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Erschienen in: European Archives of Oto-Rhino-Laryngology 1/2020

24.09.2019 | Miscellaneous

Swallowing outcomes after pediatric epiglottopexy

verfasst von: Sohit Paul Kanotra, Victoria B. Givens, Brent Keith

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 1/2020

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Abstract

Introduction

Persistent sleep apnea following tonsillectomy and adenoidectomy in children requires additional evaluation. One of the common areas of persistent upper airway obstruction in these children is the base of the tongue and lingual tonsils as well as epiglottic prolapse. Depending on the site of obstruction on sleep endoscopy or a cine MRI, surgical procedures include base of tongue reduction and lingual tonsillectomy with or without epiglottopexy.

Objective

To assess the swallowing outcomes in children undergoing epiglottopexy with lingual tonsillectomy.

Methods

A retrospective case series review of children undergoing epiglottopexy with or without lingual tonsillectomy. All patients underwent an epiglottopexy with lingual tonsillectomy using coblation. A detailed evaluation including a sleep study, sleep endoscopy, and thorough swallowing assessment preoperatively as well as postoperatively was performed.

Results

Five children underwent epiglottopexy with lingual tonsillectomy for obstructive sleep apnea. Epiglottopexy improved sleep apnea with Apnea Hypopnea Index (AHI) falling significantly from 4.6 to 0.5 (p < 0.05). All patients had a normal swallowing assessment postoperatively with functional endoscopic evaluation of swallowing (FEES) revealing no evidence of aspiration and penetration.

Conclusion

In our case series epiglottopexy with lingual tonsillectomy is a safe and effective technique, which improves sleep apnea in pediatric patients. It does not affect the swallowing mechanism, and the epiglottis still retains the laryngeal protective role.
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Literatur
1.
Zurück zum Zitat Marcus CL, Moore RH, Rosen CL et al (2013) A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med 368:2366–2376CrossRef Marcus CL, Moore RH, Rosen CL et al (2013) A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med 368:2366–2376CrossRef
2.
Zurück zum Zitat Bhattacharjee R, Kheirandish-Gozal L, Spruyt K et al (2010) Adenotonsillectomy outcomes in treatment of obstructive sleep apnea in children: a multicenter retrospective study. Am J Respir Crit Care Med 182:676–683CrossRef Bhattacharjee R, Kheirandish-Gozal L, Spruyt K et al (2010) Adenotonsillectomy outcomes in treatment of obstructive sleep apnea in children: a multicenter retrospective study. Am J Respir Crit Care Med 182:676–683CrossRef
3.
Zurück zum Zitat Friedman M, Wilson M, Lin HC, Chang HW (2009) Updated systematic review of tonsillectomy and adenoidectomy for treatment of pediatric obstructive sleep apnea/hypopnea syndrome. Otolaryngol Head Neck Surg 140:800–808CrossRef Friedman M, Wilson M, Lin HC, Chang HW (2009) Updated systematic review of tonsillectomy and adenoidectomy for treatment of pediatric obstructive sleep apnea/hypopnea syndrome. Otolaryngol Head Neck Surg 140:800–808CrossRef
4.
Zurück zum Zitat Oomen K, Modi VK (2014) Epiglottopexy with and without lingual tonsillectomy. Laryngoscope 124:1019–1022CrossRef Oomen K, Modi VK (2014) Epiglottopexy with and without lingual tonsillectomy. Laryngoscope 124:1019–1022CrossRef
5.
Zurück zum Zitat Berry R, Brooks R, Gamaldo C et al (2013) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Version 2.0.2. Darien, IL: American Academy of Sleep Medicine Berry R, Brooks R, Gamaldo C et al (2013) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Version 2.0.2. Darien, IL: American Academy of Sleep Medicine
6.
Zurück zum Zitat Bergeron M, de Alarcon A, Hart CK, Rutter MJ (2018) Factors associated with epiglottic petiole prolapse repositioning success. Laryngoscope Bergeron M, de Alarcon A, Hart CK, Rutter MJ (2018) Factors associated with epiglottic petiole prolapse repositioning success. Laryngoscope
7.
Zurück zum Zitat Werner JA, Lippert BM, Dünne AA et al (2002) Epiglottopexy for the treatment of severe laryngomalacia. Eur Arch Otorhinolaryngol 259:459–464CrossRef Werner JA, Lippert BM, Dünne AA et al (2002) Epiglottopexy for the treatment of severe laryngomalacia. Eur Arch Otorhinolaryngol 259:459–464CrossRef
8.
Zurück zum Zitat Whymark AD, Clement WA, Kubba H, Geddes NK (2006) Laser epiglottopexy for laryngomalacia: 10 years’ experience in the west of Scotland. Arch Otolaryngol Head Neck Surg 132:978–982CrossRef Whymark AD, Clement WA, Kubba H, Geddes NK (2006) Laser epiglottopexy for laryngomalacia: 10 years’ experience in the west of Scotland. Arch Otolaryngol Head Neck Surg 132:978–982CrossRef
9.
Zurück zum Zitat Sandu K, Monnier P, Reinhard A, Gorostidi F (2015) Endoscopic epiglottopexy using Lichtenberger’s needle carrier to avoid breakdown of repair. Eur Arch Otorhinolaryngol 272:3385–3390CrossRef Sandu K, Monnier P, Reinhard A, Gorostidi F (2015) Endoscopic epiglottopexy using Lichtenberger’s needle carrier to avoid breakdown of repair. Eur Arch Otorhinolaryngol 272:3385–3390CrossRef
10.
Zurück zum Zitat Yellon RF (2006) Epiglottic and base-of-tongue prolapse in children: grading and management. Laryngoscope 116:194–200CrossRef Yellon RF (2006) Epiglottic and base-of-tongue prolapse in children: grading and management. Laryngoscope 116:194–200CrossRef
11.
Zurück zum Zitat Ishman SL, Chang KW, Kennedy AA (2018) Techniques for evaluation and management of tongue-base obstruction in pediatric obstructive sleep apnea. Curr Opin Otolaryngol Head Neck Surg 26:409–416CrossRef Ishman SL, Chang KW, Kennedy AA (2018) Techniques for evaluation and management of tongue-base obstruction in pediatric obstructive sleep apnea. Curr Opin Otolaryngol Head Neck Surg 26:409–416CrossRef
12.
Zurück zum Zitat Logemann JA, Kahrilas PJ, Cheng J et al (1992) Closure mechanisms of laryngeal vestibule during swallow. Am J Physiol 262:338–344 Logemann JA, Kahrilas PJ, Cheng J et al (1992) Closure mechanisms of laryngeal vestibule during swallow. Am J Physiol 262:338–344
Metadaten
Titel
Swallowing outcomes after pediatric epiglottopexy
verfasst von
Sohit Paul Kanotra
Victoria B. Givens
Brent Keith
Publikationsdatum
24.09.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 1/2020
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05664-6

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