title: Adenotonsillectomy for obstructive sleep apnea in children with Prader-Willi syndrome.
abstract: The aim of our study was to evaluate the efficacy of adenotonsillectomy for the treatment of obstructive sleep apnea syndrome (OSA) in pediatric patients with Prader-Willi syndrome (PWS), and to describe the postoperative complications. Five patients (4 males; median age, 4.4 years; range, 1.6-14.2 years) were studied. All patients underwent an overnight cardiorespiratory sleep study. All patients had adenotonsillar hypertrophy (ATH), and two were also obese. The preoperative obstructive apnea/hypopnea index (AHI; median and range) was 12.2 (9.0-19.9) events/hr; the mean oxygen saturation was 95 (79-96)%; the nadir oxygen saturation was 71 (58-78)%; and the oxygen desaturation index (ODI) was 15.8 (11.4-35.9) events/hr. Preoperatively, patients were classified as having moderate to severe OSA. A second sleep study, performed 16 (3-43) months after adenotonsillectomy, showed a significant decrease in AHI (P = 0.009) and ODI (P = 0.009). Mean and nadir oxygen saturation did not differ significantly postsurgery (P = 0.188, P = 0.073, respectively). Four out of five children showed at least one postoperative complication. Difficult awakening from anesthesia, hemorrhages, and respiratory complications requiring reintubation and/or supplemental oxygen administration were observed. In conclusion, patients with PWS and OSA who underwent adenotonsillectomy showed a significant decrease in AHI and number of oxygen desaturations.
authors.affiliation: Respiratory Unit, Bambino Gesù Children's Research Hospital, Rome, Italy. pavone@opbg.net
authors.forename: M
authors.initials: M
authors.lastname: Pavone
authors.forename: M G
authors.initials: MG
authors.lastname: Paglietti
authors.forename: A
authors.initials: A
authors.lastname: Petrone
authors.forename: A
authors.initials: A
authors.lastname: Crinò
authors.forename: G C
authors.initials: GC
authors.lastname: De Vincentiis
authors.forename: Renato
authors.initials: R
authors.lastname: Cutrera
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D000234:Adenoids / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy; D007223:Infant; D008297:Male; D009765:Obesity / Q000150:complications; D014066:Palatine Tonsil / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D011218:Prader-Willi Syndrome / Q000150:complications*; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000601:surgery*; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome