Polysomnography outcomes for partial intracapsular versus total tonsillectomy

Jason Mangiardi, Katharina D. Graw-Panzer, Jeremy Weedon, Theresa Regis, Haesoon Lee, Nira A. Goldstein

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: To demonstrate similar improvement in pediatric sleep-disordered breathing (SDB) as determined by polysomnography (PSG) with microdebrider-assisted partial intracapsular tonsillectomy and adenoidectomy (PITA) versus Bovie electrocautery complete tonsillectomy and adenoidectomy (T&A). Methods: In this retrospective cohort study, 30 children found to have SDB by PSG who have undergone either PITA (15 participants) or T&A (15 participants) as treatment were evaluated with standardized history and physical examination and unattended home overnight PSG. Results: Median change in apnea-hypopnea index (AHI) was 1.7 (-4.9 to 29.8) for the PITA group and 2.3 (-10.9 to 64.1) for the T&A group, although there was substantially more variability in the T&A group. A mixed linear model evaluating the relation of surgical group with change in AHI demonstrated no significant differences in group means (F[1,13]. = 0.31, P= .590) but the variances differed significantly (residual likelihood ratio chi-square. = 5.24, df. = 1, P= .022). Five of 15 (33%) PITA patients and 4 of 15 (27%) T&A patients had postoperative AHI scores of ≤5; this difference was not statistically significant (Fisher exact test P= 1.000). There was no significant interaction or substantial confounding effect of age, sex, race, preoperative tonsil size, preoperative AHI, or body mass index in the model relating surgery type to reduction of postoperative AHI to ≤5. Conclusions: Our study demonstrates no clinically or statistically significant differences in PSG and clinical outcomes between PITA and T&A for treatment of pediatric SDB in otherwise healthy children.

Original languageEnglish (US)
Pages (from-to)1361-1366
Number of pages6
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume74
Issue number12
DOIs
StatePublished - Dec 2010
Externally publishedYes

Fingerprint

Adenoidectomy
Tonsillectomy
Polysomnography
Apnea
Sleep Apnea Syndromes
Pediatrics
Electrocoagulation
Palatine Tonsil
Physical Examination
Linear Models
Body Mass Index
Cohort Studies
Retrospective Studies
History
Therapeutics

Keywords

  • Obstructive sleep apnea
  • Polysomnography
  • Sleep-disordered breathing
  • Tonsillectomy

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Pediatrics, Perinatology, and Child Health

Cite this

Mangiardi, J., Graw-Panzer, K. D., Weedon, J., Regis, T., Lee, H., & Goldstein, N. A. (2010). Polysomnography outcomes for partial intracapsular versus total tonsillectomy. International Journal of Pediatric Otorhinolaryngology, 74(12), 1361-1366. https://doi.org/10.1016/j.ijporl.2010.09.003

Polysomnography outcomes for partial intracapsular versus total tonsillectomy. / Mangiardi, Jason; Graw-Panzer, Katharina D.; Weedon, Jeremy; Regis, Theresa; Lee, Haesoon; Goldstein, Nira A.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 74, No. 12, 12.2010, p. 1361-1366.

Research output: Contribution to journalArticle

Mangiardi, J, Graw-Panzer, KD, Weedon, J, Regis, T, Lee, H & Goldstein, NA 2010, 'Polysomnography outcomes for partial intracapsular versus total tonsillectomy', International Journal of Pediatric Otorhinolaryngology, vol. 74, no. 12, pp. 1361-1366. https://doi.org/10.1016/j.ijporl.2010.09.003
Mangiardi, Jason ; Graw-Panzer, Katharina D. ; Weedon, Jeremy ; Regis, Theresa ; Lee, Haesoon ; Goldstein, Nira A. / Polysomnography outcomes for partial intracapsular versus total tonsillectomy. In: International Journal of Pediatric Otorhinolaryngology. 2010 ; Vol. 74, No. 12. pp. 1361-1366.
@article{e56c03264b66477baec72e14e29580aa,
title = "Polysomnography outcomes for partial intracapsular versus total tonsillectomy",
abstract = "Objective: To demonstrate similar improvement in pediatric sleep-disordered breathing (SDB) as determined by polysomnography (PSG) with microdebrider-assisted partial intracapsular tonsillectomy and adenoidectomy (PITA) versus Bovie electrocautery complete tonsillectomy and adenoidectomy (T&A). Methods: In this retrospective cohort study, 30 children found to have SDB by PSG who have undergone either PITA (15 participants) or T&A (15 participants) as treatment were evaluated with standardized history and physical examination and unattended home overnight PSG. Results: Median change in apnea-hypopnea index (AHI) was 1.7 (-4.9 to 29.8) for the PITA group and 2.3 (-10.9 to 64.1) for the T&A group, although there was substantially more variability in the T&A group. A mixed linear model evaluating the relation of surgical group with change in AHI demonstrated no significant differences in group means (F[1,13]. = 0.31, P= .590) but the variances differed significantly (residual likelihood ratio chi-square. = 5.24, df. = 1, P= .022). Five of 15 (33{\%}) PITA patients and 4 of 15 (27{\%}) T&A patients had postoperative AHI scores of ≤5; this difference was not statistically significant (Fisher exact test P= 1.000). There was no significant interaction or substantial confounding effect of age, sex, race, preoperative tonsil size, preoperative AHI, or body mass index in the model relating surgery type to reduction of postoperative AHI to ≤5. Conclusions: Our study demonstrates no clinically or statistically significant differences in PSG and clinical outcomes between PITA and T&A for treatment of pediatric SDB in otherwise healthy children.",
keywords = "Obstructive sleep apnea, Polysomnography, Sleep-disordered breathing, Tonsillectomy",
author = "Jason Mangiardi and Graw-Panzer, {Katharina D.} and Jeremy Weedon and Theresa Regis and Haesoon Lee and Goldstein, {Nira A.}",
year = "2010",
month = "12",
doi = "10.1016/j.ijporl.2010.09.003",
language = "English (US)",
volume = "74",
pages = "1361--1366",
journal = "International Journal of Pediatric Otorhinolaryngology",
issn = "0165-5876",
publisher = "Elsevier Ireland Ltd",
number = "12",

