty on postoperative outcome, pharyngeal formation, and possible complications.

METHODS

A total of 150 children with snoring, hernia, and mouth breathing were selected. A polysomnography test was performed to confirm the diagnosis of OSAHS. The children were randomly divided into experimental and control groups. The experimental group underwent adenoidectomy, tonsillectomy, and soft palate-pharyngoplasty. The control group underwent adenoidectomy and tonsillectomy. The t-test and chi-square test were used to compare conditions such as postoperative fever, postoperative hemorrhage, and pharyngeal reflux. Postoperative efficacy and complications were interrogated and observed in the form of outpatient follow-up and telephone follow-up at 6 mo and 1 year after surgery. The curative effects were divided into two groups: Cure (snoring, snoring symptoms disappeared) and non-cure.

RESULTS

The effective rate of the experimental group was significantly higher than that of the control group, but the difference was not statistically significant (P > 0.05). The incidence of postoperative bleeding was lower in the experimental group. There was no postoperative pharyngeal reflux in either group. In the experimental group, the incidence of hyperthermia (body temperature exceeded 38.5 °C) was lower than that in the control group. The difference in postoperative swallowing pain scores between the experimental and control groups was significant.

CONCLUSION

Soft palate-pharyngoplasty can more effectively enlarge the anteroposterior diameter and transverse diameter of the isthmus faucium. Compared with surgery alone, it can better treat OSAHS in children, improve the curative effect, reduce the risk of perioperative bleeding, close the surgical cavity, reduce the risk of postoperative infection, reduce the proportion of postoperative fever, and accelerate healing. Although this process takes more time, it is simple, safe, and effective.

Keywords: Obstructive sleep apnea hypopnea syndrome, Children, Soft palate-pharyngoplasty, Efficacy, Blood, Pain

Core tip: Adenoidectomy and tonsillectomy are currently the most important treatments for children with obstructive sleep apnea hypopnea syndrome. Soft palate-pharyngoplasty can more effectively enlarge the anteroposterior diameter and transverse diameter of the isthmus faucium. Compared with surgery alone, it can better treat obstructive sleep apnea hypopnea syndrome in children, improve the curative effect, reduce the risk of perioperative bleeding, close the surgical cavity, reduce the risk of postoperative infection, reduce the proportion of postoperative fever, and accelerate healing. Although this process takes more time, it is simple, safe, and effective.