title: Prevalence of severe obstructive sleep apnea in pediatric adenotonsillectomy patients.
abstract: OBJECTIVE
  To determine the prevalence of severe obstructive sleep apnea (OSA) in a pediatric population who underwent indicated surgery for sleep disordered breathing (SDB).
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  We reviewed the charts of patients aged 2 to 18 years who underwent tonsillectomy or adenotonsillectomy over a 4-year period. Indications for preoperative polysomnography (PSG), PSG results, and perioperative complications were recorded.
  
  
  RESULTS
  Two hundred and thirty-five patients were included in the final analysis. Of these, 160 patients had preoperative PSG performed. The overall prevalence of severe OSA was 38%. The prevalence in patients for whom preoperative PSG was indicated or for which it should have been advocated according to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) clinical practice guideline was 45% and 40%, respectively, whereas the prevalence in patients with no indication for preoperative PSG was 34%. There was no significant difference between groups (P = 0.39). The overall complication rate was 11%, with the rate being significantly lower (P = 0.0022) in patients who did not have preoperative PSG performed (0%) when compared to those who did (16%).
  
  
  CONCLUSIONS
  The prevalence of severe OSA in this pediatric population was high. Specifically, a significant percentage of children who would not have received preoperative PSG under the AAO-HNS recommendations had severe OSA and were consequently admitted for overnight observation. Our results suggest that preoperative PSG should be obtained for all pediatric patients with sleep disordered breathing.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.
authors.forename: Nancy
authors.initials: N
authors.lastname: Jiang
authors.forename: Charise
authors.initials: C
authors.lastname: Muhammad
authors.forename: Yan
authors.initials: Y
authors.lastname: Ho
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Del Signore
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Sikora
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Malkin
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000601:surgery; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D014068:Tonsillectomy
keywords: OSA; Pediatric; adenotonsillectomy; clinical practice guideline; obstructive sleep apnea; prevalence; tonsillectomy