Korean J Otorhinolaryngol-Head Neck Surg.  2007 Aug;50(8):667-671.

Effect of Adenotonsillectomy on Pediatric Obstructive Sleep Apnea

• Park JJ
• Shim HJ
• Choi SM
• Yoon SW
• Shin HB
• Kim EJ
• Koo YJ
• Ahn YM

Abstract

BACKGROUND AND OBJECTIVES: Adenotonsillar hypertrophy is the leading cause for obstructive sleep apnea (OSA) in children. However, clinical improvement after adenotonsillectomy has not been confirmed objectively in Korean children. We evaluated the effects of adenotonsillectomy on polysomnography (PSG) in children with OSA.
SUBJECTS AND METHOD
Fifteen children (age range 3 to 13) who had macroscopic adenotonsillar hypertrophy and a respiratory disturbance index (RDI) greater than 1 on preoperative PSG were enrolled in this study and underwent adenotonsillectomy. All children underwent preoperative and postoperative PSG at 10 weeks after adenotonsillectomy. In addition, the care-givers of each child were asked to check the deficit hyperactivity disorder rating scale-IV (ADHD RS-IV) before and 8 weeks after surgery. Scores from the preoperative and postoperative PSG and ADHD RS-IV were compared using the paired samples t-test.
RESULTS
The improvements in RDI, apneahypoapnea index, apnea index, arousal index, lowest O2 saturation and snoring time on postoperative PSG were significant (p<0.05). About 67% (10 of 15) patients were successfully treated with surgery, but 33% (5 of 15) children had RDI greater than 1 after surgery. ADHD RS-IV score showed significant improvement (p<0.05).
CONCLUSION
This study suggests that adenotonsillectomy is effective in the treatment of childhood OSA, but dose not have perfect results. The presence of residual OSA after surgery in a large number of patients is a significant probability that deserves more studies and intervention.

Keyword

Obstructive sleep apnea; Child;Polysomnography; Tonsillectomy; Adenoidectomy

MeSH Terms

Adenoidectomy
Apnea
Arousal
Child
Humans
Hypertrophy
Polysomnography
Sleep Apnea, Obstructive*
Snoring
Tonsillectomy