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PITA improves symptoms of OSA, adenotonsillar hypertrophy

Powered intracapsular tonsillectomy and adenoidectomy was an effective treatment for pediatric patients with severe obstructive sleep apnea and adenotonsillar hypertrophy, according to recent research.

“PITA improved OSA in our series of pediatric patients by reducing obstructive apneas and hypopneas, oxygen desaturation, arousal index, carbon dioxide level, and snoring and increasing oxygen saturation nadir,” Nadia Mostovych, MD, of the department of otolaryngology–head and neck surgery, at Thomas Jefferson University, Philadelphia, and colleagues wrote. “Results are comparable to those described for traditional electrocautery tonsillectomy and support the use of PITA for the treatment of severe OSA in children with adenotonsillar hypertrophy.”

Mostovych and colleagues evaluated the medical records of 70 pediatric patients (median age, 3.7 years; 56% boys) with OSA who underwent PITA between 2010 and 2014, according to the abstract.

The researchers found the mean postoperative apnea–hypopnea index had significantly decreased from 32.4 to 5.8 (P <.001), according to the abstract. The obstructive apnea index decreased from 20.4 to 2.55 and obstructive apnea-hypopnea index also decreased from 25.5 to 3.9, whereas the arousal index decreased from 53.7 to 27.4 (P < .001). The percentage of total sleep time spent snoring decreased from 28.6 to 13.6 (P = .001) and oxygen desaturation index of 4% or more decreased from 22.0 to 4.5 (P < .001).

There was an oxygen saturation increase from 96.8 to 98.2 (P < .001) and an oxygen saturation nadir increase of 75.5 to 88.4 (P < .001), according to the abstract. Mostovych and colleagues noted that end-tidal carbon dioxide greater than 55 mm Hg was associated with a significant decrease in time (49.67 minutes vs. 19.1 minutes; P = .01). – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.