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Type 2 according to the Benjamin-Inglis classification.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cristina García-Muro, Isabel Sáenz-Moreno, Fernando Gómez-Sáez, Ana Navazo-Eguia" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Cristina" "apellidos" => "García-Muro" ] 1 => array:2 [ "nombre" => "Isabel" "apellidos" => "Sáenz-Moreno" ] 2 => array:2 [ "nombre" => "Fernando" "apellidos" => "Gómez-Sáez" ] 3 => array:2 [ "nombre" => "Ana" "apellidos" => "Navazo-Eguia" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S000165192100090X" "doi" => "10.1016/j.otorri.2021.05.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000165192100090X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573522000394?idApp=UINPBA00004N" "url" => "/21735735/0000007300000003/v1_202205140810/S2173573522000394/v1_202205140810/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173573522000564" "issn" => "21735735" "doi" => "10.1016/j.otoeng.2021.02.003" "estado" => "S300" "fechaPublicacion" => "2022-05-01" "aid" => "1085" "copyright" => "Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Acta Otorrinolaringol Esp. 2022;73:184-90" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Cholesteatoma: Influence of surgical technique and EAONO/JOS stage on audiological results" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "184" "paginaFinal" => "190" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Colesteatoma: influencia de la técnica quirúrgica y el estadio EAONO/JOS en los resultados audiológicos" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1459 "Ancho" => 2925 "Tamanyo" => 821417 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Distribution of degree of hearing loss.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Josefa Olmedo Martínez, Francisco Ropero Romero, Serafín Sánchez Gómez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Josefa" "apellidos" => "Olmedo Martínez" ] 1 => array:2 [ "nombre" => "Francisco" "apellidos" => "Ropero Romero" ] 2 => array:2 [ "nombre" => "Serafín" "apellidos" => "Sánchez Gómez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S000165192100042X" "doi" => "10.1016/j.otorri.2021.02.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000165192100042X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573522000564?idApp=UINPBA00004N" "url" => "/21735735/0000007300000003/v1_202205140810/S2173573522000564/v1_202205140810/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Brief communication</span>" "titulo" => "Is it necessary to perform a follow-up study after adenotonsillectomy in all children with moderate-severe obstructive sleep apnoea?" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "191" "paginaFinal" => "195" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Genoveva del-Río Camacho, Roberto Torre Francisco, Jesús Rodríguez Catalán, Jaime Sanabria Brossart, Rebeca López Gómez, Fernanda Troncoso Acevedo" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Genoveva" "apellidos" => "del-Río Camacho" "email" => array:1 [ 0 => "vevirio@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Roberto" "apellidos" => "Torre Francisco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Jesús" "apellidos" => "Rodríguez Catalán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Jaime" "apellidos" => "Sanabria Brossart" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Rebeca" "apellidos" => "López Gómez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Fernanda" "apellidos" => "Troncoso Acevedo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Pediatría, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio ORL, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad Multidisciplinar de Sueño, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Es necesario repetir el estudio de sueño de control a todos los niños con SAHOS moderado-severo tras la cirugía?" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1566 "Ancho" => 2174 "Tamanyo" => 119740 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Box diagram showing the average obstructive apnoea-hypopnoea index (OAHI) score according to the parents’ perception after adenotonsillectomy (complete improvement, partial improvement and no improvement).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Adenotonsillar hypertrophy in children without any underlying pathology is the most common cause of obstructive sleep apnoea - hypopnoea syndrome (OSAHS), so that adenotonsillectomy is the first line of treatment. Nevertheless, in the last decade studies have been published which detect the persistence of residual OSAHS after surgery. The rate of this in the series varies from 10% to 77%, depending basically on the definition of residual OSAHS and the presence or not in the group studied of risk factors such as obesity or other comorbidities.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a> Due to this several societies recommend the use of a sleep study check in children with severe or even moderate OSAHS prior to adenotonsillar surgery; this is also recommended for children with obesity or craniofacial malformations which favour upper airway obstruction.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Nevertheless, some previous publications state that there may be a favourable correlation between parents’ perception of symptoms after surgery and the results of polysomnography (PSG) monitoring, so that it may be possible to eliminate the said PSG in many cases.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7–10</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">This study analyses whether in our population parents’ clinical perception following adenotonsillectomy correlates sufficiently with PSG check parameters. If this is the case, then the second PSG can be restricted to children with comorbidities (including obesity) or when the parents describe symptoms that persist after surgery.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">Children were included over a 5-year period who had received total adenotonsillectomy due to a preoperative diagnosis of severe OSAHS using PSG and, in those who had had a PSG check, in the 12 months after surgery. Children with syndromes or known neurological pathology were excluded, as were those with obesity. Children whose history did not clearly specify their clinical evolution after surgery were also excluded. The PSG was performed and studied manually, according to established recommendations.