Clinical Effect of Partial Tonsillectomy in Preschool Children with OSAHS

Jinjin Yuan; Jianqi  Yi; Yaling  Liu; Hongxia Fei; Yonghao Wei

doi:10.71321/8gkgjj02

Authors

Jinjin Yuan Jiujiang University Affiliated Hospital
Jianqi Yi Jiujiang University Affiliated Hospital
Yaling Liu Jiujiang University Affiliated Hospital
Hongxia Fei Pengze County People's Hospital
Yonghao Wei Jiujiang University Affiliated Hospital

DOI:

https://doi.org/10.71321/8gkgjj02

Keywords:

preschool OSA, immune function indicators, FPS-R pain scale

Abstract

Background: To explore the optimal surgical approach for preschool children with obstructive sleep apnea (OSA) by comparing changes in venous hematological parameters, Faces Pain Scale Revision (FPS-R) pain scale scores, and OSA-18 scale scores following two different surgical treatments.
Methods: A total of 83 preschool children with OSA were enrolled, with 42 assigned to the control group (total tonsillectomy with adenoidectomy) and 41 to the experimental group (partial tonsillectomy with adenoidectomy). Preoperative and postoperative (3-day) measurements included cardiovascular disease risk factors, immune-related indicators, perioperative blood loss, postoperative FPS-R pain scale scores, and OSA-18 scale scores.
Results: Comparison between the two groups revealed no significant differences in intraoperative blood loss, primary bleeding, pre- and post-treatment OSA-18 scale scores, C-reactive protein (CRP) levels, cardiovascular disease risk factors, or immune-related indicators (all P > 0.05). However, significant differences were observed in secondary bleeding (P < 0.05) and postoperative FPS-R pain scale grades (P < 0.05). In the control group, pre- and post-treatment antistreptolysin O (ASO) levels showed no significant difference (P> 0.05), whereas in the experimental group, ASO levels decreased significantly (P < 0.05).
Conclusion: Partial tonsillectomy demonstrated comparable efficacy to total tonsillectomy in terms of intraoperative blood loss, reduction of snoring symptoms, and improvement of airway patency, with both procedures achieving stable therapeutic outcomes. No significant differences were observed between partial and total tonsillectomy regarding short-term effects on cardiovascular disease risk factors or immune function. For preschool children with OSA, partial tonsillectomy was superior to total tonsillectomy in reducing postoperative pain, secondary bleeding, and ASO levels.

References

[1] Chinese guidelines for the diagnosis and treatment of childhood obstructive sleep apnea (2020). Chinese Journal of Evidence-Based Medicine, 20(8), 883-900.

[2] Tsubomatsu C, Shintani T, Abe A, Yajima R, Takahashi N, Ito F,et al. Diagnosis and Treatment of Obstructive Sleep Apnea Syndrome in Children.Adv Otorhinolaryngol. 2016;77:105-11. https://doi.org/10.1159/000441886.

[3] China Maternal and Child Health Association Minimally Invasive Chapter Pediatric ORL Group. Standardized technical guidelines for low-temperature plasma radiofrequency ablation in pediatric tonsil and adenoid surgery. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 39(2), 97-109. https://doi.org/10.13201/j.issn.2096-7993.2025.02.001.

[4] Wu JC, Chen WH, Lan Q, Zhang KY. Clinical study on the impact of tonsillectomy and adenoidectomy on immune function in children with OSAHS. Chinese and Foreign Medical Research, 19(23), 1-5.1-5. https://doi.org/10.14033/j.cnki.cfmr.2021.23.001.

[5] Yin MD. Immunological basis for indications of tonsillectomy and adenoidectomy in children. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 24(9), 385, 391.

[6] Xiao XS. Evaluation of commonly used clinical pain assessment methods. Modern Hospital, (12), 32-35.

[7] Wang XH, Zhao RX. Long-term effects of childhood tonsillectomy on human immune function. Chinese Journal of Otorhinolaryngology in Integrative Medicine, (6), 420-423. https://doi.org/10.16542/j.cnki.issn.1007-4856.2007.06.018.

[8] Eviatar E, Kessler A, Shlamkovitch N, Vaiman M, Zilber D, Gavriel H. Tonsillectomy vs. partial tonsillectomy for OSAS in children--10 years post-surgery follow-up. Int J Pediatr Otorhinolaryngol. 2009 May;73(5):637-40.): https://doi.org/10.1016/j.ijporl.2008.12.012.

[9] Hua F, Zhao T, Walsh T, Sun Q, Chen X, Worthington H, et al. Effects of adenotonsillectomy on the growth of children with obstructive sleep apnoea-hypopnea syndrome (OSAHS): protocol for a systematic review. BMJ Open. 2019 Aug 18;9(8):e030866. https://doi.org/10.1136/bmjopen-2019-030866.

[10] Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Jun 18;139(25):e1082-e1143. https://doi.org/10.1161/CIR.0000000000001172.

[11] Yi RN, Liu T, Guo DW, Wang M. Changes in immune function after tonsillectomy and adenoidectomy in children with OSAHS. Chinese Journal of Otorhinolaryngology-Skull Base Surgery, 26(1), 101-104.

[12] Zhou CY, Dai ZY. Effects of adenoidectomy with simple tonsil ablation or partial tonsillectomy with ablation on postoperative immune function in children with OSAHS. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 25(21), 990-992.

[13] Wang S, Zhang Q, Luo BM. Effects of partial versus total tonsillectomy on immune function in children with OSAHS and a history of recurrent respiratory infections. Hainan Medical Journal, 35(17), 2464-2469.

[14] Qiu SY, Liu DB, Zhong JW. Interpretation of 2018 French Society of Otorhinolaryngology-Head and Neck Surgery guidelines: The role of different treatment options for pediatric OSAHS. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 34(2), 97-100. https://doi.org/10.13201/j.issn.1001-1781.2020.02.001.