title: Children with severe or moderate obstructive sleep apnoea syndrome show a high incidence of persistence after adenotonsillectomy.
abstract: CONCLUSIONS
  Persistent obstructive sleep apnoea syndrome (OSAS) occurs in approximately 20% of normal-weight children after adenotonsillectomy (T&A) and, in nearly 70% of them, it is caused by adenoid regrowth. Patients with severe or moderate OSAS showed a high incidence of persistent disease even after T&A. Allergic disease, severity and large adenoid size are associated with adenoid regrowth and persistent disease.
  
  
  OBJECTIVE
  To investigate factors contributing to persistent OSAS and adenoid regrowth after T&A in normal-weight children.
  
  
  METHODS
  This was a prospective, observational study at a single institute and involved 49 normal-weight children with severe or moderate OSAS (apnoea-hypopnoea index, AHI, ≥ 5) who underwent T&A. Background information, nasal endoscopic data and pre- and postoperative polysomnographic data were collected. A third polysomnography (PSG) was performed 1.5 year postoperatively in children who subsequently developed symptoms of sleep disturbance.
  
  
  RESULTS
  Thirteen children (27%, 13/49) were symptomatic 1.5 years after T&A. Allergic rhinitis (38.5% vs 11.1%, p = 0.03) and allergic disease (69.2% vs 30.6%, p = 0.02) were seen more frequently in these children. A third PSG confirmed persistent disease (AHI ≥ 5) in nine children (18.4%, 9/49). Six children (12.2%, 6/49) were diagnosed as having adenoid regrowth and three (6.1%, 3/49) underwent revision adenoidectomy.
authors.affiliation: Department of Otorhinolaryngology, Graduate School of Medicine, Nagoya University, Nagoya, Japan. mi-man@ra2.so-net.ne.jp
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Tagaya
authors.forename: Seiichi
authors.initials: S
authors.lastname: Nakata
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Yasuma
authors.forename: Ron B
authors.initials: RB
authors.lastname: Mitchell
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Sasaki
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Mami
authors.initials: M
authors.lastname: Morinaga
authors.forename: Hironao
authors.initials: H
authors.lastname: Otake
authors.forename: Masaaki
authors.initials: M
authors.lastname: Teranishi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakashima
mesh_terms: D000233:Adenoidectomy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000601:surgery*; D014068:Tonsillectomy; D017211:Treatment Failure