Tonsillectomy in adults with obstructive sleep apnea.
To study whether tonsillectomy is effective on obstructive sleep apnea (OSA) in adults with large tonsils.



A multicenter prospective interventional study.



The study comprised 28 patients with OSA, an apnea-hypopnea index of > 10, large tonsils (Friedman tonsil size 3 and 4), and age 18 to 59 years. They were derived from 41 consecutive males and females with large tonsils referred for a suspicion of sleep apnea to the ear, nose, and throat departments in Umeå, Skellefteå, and Sunderbyn in northern Sweden. The primary outcome was the apnea-hypopnea index, measured with polygraphic sleep apnea recordings 6 months after surgery. Secondary outcomes included daytime sleepiness, as measured with the Epworth Sleepiness Scale, and swallowing function, using video-fluoroscopy.



The apnea-hypopnea index was reduced from a mean of 40 units per hour (95% confidence interval [CI] 28-51) to seven units per hour (95% CI 3-11), P < 0.001, at the 6-month follow-up after surgery. The apnea-hypopnea index was reduced in all patients and 18 (64%) were cured. The Epworth Sleepiness Scale was reduced from a mean of 11 (95% CI 8-13) to 6.0 (95% CI 4-7), P < 0.001. A swallowing dysfunction was found in seven of eight investigated patients before surgery. Of those, swallowing function improved in five patients after surgery, whereas no one deteriorated.



Tonsillectomy may be effective treatment for adult patients with OSA and large tonsils. Tonsillectomy may be suggested for adults with OSA and large tonsils.



4. Laryngoscope, 126:2859-2862, 2016.
Department of Clinical Sciences/Otorhinolaryngology, Umeå University, Umeå, Sweden.
Thorbjörn
T
Holmlund
Department of Surgical and Perioperative Sciences/Surgery, Umeå University, Umeå, Sweden.
Karl A
KA
Franklin
Department of Odontology/Oral and Maxillofacial Radiology, Umeå University, Umeå, Sweden.
Eva
E
Levring Jäghagen
Department of Umeå School of Business and Economics/Statistics, Umeå University, Umeå, Sweden.|Department of Public Health and Clinical Medicine/Epidemiology and Global Health, Umeå University, Umeå, Sweden.
Marie
M
Lindkvist
Department of Clinical Sciences/Otorhinolaryngology, Umeå University, Umeå, Sweden.
Torbjörn
T
Larsson
Department of Public Health and Clinical Medicine/Medicine, Umeå University, Umeå, Sweden.
Carin
C
Sahlin
Department of Clinical Sciences/Otorhinolaryngology, Umeå University, Umeå, Sweden.
Diana
D
Berggren
D000328:Adult; D003679:Deglutition / Q000502:physiology; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D006984:Hypertrophy; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology* / Q000601:surgery; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery*; D014068:Tonsillectomy / Q000009:adverse effects
OSA; tonsillar hypertrophy; tonsillectomy