Outcome of adenotonsillectomy for obstructive sleep apnea syndrome in children.
OBJECTIVE
We evaluated the outcome of adenotonsillectomy for obstructive sleep apnea syndrome (OSAS) in children using polysomnography (PSG) data and a quality-of-life (QOL) instrument.


METHODS
We enrolled children (4 to 14 years of age) who had OSAS diagnosed by overnight PSG and who underwent both adenoidectomy and tonsillectomy between January 2003 and February 2008. All of them had completed postoperative PSG and a paired Obstructive Sleep Apnea 18-Item Quality-of-Life Questionnaire (OSA-18) survey. The statistical analyses were performed with a statistical software package.


RESULTS
The study included 84 children with a mean age of 7.1 years. The mean preoperative apnea-hypopnea index (AHI) for the study population was 24.6, and the mean postoperative AHI was 3.8 episodes per hour. The percentage of children who had normal PSG parameters after adenotonsillectomy ranged from 69.0% to 86.9% because of fluctuation of the criteria used to define OSAS. Nine children (30%) with severe preoperative OSAS had persistent OSAS (an AHI of at least (5) after surgery. Improvements in QOL were comparable in the cured and not-cured groups (p > 0.05). Risk factors for persistent OSAS were obesity and a high preoperative AHI, on multiple logistic regression analysis.


CONCLUSIONS
Adenotonsillectomy is associated with improvements in PSG, behavior, and QOL in children with OSAS. However, it may not resolve OSAS in all children. The efficacy and role of additional therapeutic options require more study.
Ye
Jin
J
Department of Sleep Study, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Liu
Hui
H
Zhang
Ge-hua
GH
Li
Peng
P
Yang
Qin-tai
QT
Liu
Xian
X
Li
Yuan
Y
D000233:Adenoidectomy; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D017286:Polysomnography; D011788:Quality of Life; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014068:Tonsillectomy; D016896:Treatment Outcome