{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:29:12Z","timestamp":1784068152618,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to evaluate the long\u2010term efficacy and safety of microdebrider\u2010assisted endoscopic powered intracapsular tonsillectomy and adenoidectomy (PITA) in pediatric patients with obstructive sleep apnea (OSA) using caregiver\u2010reported retrospective assessments of pre\u2010 and post\u2010operative symptom states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center retrospective observational study included 65 children aged &lt;\u200915\u2009years who underwent PITA and at least 1\u2009year of postoperative follow\u2010up. Caregivers completed a structured postoperative questionnaire, retrospectively assessing preoperative and postoperative symptom severity using the validated Japanese version of the Obstructive Sleep Apnea Questionnaire\u201018 (OSA\u201018). The questionnaire evaluated sleep disturbance, physical symptoms, emotional distress, daytime functioning, and caregiver concerns. Postoperative complications, including tonsillitis, peritonsillar abscess, and perceived symptom recurrence, were also assessed. All surgeries were performed using an endoscopic PITA technique designed to preserve the tonsillar capsules.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 65 pediatric patients (median follow\u2010up, 48.0\u2009months; interquartile range, 25.0\u201365.0), significant improvements were observed across all five OSA\u201018 domains. The mean preoperative scores were 5.2, 4.5, 2.3, 3.4, and 4.7 for sleep disturbance, physical symptoms, emotional distress, daytime functioning, and caregiver concerns, respectively. Postoperative scores improved to 1.7, 2.3, 1.7, 2.1, and 1.8, respectively (all,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Subgroup analyses showed no significant differences in outcomes based on follow\u2010up duration (&lt;\u20095 vs. \u2265\u20095\u2009years) or age at surgery (\u2264\u20094 vs. &gt;\u20094\u2009years), suggesting durable and consistent long\u2010term benefits of PITA regardless of age or time since surgery. No peritonsillar abscesses were reported; only three patients (4.6%) experienced postoperative tonsillitis. Thirteen percent of the caregivers reported a subjective recurrence of symptoms; however, none required revision surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PITA is a potentially safe and effective long\u2010term surgical option for pediatric OSA. Retrospective caregiver evaluation revealed sustained symptom improvement, minimal postoperative complications, and high satisfaction levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70274","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T14:30:26Z","timestamp":1759501826000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Long\u2010Term Outcomes of Microdebrider\u2010Assisted Endoscopic Powered Intracapsular Tonsillectomy and Adenoidectomy in Pediatric Obstructive Sleep Apnea: A Questionnaire\u2010Based Observational Study"],"prefix":"10.1002","volume":"10","author":[{"given":"Ryota","family":"Koshu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6281-2782","authenticated-orcid":false,"given":"Masao","family":"Noda","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Jichi Medical University  Shimotsuke Japan"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Kanazawa University  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruna","family":"Nakamoto","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Jichi Medical University  Shimotsuke 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