}

TY - JOUR

T1 - Polysomnography outcomes for partial intracapsular versus total tonsillectomy

AU - Mangiardi, Jason

AU - Graw-Panzer, Katharina D.

AU - Weedon, Jeremy

AU - Regis, Theresa

AU - Lee, Haesoon

AU - Goldstein, Nira A.

PY - 2010/12

Y1 - 2010/12

N2 - Objective: To demonstrate similar improvement in pediatric sleep-disordered breathing (SDB) as determined by polysomnography (PSG) with microdebrider-assisted partial intracapsular tonsillectomy and adenoidectomy (PITA) versus Bovie electrocautery complete tonsillectomy and adenoidectomy (T&A). Methods: In this retrospective cohort study, 30 children found to have SDB by PSG who have undergone either PITA (15 participants) or T&A (15 participants) as treatment were evaluated with standardized history and physical examination and unattended home overnight PSG. Results: Median change in apnea-hypopnea index (AHI) was 1.7 (-4.9 to 29.8) for the PITA group and 2.3 (-10.9 to 64.1) for the T&A group, although there was substantially more variability in the T&A group. A mixed linear model evaluating the relation of surgical group with change in AHI demonstrated no significant differences in group means (F[1,13]. = 0.31, P= .590) but the variances differed significantly (residual likelihood ratio chi-square. = 5.24, df. = 1, P= .022). Five of 15 (33%) PITA patients and 4 of 15 (27%) T&A patients had postoperative AHI scores of ≤5; this difference was not statistically significant (Fisher exact test P= 1.000). There was no significant interaction or substantial confounding effect of age, sex, race, preoperative tonsil size, preoperative AHI, or body mass index in the model relating surgery type to reduction of postoperative AHI to ≤5. Conclusions: Our study demonstrates no clinically or statistically significant differences in PSG and clinical outcomes between PITA and T&A for treatment of pediatric SDB in otherwise healthy children.

AB - Objective: To demonstrate similar improvement in pediatric sleep-disordered breathing (SDB) as determined by polysomnography (PSG) with microdebrider-assisted partial intracapsular tonsillectomy and adenoidectomy (PITA) versus Bovie electrocautery complete tonsillectomy and adenoidectomy (T&A). Methods: In this retrospective cohort study, 30 children found to have SDB by PSG who have undergone either PITA (15 participants) or T&A (15 participants) as treatment were evaluated with standardized history and physical examination and unattended home overnight PSG. Results: Median change in apnea-hypopnea index (AHI) was 1.7 (-4.9 to 29.8) for the PITA group and 2.3 (-10.9 to 64.1) for the T&A group, although there was substantially more variability in the T&A group. A mixed linear model evaluating the relation of surgical group with change in AHI demonstrated no significant differences in group means (F[1,13]. = 0.31, P= .590) but the variances differed significantly (residual likelihood ratio chi-square. = 5.24, df. = 1, P= .022). Five of 15 (33%) PITA patients and 4 of 15 (27%) T&A patients had postoperative AHI scores of ≤5; this difference was not statistically significant (Fisher exact test P= 1.000). There was no significant interaction or substantial confounding effect of age, sex, race, preoperative tonsil size, preoperative AHI, or body mass index in the model relating surgery type to reduction of postoperative AHI to ≤5. Conclusions: Our study demonstrates no clinically or statistically significant differences in PSG and clinical outcomes between PITA and T&A for treatment of pediatric SDB in otherwise healthy children.

KW - Obstructive sleep apnea

KW - Polysomnography

KW - Sleep-disordered breathing

KW - Tonsillectomy

UR - http://www.scopus.com/inward/record.url?scp=78449301602&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78449301602&partnerID=8YFLogxK

U2 - 10.1016/j.ijporl.2010.09.003

DO - 10.1016/j.ijporl.2010.09.003

M3 - Article

C2 - 20880595

AN - SCOPUS:78449301602

VL - 74

SP - 1361

EP - 1366

JO - International Journal of Pediatric Otorhinolaryngology

JF - International Journal of Pediatric Otorhinolaryngology

SN - 0165-5876

IS - 12

ER -