Article record

儿童阻塞性睡眠呼吸暂停中同期扁桃体切除术或鼻甲成形术与单纯腺样体切除术的比较：结局、并发症与手术时间

Concurrent tonsillectomy or turbinoplasty vs. adenoidectomy alone in pediatric obstructive sleep apnea: outcomes, complications, and operative time.

临床研究咽喉科IF 1.8Q2

文献信息

PMID	42790174
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Luluh Alsughayer 查看其他 6 位作者 Reem Alkublan；Abdulrahman Badghaish；Abdullah Alsaid；Zahra AlMomen；Abdullah AlJasser；Abdulmajeed Zakzouk
作者单位	Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Electronic address: Lulu.yousef.s@gmail.com. 查看其他 5 条单位信息 Department of Otolaryngology-Head and Neck Surgery, King Saud Medical City, Riyadh, Saudi Arabia.；College of Medicine, King Saud University, Riyadh, Saudi Arabia.；Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia; King Khalid Hospital, Hail, Saudi Arabia.；Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Qatif Central Hospital, Eastern Province, Saudi Arabia.；Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
期刊	American journal of otolaryngology
SCI 分区	Q2
IF	1.8
研究类型	临床研究 · 临床
所属专科	咽喉科

中文摘要

目的： 评估在儿童阻塞性睡眠呼吸暂停（OSA）患者中，腺样体切除术同时联合扁桃体切除术或鼻甲成形术的附加获益。
方法： 这是一项前瞻性队列研究，共纳入146例接受单纯腺样体切除术（AD）、腺样体扁桃体切除术（ADTS）或鼻甲成形术联合腺样体切除术伴或不伴扁桃体切除术（T + AD±TS）的儿童。研究于2021年4月至2024年8月在沙特阿拉伯利雅得King Abdulaziz大学医院进行。排除成人和患有神经系统疾病或上气道及颅面畸形的患者。通过儿童睡眠问卷-睡眠相关呼吸障碍（PSQ-SRBD）、再次手术率、并发症和父母满意度评估术后结局。采用logistic回归分析确定残余OSA和其他临床结局的独立预测因素。
结果： 与单纯AD相比，ADTS（调整比值比[aOR] = 0.187，95% CI：0.052-0.667，p = 0.010）和T + AD±TS（aOR = 0.053，95% CI：0.005-0.541，p = 0.013）均显著降低术后残余OSA的比值。ADTS还与较低的再次手术率相关（OR = 0.214，95% CI：0.063-0.730，p = 0.014）。并发症发生率和父母满意度在各组间无差异（p > 0.05）。
结论： 同期扁桃体切除术或鼻甲成形术可增强腺样体切除术治疗儿童OSA的效果，且不增加并发症。尽管手术时间较长，联合手术可改善症状缓解并减少再次手术的需要。建议根据解剖和临床特征进行个体化手术规划。

英文摘要

OBJECTIVE: To evaluate the added benefit of concurrent tonsillectomy or turbinoplasty when performed alongside adenoidectomy in pediatric patients with obstructive sleep apnea (OSA).
METHODS: This is a prospective cohort study including a total of 146 children who underwent adenoidectomy alone (AD), adenotonsillectomy (ADTS), or turbinoplasty with adenoidectomy with or without tonsillectomy (T + AD±TS). The study was performed in King Abdulaziz University Hospital, Riyadh, Saudi Arabia between April 2021 and August 2024. Adults and patients with neurological disease or upper airway and craniofacial anomalies were excluded. Postoperative outcomes were assessed via the Pediatric Sleep Questionnaire-Sleep Related Breathing Disorder (PSQ-SRBD), revision surgery rates, complications, and parental satisfaction. Logistic regression analyses were used to identify independent predictors of residual OSA and other clinical outcomes.
RESULTS: Compared to AD alone, both ADTS (adjusted odds ratio [aOR] = 0.187, 95% CI: 0.052-0.667, p = 0.010) and T + AD±TS (aOR = 0.053, 95% CI: 0.005-0.541, p = 0.013) significantly reduced the odds of postoperative residual OSA. ADTS was also associated with lower revision rate (OR = 0.214, 95% CI: 0.063-0.730, p = 0.014). Complication rate and parental satisfaction did not differ between the groups (p > 0.05).
CONCLUSION: Concurrent tonsillectomy or turbinoplasty enhances the effectiveness of adenoidectomy in managing pediatric OSA without increasing complications. Despite longer operative times, combined procedures improve symptom resolution and reduce the need for revision surgery. Individualized surgical planning based on anatomical and clinical features is recommended.