Outcome of Laser or Debrider Tonsillotomy Versus Tonsillectomy in Obstructive Sleep Apnea

NCT ID: NCT01319058

Last Updated: 2016-10-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

88 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-08-31

Study Completion Date

2013-07-31

Brief Summary

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Tonsil surgery for children suffering from obstructive sleep apnea have significant post operative morbidity including pain and occasionally bleeding. This morbidity is partly caused by post surgical inflammation. This inflammatory process can be quantified using various proinflammatory cytokines.

the goal of this study is to objectively compare the inflammatory process after treatment of obstructive sleep apnea with different surgical approaches to the enlarged tonsils.

Detailed Description

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Tonsil surgery for children suffering from obstructive sleep apnea have significant post operative morbidity including pain and occasionally bleeding. This morbidity is partly caused by post surgical inflammation. This inflammatory process can be quantified using various proinflammatory cytokines.

the goal of this study is to objectively compare the inflammatory process after treatment of obstructive sleep apnea with different surgical approaches to the enlarged tonsils.

In the study three approaches are prospectively compared:

1. Tonsillectomy - using electrocautery resecting all tonsillar tissue.
2. Debrider Tonsillotomy - reducing the tonsillar tissue with a debrider.
3. laser Tonsillotomy - reducing tonsillar tissue using a CO2 laser.

All patients will be randomized to one of three arms. Each arm will include 25 children.

All children will have a preoperative and postoperative sleep study. Questioners assessing pain, amount of medication used to control pain and sleep disturbance during the first 7 days after surgery will be filled by the child caretaker.

Blood will be drawn immediately before surgery and 18-24 hours after surgery. The following blood products will be assessed: White blood cells, clotting factors, C reactive protein, IL1 beta,TNF alpha, IL6, IL2.

If the study will show objectively and subjectively that partial resection of the tonsil compared to complete tonsillectomy is less painful and has less postoperative inflammation.

Conditions

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Obstructive Sleep Apnea

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Electrocautery tonsillectomy

Children undergoing tonsillectomy and adenoidectomy for obstructive sleep apnea

Group Type ACTIVE_COMPARATOR

Tonsillectomy, laser tonsillotomy, debrider tonsillotomy

Intervention Type PROCEDURE

Each arm will be treated by one of the three methods in addition to adenoidectomy

Debrider tonsillotomy

Children undergoing debrider tonsillotomy + adenoidectomy for obstructive sleep apnea.

Group Type ACTIVE_COMPARATOR

Tonsillectomy, laser tonsillotomy, debrider tonsillotomy

Intervention Type PROCEDURE

Each arm will be treated by one of the three methods in addition to adenoidectomy

Laser tonsillotomy

Children undergoing laser tonsillotomy + adenoidectomy for obstructive sleep apnea.

Group Type ACTIVE_COMPARATOR

Tonsillectomy, laser tonsillotomy, debrider tonsillotomy

Intervention Type PROCEDURE

Each arm will be treated by one of the three methods in addition to adenoidectomy

Interventions

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Tonsillectomy, laser tonsillotomy, debrider tonsillotomy

Each arm will be treated by one of the three methods in addition to adenoidectomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

age 2-16 obstructive sleep apnea AHI\>5 Hypertrophy of tonsils and adenoids

\-

Exclusion Criteria

Children with recurrent tonsillitis craniofacial anomalies Neuromuscular disease Down syndrome
Minimum Eligible Age

2 Years

Maximum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Soroka University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Ben-Zion Joshua

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marc M Puterman, MD

Role: PRINCIPAL_INVESTIGATOR

Soroka University Medical Center

Aviv D Goldbart, MD

Role: STUDY_DIRECTOR

Soroka University Medical Center

Locations

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Soroka Hospital

Beersheba, , Israel

Site Status

Countries

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Israel

References

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Friedman BC, Hendeles-Amitai A, Kozminsky E, Leiberman A, Friger M, Tarasiuk A, Tal A. Adenotonsillectomy improves neurocognitive function in children with obstructive sleep apnea syndrome. Sleep. 2003 Dec 15;26(8):999-1005. doi: 10.1093/sleep/26.8.999.

Reference Type BACKGROUND
PMID: 14746381 (View on PubMed)

Ericsson E, Lundeborg I, Hultcrantz E. Child behavior and quality of life before and after tonsillotomy versus tonsillectomy. Int J Pediatr Otorhinolaryngol. 2009 Sep;73(9):1254-62. doi: 10.1016/j.ijporl.2009.05.015. Epub 2009 Jun 17.

Reference Type BACKGROUND
PMID: 19539380 (View on PubMed)

Anand A, Vilela RJ, Guarisco JL. Intracapsular versus standard tonsillectomy: review of literature. J La State Med Soc. 2005 Sep-Oct;157(5):259-61.

Reference Type BACKGROUND
PMID: 16374970 (View on PubMed)

Blackshaw H, Springford LR, Zhang LY, Wang B, Venekamp RP, Schilder AG. Tonsillectomy versus tonsillotomy for obstructive sleep-disordered breathing in children. Cochrane Database Syst Rev. 2020 Apr 29;4(4):CD011365. doi: 10.1002/14651858.CD011365.pub2.

Reference Type DERIVED
PMID: 32347984 (View on PubMed)

Other Identifiers

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sor495810ctil

Identifier Type: -

Identifier Source: org_study_id

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