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> OSAHS was defined as when the obstructive apnoea-hypopnoea index (OAHI) was ≥2/h and severe OSAHS when the OAHI was >10/h, according to the European Respiratory Society (ERS) consensus document.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Data were gathered retrospectively from patients’ clinical histories, on their clinical evolution after surgery before their second PSG, when parents were asked about the persistence of respiratory sleep disorders. When the reply was that the patient now never snored and that no apnoea had been seen this was considered to be a “complete improvement”. When only snoring persisted without apnoea being observed, this was considered to be a “partial improvement”, and when both symptoms (snoring and apnoea) persisted, this was considered to be “no improvement”. Symptoms were considered to be present when they occurred at any time of the night on any day of the week: all of the time, most of the time or sometimes.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The quantitative variables have been expressed as an average and 95% confidence interval, while the qualitative variables are shown as percentages. The Student t-test was used to compare polysomnographic data before and after surgery. The chi-squared test was used to compare the PSG result after treatment with the parents’ clinical impression at that time. Values of <span class="elsevierStyleItalic">P</span> < 0.05 were considered to be statistically significant.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The Ethics Committee of the hospital gave its approval prior to the review of the clinical histories. Family members were not asked to give their informed consent as this is a retrospective study which did not modify normal clinical practice.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">After applying the aforesaid criteria the group studied contained 41 children (65.85% males). The average time between both PSG was 7.98 months (95% CI: 6.71, 9.24). The preoperative OAHI in all of the children was higher than the postoperative figure, reducing the average OAHI from 27.95 (95% CI: 22.00, 33.90) at the basal moment to 1.59 (95% CI: 0.24, 2.94) in the PSG check (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The rate of cure (OAHI < 2/h after surgery) was 80.48% (33 children), and the percentage of residual OSAHS was 19.51% (8 children).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows the box diagram where the average OAHI in the PSG check is displayed according to the parents’ perception of the symptoms after the adenotonsillar surgery: complete improvement (0.63/h), partial improvement (1.51/h) and no improvement (11.96/h). <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the parents’ perception after surgery and whether the OSAHS persisted or not in the PSG check. In the group of children who the parents perceived as being “complete resolution” (n = 32), only 3 children had a residual OAHI ≥ 2, with a maximum OAHI of 2.6/h (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Discussion</span><p id="par0050" class="elsevierStylePara elsevierViewall">This study seems to indicate that there is a good correlation between parents’ clinical perception after surgery and the result of a PSG check, given that when the said perception consisted of complete improvement, in 90.62% of cases this was accompanied by an OAHI < 2/h in the PSG check. On the other hand, when the parents’ perception did not correspond to complete improvement, more than half of the children (55.5%) were found to have residual SAHS in the PSG check.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Studies have been published which contain data similar to ours.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7–9</span></a> Suen et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> observed a good correlation between parents’ perceptions (which were analysed using questions similar to ours: no improvement, partial improvement and complete improvement) after surgery and the AHI in the PSG check. The curation rate cannot be compared to ours as they selected a different OAHI for the diagnosis of OSAHS (>5). Nevertheless, they do state that all of the patients with residual OSAHS had persistent snoring after surgery. In 2010, Nieminen et al. studied 27 children with OSAHS (AHI > 1) and observed that none of those who had ceased to snore after surgery still had OSAHS in the PSG check.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> In 2007 Mitchell studied 79 children who had been diagnosed with OSAHS (AHI ≥ 5) and had received surgery, whose parents completed the OSA-18 questionnaire before and after the operation. He too found a good relationship between the persistence of symptoms after surgery and the finding of persistent OSAHS in the PSG check, given that when the parents awarded a score > 20 in “sleep domain” of the questionnaire or they mentioned persistent snoring, this was associated with persistent OSAHS in the PSG check, while none of the children whose carers awarded a score < 20 in the “sleep domain” still had OSAHS after surgery.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Lastly, in 2016 Villa et al. published a study in which they evaluated the usefulness of a questionnaire they had prepared (SCR), which combined data from ear, nose and throat examination and the clinical history. They state that when AHI ≥ 1 is found to persist in the PSG check, the SCR result after treatment was positive in the majority of cases, showing an excellent correlation with the PSG. However, a high percentage (61.7%) of children who had received adenotonsillectomy and whose questionnaire was negative were found to still have AHI ≥ 1 in the PSG check, so that the questionnaire may not be a good tool in this respect.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Nevertheless, these studies do not seem to have provided enough evidence to support any change in the recommendations by medical associations.</p><p id="par0060" class="elsevierStylePara elsevierViewall">On the other hand, our study has many limitations. Firstly, the limit selected for OSAHS (OAHI ≥ 2/h) does not coincide with the one used in other publications. Notwithstanding this, our study is of normal clinical practice, and this is the level of AHI over which in our practice we consider pathology to exist, based on the recommendation of the ERS.