THE EFFECT OF ADENOTONSILLECTOMY ON OXYGEN SATURATION IN CHILDREN WITH SLEEP DISORDERED BREATHING
Irena Božanić Željka Roje Goran Račić
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Sažetak Sleep disordered breathing (SDB) is a collective name for various symptoms characterized by a pathologic form of breathing during sleep. Objectives are to evaluate correlation between the size of tonsils and adenoid tissue and SDB based on the fall in oxygen saturation of peripheral blood in children with SDB and to determine the effect of adenotonsillectomy on the improvement of the parameters set forth. The study included 30 children aged 2-10 with SDB, with enlargement of palatine tonsils and adenoid tissue as the main obstruction. Demographic data and heterohistory were taken from parents/guardians accompanying the children for the scheduled operation. Oropharyngoscopic and fiber endoscopic tests as well as bipolar diathermy coagulation adenotonsillectomy with surgical sets for multiple use were performed by an ENT specialist. Pulse oxymeter was placed on the forefinger of the fallen-asleep child and was removed in the morning after awakening. Heterohistory and pulse oxymetry control were taken at home after four weeks. All subjects completed the study. The mean patient age was 4.25 (2-8.5) years; there were 16 (53.3%) male and 14 (46.7%) female patients. The most prevalent symptoms were snoring and respiratory pauses (100%), restless sleep (97%), sweating (73%) and sleepiness during the day (57%). All of the children presented grade three or four of tonsillar hyperplasia and fiber endoscopic finding. All parents (100%) were worried because of the symptoms. Symptom relief was proved after adenotonsillectomy. The mean O2 saturation (%) was 77.7437.293 before and 87.884.25 after adenotonsillectomy (p<0.0001). Total duration of oxygen desaturation of >4% was 21.74128.67 before and 0.3670.29 after the operation (p=0.0001). The number of O2 desaturation below 90% per hour was 53.73 before adenotonsillectomy and decreased to 14.60 after the operation (p<0.0001). All parents (100%) were satisfied with the results of the operation. Adenotonsillectomy decreased the symptoms and improved the oxygen saturation measures by nocturnal pulse oxymetry in children with SDB.