Effectiveness of Powered Intracapsular Tonsillectomy in Children With Severe Obstructive Sleep Apnea

Importance Powered intracapsular tonsillectomy and adenoidectomy (PITA) is an increasingly common pediatric procedure. Few studies have examined its effectiveness in children with severe obstructive sleep apnea (OSA). Objective To assess the effectiveness of PITA in patients with severe OSA as evidenced by change in polysomnographic parameters. Design, Setting, and Participants We performed a case series study with medical record review of 70 children with severe OSA who underwent PITA at a tertiary care pediatric hospital from January 1, 2010, through December 31, 2014. Main Outcomes and Measures Preoperative and postoperative polysomnographic parameters. Results Of the 70 children with severe OSA who underwent PITA, 39 (56%) were boys, and the median age at surgery was 3.7 years. There were significant mean (SD) decreases in the postoperative apnea-hypopnea index (32.4 [28.4] vs 5.8 [9.7], P P P P  = .001), and oxygen desaturation index of 4% or more (22.9 [26.4] vs 4.5 [9.9], P P P P  = .01). Conclusions and Relevance Powered intracapsular tonsillectomy and adenoidectomy improved OSA in this series of pediatric patients by reducing obstructive apneas and hypopneas, oxygen desaturation, arousal index, carbon dioxide level, and snoring, as well as increasing oxygen saturation nadir. Results are comparable to those described for traditional electrocautery tonsillectomy and support the use of PITA for the treatment of severe OSA in children with adenotonsillar hypertrophy.