The effect of adenotonsillectomy on children suffering from obstructive sleep apnea syndrome (OSAS): the Negev perspective.
OBJECTIVE
To present the Negev perspective in recent decades as to the effect of adenotonsillectomy regarding clinical and polysomnographic features, cardiopulmonary morbidity, growth, neurocognitive function, health care services utilization, and enuresis by reviewing current related literature.


METHODS
All relevant published data by the Soroka University Medical Center and related community medical services were reviewed and compared to MEDLINE linked literature regarding aspects of childhood obstructive sleep apnea published through November 2005.


RESULTS
Published data support a significant effect of adenotonsillectomy on the associated co morbidities: adenotonsillectomy resulted in the reduction of pulmonary hypertension, improved growth as a result of an increase in growth hormone secretion, improvement of neurocognitive function to the normal range, reduction in nocturnal enuresis, as well as reducing general morbidities, as reflected by the reduction in health care utilization. However, there are still uncertainties relating to major aspects. There is no specific definition for OSAS grading, or for generating a guideline for surgical treatment and refinement of the indications of T&A.


CONCLUSIONS
Adenotonsillectomy has a beneficial effect on children with OSAS, however, further research is required before recommendations for the treatment of OSAS in children can be formulated.
Leiberman
Alberto
A
Department of Otolaryngology, Head & Neck Surgery, Soroka University Medical Center, PO Box 151, Beer-Sheva 84101, Israel. alberto@bgu.ac.il
Stiller-Timor
Liran
L
Tarasiuk
Ariel
A
Tal
Asher
A
D000233:Adenoidectomy; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000209:etiology; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology / Q000209:etiology; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D015508:Nasal Obstruction / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D053206:Nocturnal Enuresis / Q000453:epidemiology / Q000209:etiology; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D014068:Tonsillectomy; D016896:Treatment Outcome