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Objective <p>To analyze clinical data from 112 pediatric patients with adenoid hypertrophy complicated by posterior septal hypertrophy, inferior turbinate hypertrophy, and eustachian tube hypertrophy, and to evaluate the efficacy and safety of endoscopic posterior nasal aperture contouring surgery for Obstructive sleep apnea-hypopnea syndrome (OSAHS). </p> Methods <p>We conducted a retrospective analysis of 120 children (ages 4–12 years) diagnosed with multiplanar stenotic OSAHS who underwent endoscopic posterior nasal aperture contouring using radiofrequency ablation between January 2020 and June 2024. Postoperative outcomes were assessed over a 12-month follow-up period using portable sleep monitoring (OAHI index), electronic nasopharyngoscopy, the OSA-18 quality of life questionnaire, and complication rates.</p> Results <p>The mean OAHI index significantly decreased from 12.7 ± 6.2 events/hour preoperatively to 2.1 ± 1.5 events/hour within 1–3 months post-surgery (<i>P</i> &lt; 0.001). At 12 months, all 112 patients maintained stable OAHI levels averaging 1.5 ± 1.2 events/hour. The residual OSAHS rate was 24.1%, and the overall treatment efficacy rate reached 100%.Endoscopic examination revealed a significant enlargement of the posterior nasal aperture, with 88.4% of patients improving from preoperative grade III–IV to grade I (88.4%) or grade II (11.6%) openness. No severe complications, such as posterior nasal adhesion, eustachian tube dysfunction, or postoperative hemorrhage, were observed during follow-up.</p> Conclusion <p>Endoscopic contouring of the posterior nasal aperture, combined with simultaneous intervention of multiplanar anatomical structures, significantly and durably improves airway obstruction in children with multiplanar stenotic OSAHS. This procedure demonstrates a strong safety profile with a low risk of residual OSAHS, represents a promising therapeutic option for this OSAHS subtype.</p>

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Endoscopic contouring of posterior nasal aperture in children clinical efficacy of multiplanar stenotic OSA: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月10日

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  • Haiyan Deng,
  • Wanting Li,
  • Yanjiao Xu,
  • Yufeng Guo,
  • Xiaohui Wu,
  • Xingqiang Gao

摘要

Objective

To analyze clinical data from 112 pediatric patients with adenoid hypertrophy complicated by posterior septal hypertrophy, inferior turbinate hypertrophy, and eustachian tube hypertrophy, and to evaluate the efficacy and safety of endoscopic posterior nasal aperture contouring surgery for Obstructive sleep apnea-hypopnea syndrome (OSAHS).

Methods

We conducted a retrospective analysis of 120 children (ages 4–12 years) diagnosed with multiplanar stenotic OSAHS who underwent endoscopic posterior nasal aperture contouring using radiofrequency ablation between January 2020 and June 2024. Postoperative outcomes were assessed over a 12-month follow-up period using portable sleep monitoring (OAHI index), electronic nasopharyngoscopy, the OSA-18 quality of life questionnaire, and complication rates.

Results

The mean OAHI index significantly decreased from 12.7 ± 6.2 events/hour preoperatively to 2.1 ± 1.5 events/hour within 1–3 months post-surgery (P < 0.001). At 12 months, all 112 patients maintained stable OAHI levels averaging 1.5 ± 1.2 events/hour. The residual OSAHS rate was 24.1%, and the overall treatment efficacy rate reached 100%.Endoscopic examination revealed a significant enlargement of the posterior nasal aperture, with 88.4% of patients improving from preoperative grade III–IV to grade I (88.4%) or grade II (11.6%) openness. No severe complications, such as posterior nasal adhesion, eustachian tube dysfunction, or postoperative hemorrhage, were observed during follow-up.

Conclusion

Endoscopic contouring of the posterior nasal aperture, combined with simultaneous intervention of multiplanar anatomical structures, significantly and durably improves airway obstruction in children with multiplanar stenotic OSAHS. This procedure demonstrates a strong safety profile with a low risk of residual OSAHS, represents a promising therapeutic option for this OSAHS subtype.