Endoscopic Powered Intracapsular Tonsillectomy and Adenoidectomy in Pediatric Obstructive Sleep Apnea With High-Risk Comorbid Disease Conditions: A Case Series

Pediatric obstructive sleep apnea (OSA) caused by adenoids or an enlarged palatine tonsil has a negative impact on physical and mental growth. Surgical removal of the tissue is effective but entails a life-threatening risk of postoperative bleeding, which is up to 30 times higher in chronic pediatri...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-06, Vol.16 (6), p.e61621
Main Authors: Noda, Masao, Koshu, Ryota, Dias, Mari, Saito, Chizu, Ito, Makoto
Format: Article
Language:English
Subjects:
Airway management
Asthma
Cerebral palsy
Chronic illnesses
Comorbidity
Disease
Endoscopy
Females
Hospitals
Oral Medicine
Otolaryngology
Patients
Pediatric Surgery
Pediatrics
Sleep apnea
Throat surgery
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Summary:Pediatric obstructive sleep apnea (OSA) caused by adenoids or an enlarged palatine tonsil has a negative impact on physical and mental growth. Surgical removal of the tissue is effective but entails a life-threatening risk of postoperative bleeding, which is up to 30 times higher in chronic pediatric disease cases. However, endoscopes and resection devices provide safe, reliable surgical methods. Here, we report the efficacy and safety of endoscopic powered intracapsular tonsillectomy and adenoidectomy (PITA) for pediatric OSA in patients with high-risk comorbidities. This retrospective case series included pediatric patients with OSA who underwent PITA at a single tertiary medical center between April 2017 and May 2023. Ten patients (three males and seven females; mean age 6.4 years, range 2-12 years) were included; all met the Japanese criteria for complex chronic pediatric conditions. The average operative time was 61 min; a microdebrider was used in eight cases and a coblator in two cases. Although there was no postoperative bleeding, one case experienced regrowth. Our data show that an endoscopic PITA approach could reduce the risk of severe bleeding and relieve the sleeping conditions of pediatric patients with complex chronic OSA.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.61621