Published online Feb 26, 2020. doi: 10.12998/wjcc.v8.i4.679
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
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. In order to improve the postoperative outcome of children with OSAHS, and improve the safety of operation,this study made a clinical observation of the effect of soft palate-pharyngoplasty on postoperative outcome, pharyngeal formation and possible complications.
For children with OSAHS, soft palate-pharyngoplasty and adenoidectomy can more effectively enlarge the airway, so snoring and mouth breathing symptoms are better after surgery. Although generally considered safe and simple, the risk of tonsillectomy varies in frequency and severity. The incidence of postoperative bleeding, intraoperative infection, and delayed healing is still not low, and life-threatening postoperative bleeding events have also occurred. How to maximize the upper airway, improve the surgical cure rate, reduce the risk of bleeding, shorten the pain duration of children, and accelerate healing, is worth discussing.
These 150 children have different degrees of the following symptoms: Snoring during sleep, suffocation, mouth breathing, double nasal congestion, night awakening, inattention, memory loss, recurrent tonsillitis, etc. The child patients were given a 3D-computed tomography of the respiratory tract and were diagnosed as OSAHS by sleep respiration monitoring, and were hospitalized for surgical treatment under general anesthesia.
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 χ2 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 effect was divided into two groups, cure (snoring, snoring symptoms disappeared) and non-cure.
In the experimental group, 71 cases were cured (94.7%), 4 cases (5.3%) were not cured; in the control group 68 cases (90.7%) were cured, and 7 cases (9.3%) were not cured. The effective rate of the experimental group was significantly higher than that of the control group, but the difference was not statistically significant. Four cases of postoperative bleeding occurred in the control group, which occurred 5-10 d after surgery. There were 0 cases of postoperative bleeding in the experimental group. There was no postoperative pharyngeal reflux in either group. In the experiment group, 1 case of hyperthermia occured, and 8 cases occurred in the control group. The difference was statistically significant. The postoperative swallowing pain scores of the experiment group and the control group was statistically significant.
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.And it is worthy of clinical promotion