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No differences in clinical outcomes seen for ETA, ITA procedures in patients with OSA

Researchers observed similar short-term follow-up outcomes for extracapsular tonsillectomy and adenoidectomy and intracapsular tonsillectomy and adenoidectomy in pediatric patients with obstructive sleep apnea syndrome, according to a retrospective cohort study.

However, the researchers noted in one group of obese patients with asthma who underwent intracapsular tonsillectomy and adenoidectomy (ITA) a significant risk for developing postoperative obstructive sleep apnea syndrome (OSAS) (OR = 16.5; 95% CI, 1.1-250.2), according to the abstract.

“This study reinforces the findings that [extracapsular tonsillectomy and adenoidectomy (ETA)] and ITA have similar outcomes on short-term follow-up in treatment of OSAS in children and that both procedures remain adequate options in otherwise healthy children,” Pamela Mukhatiyar, MD, pediatrician at the division of pediatric respiratory and sleep medicine, The Children’s Hospital at Montefiore, Albert Einstein College of Medicine in New York, and colleagues wrote. “To our knowledge, this study is the first to support performing ETA over ITA in patients with comorbid diagnoses of both asthma and obesity.”

Mukhatiyar and colleagues retrospectively analyzed the medical records of 89 children who underwent either ETA (n = 52; mean age, 7.5 years; 60% obese; mean apnea-hypopnea index [AHI], 17) or ITA (n = 37; mean age, 5.2 years; 30% obese; mean AHI, 24.1) at a pediatric hospital by performing a search of the billing codes within the hospital for adenotonsillectomy and polysomnography. Thirty-eight percent of the patients in each group had asthma.

Patient inclusion criteria required no previous history of craniofacial or neurological disorders, which was confirmed through polysomnography 2 years preoperatively. The patients also received a polysomnography 2 years postoperatively, when the researchers measured the success of the procedures, according to the abstract.

A treatment failure was defined as OSA postoperatively that included an AHI of 5 events per hour or more.

Although there were no significant differences in clinical outcomes, both groups showed a significant improvement in OSAS through polysomnography outcomes; however, there was no significant association between age, procedure type or body mass index regarding surgery success. – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.