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> If we re-analyse our sample considering an AHI ≥ 1/h to be pathological (as this limit has habitually been used in the literature in recent years), we find that OSAHS persists in 13 of the 41 children, which would be equivalent to a curation rate of 68.29%, which is higher than the rate found in other publications.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3</span></a> With this change, of the 32 children whose parents described the disappearance of snoring as well as episodes of apnoea, 7 (21.8%) of them would still have an AHI ≥ 1/h after surgery. This would mean that 78.12% of the children would have an AHI < 1/h in the PSG check when the parents had described the complete absence of symptoms, and this would still be a good correlation. Moreover, the maximum AHI in this group would still stand at 2.6/h.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Another limitation, and without doubt a more important one, is the retrospective nature of the study. This meant that many children had to be excluded because their clinical history did not specifically mention the evaluation of the persistence of snoring and/or episodes of apnoea after surgery. Additionally, not all of the children diagnosed with severe OSAHS were subjected to a subsequent study, in some cases because this was not requested, and in others because the parents did not attend. On the other hand, we lack data that would allow us to analyse the evolution of the obese patients. This is because very few obese children were studied, and they were excluded from the final analysis, so that no conclusion could be drawn. The number of subjects was also drastically reduced by the attempt to homogenise the sample by excluding patients who had not been subjected to a PSG, or when the surgery did not consist of total adenotonsillectomy.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Nevertheless, our greatest limitation was paradoxically the high curation rate, as this meant that only 7 patients (19.51%) had residual OSAHS, which is a very small group for the purpose of analysing their parents’ perception. Therefore, although our data seem to indicate that when parents describe the absence of symptoms after surgery, the PSG check is practically always normal, we believe that more prospective studies are therefore required, with a higher number of subjects, to confirm our data and to determine which children should be monitored after surgical treatment.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Our work does not in any way wish to suggest that adenotonsillar surgery resolves OSAHS in all of the children who receive this treatment; in fact, OSAHS remained after surgery in 19.51% or 21.8% of the patients in the sample studied (depending on whether we select OAHI ≥ 2 or >1, respectively). It simply tries to show that, in a child without underlying pathology or obesity, the information supplied by parents about their clinical evolution after surgery may be of value and even decisive when selecting the patients who should be subjected to monitoring.</p><p id="par0080" class="elsevierStylePara elsevierViewall">We are unaware of the reason why parents’ perception changes and ceases to be useful in predicting the result of the basal PSG, as other studies have shown,<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> when it is a good guide for predicting the result of the subsequent PSG check. This may be because the sample is composed of children diagnosed with OSAHS whose parents are able to detect a change following treatment, although other theories may be possible. We nevertheless believe that our study will be useful at the least in encouraging the performance of similar studies which are prospective, with a more appropriate methodology, repeating the questionnaire instead of reviewing clinical histories and with more subjects, to confirm our findings. This would help to reduce the number of sleep studies, reducing waiting lists and thereby optimizing the workload of our sleep units, restricting PSG after treatment to those children with an underlying pathology (including obesity) or when the clinical improvement described by the parents is incomplete following surgery.</p><p id="par0085" class="elsevierStylePara elsevierViewall">We therefore conclude that in a child without underlying pathology, the information supplied by the parents about their clinical evolution after surgery may be decisive in the selection of those patients for whom subsequent monitoring should be requested, preventing work overload in sleep units.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conflict of interests</span><p id="par0090" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1709577" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1512138" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1709578" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1512139" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-04-10" "fechaAceptado" => "2021-06-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1512138" "palabras" => array:3 [ 0 => "Obstructive sleep apnoea" 1 => "Adenotonsillectomy" 2 => "Polysomnography" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1512139" "palabras" => array:3 [ 0 => "Síndrome de apnea-hipopnea de sueño" 1 => "Adenoamigdalectomía" 2 => "Polisomnografía" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Hypertrophy of adenotonsillar tissue is the most common cause of OSAS in otherwise healthy children, and therefore adenotonsillectomy is the first line treatment. Scientific societies recommend nocturnal follow-up PSG to assess for residual OSAS in children with preoperative evidence for moderate to severe OSAS, obesity, craniofacial anomalies that obstruct the upper airway and neurological disorders, based on the increasing trend of publications reporting residual OSAS after adenotonsillectomy. Follow-up PSG values in children with a pre-operative diagnosis of severe OSAS were analysed retrospectively, and compared to the parents’ impression after ENT surgery. The study population included 41 healthy children with severe OSAS and adenotonsillar surgery. The percentage of children with normal PSG parameters (AHI < 2/h) after adenotonsillectomy was 80.48%. A very good correlation was observed between the parents’ perception after treatment and the follow-up PSG parameters, specifically when the parents perceived that the patient had shown “complete resolution” (no snoring or apnoea), 90.62% of the children had an AHI < 2/h in the follow-up PSG, the maximum residual AHI being 2.6/h. In healthy children with no underlying pathology, the information provided by the parents on clinical progression after surgery could be useful and might enable the selection of those patients who require a follow-up study, avoiding overload in sleep units.