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Neue Techniken der Tonsillenchirurgie beim obstruktiven Schlafapnoe-Syndrom des Kindes

verfasst von: Dr. R. de la Chaux, M. Patscheider, E. Krause, A. Dreher

Erschienen in: Somnologie | Ausgabe 3/2009

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Zusammenfassung

Therapie der Wahl beim obstruktiven Schlafapnoe-Syndrom (OSAS) des Kindes war bis vor wenigen Jahren die Tonsillektomie mit Adenotomie. Der vorliegende Artikel gibt anhand einer Literaturrecherche einen Überblick über neuere Techniken der Tonsillenchirurgie, insbesondere der Tonsillotomie, und deren Auswirkungen auf die polysomnographisch erfassten Atemparameter. Während mit der Tonsillektomie und Adenotomie Heilungsraten von 85% erzielt werden, liegen die Heilungsraten nach Tonsillotomie und Adenotomie abhängig vom Operationsverfahren bei 50–93%. Deutlich schlechtere Heilungsraten nach Tonsillektomie zeigen jüngere und übergewichtige Kinder sowie Kinder mit einem ungünstigen Ausgangsbefund in der Polysomnographie. Insgesamt ist die Datenlage jedoch noch sehr schwach, so dass prospektive Vergleichsstudien mit den verschiedenen Techniken zu fordern sind, bis eine endgültige Empfehlung herausgegeben werden kann. Unabhängig davon, bietet die Tonsillotomie gegenüber der Tonsillektomie den Vorteil der geringeren postoperativen Nachblutungsgefahr sowie den geringeren postoperativen Schmerzen. Ein Nachwachsen der Rest-Tonsillen nach Tonsillotomie ist jedoch möglich und kann zu erneuten Beschwerden der Kinder führen.

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Titel: Neue Techniken der Tonsillenchirurgie beim obstruktiven Schlafapnoe-Syndrom des Kindes
verfasst von: Dr. R. de la Chaux
M. Patscheider
E. Krause
A. Dreher
Publikationsdatum: 01.09.2009
Verlag: D. Steinkopff-Verlag
Erschienen in: Somnologie / Ausgabe 3/2009
Print ISSN: 1432-9123
Elektronische ISSN: 1439-054X
DOI: https://doi.org/10.1007/s11818-009-0416-6

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