title: Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children.
abstract: To determine the prevalence of residual obstructive sleep apnea (OSA) in children who had adenotonsillectomy (AT) and to identify the risk factors for residual OSA after AT.
  
  
  
  Retrospective chart review.
  
  
  
  Children with OSA who had AT at a tertiary care children's hospital were reviewed. Data pertaining to demographics, past medical history, body mass index, tonsil and adenoid size, and polysomnography were obtained. Residual OSA was defined as apnea hypopnea index (AHI) greater than 2. The rate of residual OSA and risk factors for residual OSA were assessed.
  
  
  
  One hundred sixty-nine children with OSA underwent polysomnography before and after AT. The prevalence of residual OSA was 38%. The prevalence of residual OSA in obese patients (49%) was higher than that of nonobese patients (27%) (P = .02). Patients with neurological/developmental/craniofacial abnormalities had higher prevalence of residual OSA (44%) than patients without comorbidities (33%) (P < .05). The prevalence of residual OSA in patients with severe OSA (42%) was higher than patients with moderate (29%) or mild OSA (0%) (P = .03). Teenage patients (67%) had a higher prevalence of residual OSA than toddlers (27%), preschooler (33%), and middle childhood groups (29%) (P = .03).
  
  
  
  The majority of children had improvement in OSA after AT. The choice of AHI threshold used to define residual OSA influenced the prevalence of residual OSA. Teenagers and children with obesity, comorbidities including neurological/developmental/craniofacial abnormalities alone or in combination with asthma, or severe OSA have a high risk of residual OSA.
  
  
  
  4 Laryngoscope, 126:2624-2629, 2016.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Matin
authors.initials: M
authors.lastname: Imanguli
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas. seckin.ulualp@utsouthwestern.edu.|Division of Pediatric Otolaryngology, Children's Medical Center, Dallas, Texas, U.S.A.. seckin.ulualp@utsouthwestern.edu.
authors.forename: Seckin O
authors.initials: SO
authors.lastname: Ulualp
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects* / Q000379:methods; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D063766:Pediatric Obesity / Q000150:complications; D017286:Polysomnography; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000209:etiology* / Q000601:surgery*; D014068:Tonsillectomy / Q000009:adverse effects* / Q000379:methods
keywords: Obstructive sleep apnea; children; obesity; polysomnography