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La hipertrofia adenoamigdalar es, en niños sin patología de base, la causa más frecuente de SAHOS y, por tanto, la adenoamigdalectomía constituye la primera línea de tratamiento. Diferentes sociedades científicas recomiendan la realización de una PSG de control en el seguimiento, en caso de niños con patología de base o si el diagnóstico previo a la cirugía era de SAHOS moderado o severo, debido a la tendencia creciente de publicaciones con SAHOS residual tras adenoamigdalectomía. Se analiza retrospectivamente la correlación entre la percepción de los padres tras cirugía ORL y el resultado de la PSG de control en niños con diagnóstico de SAHOS severo en los que se ha realizado tratamiento quirúrgico. Se incluyeron 41 niños con SAHOS severo y cirugía adenoamigdalar, cuya tasa de curación ha sido del 80,48%. Se observa muy buena correlación entre la percepción de los padres tras el tratamiento y los índices en la PSG de control, destacando que cuando los padres percibían que el paciente había experimentado una «resolución completa» (no ronquido ni apneas), el 90,62% de los niños presentaban un IAHO < 2/h en el control posterior al tratamiento, siendo el IAHO residual máximo de 2,6/h. Concluimos que, en un niño sin patología de base, la información aportada por los padres acerca de la evolución clínica tras la cirugía podría ser discriminativa para elegir a aquellos pacientes a los que solicitar un estudio de control, evitando sobrecargas en las unidades de sueño.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: del-Río Camacho G, Torre Francisco R, Rodríguez Catalán J, Sanabria Brossart J, López Gómez R, Troncoso Acevedo F. ¿Es necesario repetir el estudio de sueño de control a todos los niños con SAHOS moderado-severo tras la cirugía? Acta Otorrinolaringol Esp. 2022;73:191–195.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1566 "Ancho" => 2174 "Tamanyo" => 119740 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Box diagram showing the average obstructive apnoea-hypopnoea index (OAHI) score according to the parents’ perception after adenotonsillectomy (complete improvement, partial improvement and no improvement).</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">OAHI: obstructive apnoea-hypopnoea index; IC: central apnoea index; IDO: desaturations index; BMI: body mass index.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Basal PSG (n = 41) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PSG check (n = 41) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Average (95% CI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Average (95% CI) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.88 (3.37–4.38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.67 (4.11–5.22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Weight (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (14.44–17.55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.42 (16.69–20.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Height (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">102.33 (98.35–106.31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">105.67 (101.89–109.44) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.97 (14.43–15.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.10 (15.54–16.65) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Z score BMI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.75 (−1.10 to −0.40) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.06 (−0.37 to 0.25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">OAHI (/h) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.95 (22.00–33.90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.59 (0.24–2.94) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IC (/h) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.05 (1.37–2.73) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.69–1.31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IDO (/h) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.20 (27.16–41.24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.87 (2.13–5.62) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Average saturation (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.25 (95.63–96.87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">97.59 (97.29–97.88) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Minimum saturation (nadir) (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">76.98 (72.31–81.64) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90.67 (89.21–92.12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T90 (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.63 (2.27–12.98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.18 (0.13–0.49) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2903369.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Anthropometric values and PSG results, basal and subsequent check.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">OAHI: obstructive apnoea-hypopnoea index; PSG: polysomnography; OSAHS: obstructive sleep apnoea-hypopnoea syndrome.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Complete improvement (n = 32) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No complete improvement (partial improvement + no improvement) (n = 9) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">OAHI < 2/h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (90.62%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (44.4%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">OAHI ≥ 2/h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (9.37%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (55.5%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2903368.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Parents’ perception after surgery and the persistence or otherwise of OSAHS in the PSG check (<span class="elsevierStyleItalic">P</span> < 0.001).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adenotonsillectomy outcomes in treatment of obstructive sleep apnea in children: a multicenter retrospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. 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