Tonsillar pillars suturing: additional benefit to adenotonsillectomy in children with OSAS? A prospective study

Detalhes bibliográficos
Autor(a) principal: Gonçalves, Ana Isabel C.
Data de Publicação: 2020
Outros Autores: Carção, André, Duarte, Delfim, Vilhena , Ditza de
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.34631/sporl.825
Resumo: Objectives: To evaluate the impact, in the short and medium term, of the tonsillar pillars suturing on the postoperative results of children with sleep disordered breathing submitted to total bilateral adenotonsillectomy.  Material and Methods: Prospective study of children who underwent adenotonsillectomy between January and July 2019 due to adenotonsillar hypertrophy associated with symptoms compatible with obstructive sleep apnea syndrome (OSAS). Children were alternately included in the intervention group (suture of tonsillar pillars) or in the control group (without pillars suturing). The evaluated results consisted in the improvement/resolution of OSAS assessed through the Pediatric Sleep Questionnaire (PSQ), the rate of complications after surgery and the intensity of postoperative pain, assessed using the Wong-Baker Faces Scale and the number of days of analgesia and liquid diet.  Results: Included 50 children, 25 in each group, aged 3 to 17 years old. A statistically significant difference was found between the average total PSQ score at the 1st, 2nd and 6th postoperative months between the 2 groups (1st month: p <0.001; 2nd month: p <0.001; 6th month: p = 0.042), and the control group always had average total scores higher than the intervention group. There was a statistically significant difference between the mean pain intensity on the 1st postoperative day between groups (p <0.001), with a lower mean pain intensity in the intervention group. There was also a significant difference between the average number of days of analgesia and liquid diet in the 2 groups studied (p = 0.004 and p = 0.019, respectively), with the intervention group having the lowest number of days of analgesia and liquid diet. The rate of post-tonsillectomy hemorrhage was 16% in each group.  Conclusions: Our study shows an evident additional benefit of tonsillar pillars suture to adenotonsillectomy in children with OSAS, conferring a significant benefit in the improvement of obstructive sleep pathology, right from the 1st month and remaining in the 2nd and 6th postoperative months. It also showed benefit in the pain intensity assessed on the 1st postoperative day and in the decrease in the number of days of analgesia and liquid diet. No differences were found in postoperative complications between groups. 
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spelling Tonsillar pillars suturing: additional benefit to adenotonsillectomy in children with OSAS? A prospective studySutura de pilares amigdalinos: benefício adicional à adenoamigdalectomia em crianças com SAOS? Um estudo prospetivoadenotonsillectomychildrenobstructive sleep apneasleep disorderspillars suturingadenoamigdalectomiacriançasapneia obstrutiva do sonodistúrbios do sonosutura de pilaresObjectives: To evaluate the impact, in the short and medium term, of the tonsillar pillars suturing on the postoperative results of children with sleep disordered breathing submitted to total bilateral adenotonsillectomy.  Material and Methods: Prospective study of children who underwent adenotonsillectomy between January and July 2019 due to adenotonsillar hypertrophy associated with symptoms compatible with obstructive sleep apnea syndrome (OSAS). Children were alternately included in the intervention group (suture of tonsillar pillars) or in the control group (without pillars suturing). The evaluated results consisted in the improvement/resolution of OSAS assessed through the Pediatric Sleep Questionnaire (PSQ), the rate of complications after surgery and the intensity of postoperative pain, assessed using the Wong-Baker Faces Scale and the number of days of analgesia and liquid diet.  Results: Included 50 children, 25 in each group, aged 3 to 17 years old. A statistically significant difference was found between the average total PSQ score at the 1st, 2nd and 6th postoperative months between the 2 groups (1st month: p <0.001; 2nd month: p <0.001; 6th month: p = 0.042), and the control group always had average total scores higher than the intervention group. There was a statistically significant difference between the mean pain intensity on the 1st postoperative day between groups (p <0.001), with a lower mean pain intensity in the intervention group. There was also a significant difference between the average number of days of analgesia and liquid diet in the 2 groups studied (p = 0.004 and p = 0.019, respectively), with the intervention group having the lowest number of days of analgesia and liquid diet. The rate of post-tonsillectomy hemorrhage was 16% in each group.  