편도 및 아데노이드 절제술 후 잔존하는 코골이가 있는 소아 환자에서 하비갑개 후방 축소술이 증상 호전에 미치는 영향

Background and Objectives: Chronic upper airway obstruction attributable to adenotonsillar hypertrophy is the most common cause of sleep disordered breathing (SDB) in children. Palatine tonsillectomy and adenoidectomy (T&A) is effective for the treatment of pediatric OSA patients. However, in some children, there are still unresolved snoring and obstructive sleep apnea after the operation. This study is aimed at evaluating the efficacy of posterior coblation of inferior turbinate with remained snoring and sleep apnea after pediatric tonsillectomy and adenoidectomy. Materials and Methods: We performed Prospective study about 41 children who had done tonsillectomy and adenoidectomy but still suffering from simple snoring and mouth breath, aged between 8 to 15 years old, from January to December in 2015. We did additional inferior coblation of inferior turbinate for 41 patients. Over the period between preoperation and 1, 3, 6, 12 months after operation, we evaluated Apnea-Hypopnea Index (AHI), oxygen saturation by polysomnography, degree of snoring by Visual Analogue Sacle (VAS) score, satisfaction for quality of sleep by Epworth Sleepiness Scale (ESS), Minimal Cross section Area (MCA) and volume of nasal cavity by acoustic rhinometry, respectively. Results: After Posterior coblation of Inferior turbinate, the volume of nasal cavity voulme and MCA increased. There were significant improvements of AHI, oxygen saturation, MCA VAS and ESS score after tonsillectomy and adenoidectomy. But Additional posterior coblation did not make meaningful changes in AHI and saturation compared with tonsillectomy and adenoidectomy. Conclusions: As for pediatric OSA surgery, the evaluation of posterior nasal cavity is an indispensable factor for improving the quality of sleep and snoring. When treating pediatric OSA patients who have nasal obstruction, Posteior Coblation of inferior turbinate should be considered. (J Clinical Otolaryngol 2018;29:57-62)