The effectiveness of tonsillectomy and adenoidectomy in the treatment of pediatric obstructive sleep apnea/hypopnea syndrome: a meta-analysis.
OBJECTIVE
Present and evaluate the currently available literature reporting on the effectiveness of adenotonsillectomy (T/A) in treating obstructive sleep apnea/hypopnea syndrome (OSAHS) in uncomplicated pediatric patients.


METHODS
Systematic review of the literature and meta-analysis of the reduction of the polysomnogram (PSG)-measured Apnea Hypopnea Index (AHI events/hour) resulting from T/A and the overall success rate of T/A in normalizing PSG measurements (%).


RESULTS
Fourteen studies met the inclusion criteria. Mean sample size was 28. All were case series (level 4 evidence). The summary change in AHI was a reduction of 13.92 events per hour (random effects model 95% CI 10.05-17.79, P < 0.001) from T/A. The summary success rate of T/A in normalizing PSG was 82.9% (random effects model 95% CI 76.2%-89.5%, P < 0.001).


CONCLUSIONS
T/A is effective in the treatment of OSAHS. However, success rates are far below 100%, which could have far-reaching pediatric public health consequences.


METHODS
B-2a.
Brietzke
Scott E
SE
Department of Otolaryngology, Walter Reed Army Medical Center, Washington, DC 20307, USA. sbrietzke@msn.com
Gallagher
Daniel
D
D000233:Adenoidectomy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010160:Palate, Soft; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D014068:Tonsillectomy; D016896:Treatment Outcome