Conclusions: Our study shows an evident additional benefit of tonsillar pillars suture to adenotonsillectomy in children with OSAS, conferring a significant benefit in the improvement of obstructive sleep pathology, right from the 1st month and remaining in the 2nd and 6th postoperative months. It also showed benefit in the pain intensity assessed on the 1st postoperative day and in the decrease in the number of days of analgesia and liquid diet. No differences were found in postoperative complications between groups. Objetivos: Avaliar o impacto, a curto e médio prazo, da sutura de pilares amigdalinos nos resultados pós-operatórios das crianças com patologia obstrutiva do sono submetidas a adenoamigdalectomia total bilateral.  Material e Métodos: Estudo prospetivo das crianças submetidas a adenoamigdalectomia entre janeiro e julho de 2019 por hipertrofia adenoamigdalina associada a sintomas compatíveis com síndrome de apneia obstrutiva do sono (SAOS). As crianças foram, alternadamente, incluídas no grupo intervenção (sutura de pilares amigdalinos) ou no grupo controlo (sem sutura de pilares). Os resultados avaliados consistiram na melhoria/resolução da SAOS avaliada através do Questionário Pediátrico do Sono (QPS), na taxa de complicações após cirurgia e na intensidade da dor pós-operatória, avaliada através da Escala de Faces de Wong-Baker e do número de dias de analgesia e de dieta líquida.  Resultados: Incluídas 50 crianças, 25 por grupo, entre os 3 e 17 anos. Foi encontrada diferença estatisticamente significativa entre o score total médio do QPS aos 1.º, 2.º e 6.º meses pós-operatórios entre os 2 grupos (1.º mês: p< 0,001; 2.º mês: p<0,001; 6.º mês: p=0,042), sendo que o grupo controlo teve sempre scores totais médios superiores ao grupo intervenção. Existiu diferença estatisticamente significativa entre a média da dor ao 1.º dia pós-operatório entre os grupos (p<0,001), com uma média de intensidade de dor inferior no grupo intervenção. Houve também diferença significativa entre a média do número de dias de analgesia e de dieta líquida nos 2 grupos estudados (p=0,004 e p=0,019, respetivamente), sendo o grupo intervenção aquele que registou menor número de dias de analgesia e de dieta líquida. A taxa de hemorragia pós-amigdalectomia foi de 16% em cada grupo.  Conclusões: O nosso estudo mostra um evidente benefício adicional da sutura de pilares amigdalinos à adenoamigdalectomia em crianças com SAOS, conferindo benefício significativo na melhoria da patologia obstrutiva do sono, logo desde o 1.º mês e mantendo-se nos 2.º e 6.º meses pós-operatórios. Também mostrou benefício na dor avaliada ao 1.º dia pós-operatório e na diminuição do número de dias de analgesia e de dieta líquida. Sem diferenças nas complicações pós-operatórias entre os grupos. Sociedade Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço2020-12-05info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34631/sporl.825https://doi.org/10.34631/sporl.825Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery; Vol. 58 No. 4 (2020): December; 189-198Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço; Vol. 58 Núm. 4 (2020): Dezembro; 189-198Revista Portuguesa de Otorrinolaringologia-Cirurgia de Cabeça e Pescoço; Vol. 58 N.º 4 (2020): Dezembro; 189-1982184-6499reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://journalsporl.com/index.php/sporl/article/view/2232https://journalsporl.com/index.php/sporl/article/view/2232/204Direitos de Autor (c) 2020 Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoçoinfo:eu-repo/semantics/openAccessGonçalves, Ana Isabel C.Carção, AndréDuarte, DelfimVilhena , Ditza de2024-06-06T12:57:30Zoai:journalsporl.com:article/2232Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-06-06T12:57:30Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Tonsillar pillars suturing: additional benefit to adenotonsillectomy in children with OSAS? A prospective study
Sutura de pilares amigdalinos: benefício adicional à adenoamigdalectomia em crianças com SAOS? Um estudo prospetivo
title Tonsillar pillars suturing: additional benefit to adenotonsillectomy in children with OSAS? A prospective study
spellingShingle Tonsillar pillars suturing: additional benefit to adenotonsillectomy in children with OSAS? A prospective study
Gonçalves, Ana Isabel C.
adenotonsillectomy
children
obstructive sleep apnea
sleep disorders
pillars suturing
adenoamigdalectomia
crianças
apneia obstrutiva do sono
distúrbios do sono
sutura de pilares
title_short Tonsillar pillars suturing: additional benefit to adenotonsillectomy in children with OSAS? A prospective study
title_full Tonsillar pillars suturing: additional benefit to adenotonsillectomy in children with OSAS? A prospective study
title_fullStr Tonsillar pillars suturing: additional benefit to adenotonsillectomy in children with OSAS? A prospective study
title_full_unstemmed Tonsillar pillars suturing: additional benefit to adenotonsillectomy in children with OSAS? A prospective study
title_sort Tonsillar pillars suturing: additional benefit to adenotonsillectomy in children with OSAS? A prospective study
author Gonçalves, Ana Isabel C.
author_facet Gonçalves, Ana Isabel C.
Carção, André
Duarte, Delfim
Vilhena , Ditza de
author_role author
author2 Carção, André
Duarte, Delfim
Vilhena , Ditza de
author2_role author
author
author
dc.contributor.author.fl_str_mv Gonçalves, Ana Isabel C.
Carção, André
Duarte, Delfim
Vilhena , Ditza de
dc.subject.por.fl_str_mv adenotonsillectomy
children
obstructive sleep apnea
sleep disorders
pillars suturing
adenoamigdalectomia
crianças
apneia obstrutiva do sono
distúrbios do sono
sutura de pilares
topic adenotonsillectomy
children
obstructive sleep apnea
sleep disorders
pillars suturing
adenoamigdalectomia
crianças
apneia obstrutiva do sono
distúrbios do sono
sutura de pilares
description Objectives: To evaluate the impact, in the short and medium term, of the tonsillar pillars suturing on the postoperative results of children with sleep disordered breathing submitted to total bilateral adenotonsillectomy.  Material and Methods: Prospective study of children who underwent adenotonsillectomy between January and July 2019 due to adenotonsillar hypertrophy associated with symptoms compatible with obstructive sleep apnea syndrome (OSAS). Children were alternately included in the intervention group (suture of tonsillar pillars) or in the control group (without pillars suturing). The evaluated results consisted in the improvement/resolution of OSAS assessed through the Pediatric Sleep Questionnaire (PSQ), the rate of complications after surgery and the intensity of postoperative pain, assessed using the Wong-Baker Faces Scale and the number of days of analgesia and liquid diet.  Results: Included 50 children, 25 in each group, aged 3 to 17 years old. A statistically significant difference was found between the average total PSQ score at the 1st, 2nd and 6th postoperative months between the 2 groups (1st month: p <0.001; 2nd month: p <0.001; 6th month: p = 0.042), and the control group always had average total scores higher than the intervention group. There was a statistically significant difference between the mean pain intensity on the 1st postoperative day between groups (p <0.001), with a lower mean pain intensity in the intervention group. There was also a significant difference between the average number of days of analgesia and liquid diet in the 2 groups studied (p = 0.004 and p = 0.019, respectively), with the intervention group having the lowest number of days of analgesia and liquid diet. The rate of post-tonsillectomy hemorrhage was 16% in each group.  Conclusions: Our study shows an evident additional benefit of tonsillar pillars suture to adenotonsillectomy in children with OSAS, conferring a significant benefit in the improvement of obstructive sleep pathology, right from the 1st month and remaining in the 2nd and 6th postoperative months. It also showed benefit in the pain intensity assessed on the 1st postoperative day and in the decrease in the number of days of analgesia and liquid diet. No differences were found in postoperative complications between groups. 
publishDate 2020
dc.date.none.fl_str_mv 2020-12-05
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.34631/sporl.825
https://doi.org/10.34631/sporl.825
url https://doi.org/10.34631/sporl.825
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://journalsporl.com/index.php/sporl/article/view/2232
https://journalsporl.com/index.php/sporl/article/view/2232/204
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço
publisher.none.fl_str_mv Sociedade Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço
dc.source.none.fl_str_mv Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery; Vol. 58 No. 4 (2020): December; 189-198
Revista Portuguesa de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço; Vol. 58 Núm. 4 (2020): Dezembro; 189-198
Revista Portuguesa de Otorrinolaringologia-Cirurgia de Cabeça e Pescoço; Vol. 58 N.º 4 (2020): Dezembro; 189-198
2184-6499
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv mluisa.alvim@gmail.com
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