title: The effect of adenotonsillectomy on obstructive sleep apnea in children with Down syndrome.
abstract: OBJECTIVE
  Children with Down syndrome (DS) are liable to develop obstructive sleep apnea (OSA) due to many anatomical airway abnormalities. The tonsils and adenoid occupy part of the airway space, and their removal may be helpful in relieving airway obstruction. The aim of this study was to assess the effectiveness of adenotonsillectomy in the treatment of OSA in those children.
  
  
  METHODS
  Fifty DS children with difficult breathing were recruited, and they were subjected to polysomnographic examination (PSG). Patients with apnea-hypopnea index (AHI) > 1 were considered to have OSA. Adenotonsillectomy was performed for patients who had OSA and adenotonsillar hypertrophy, and after 3 months PSG was done for them with recording of the same preoperative parameters.
  
  
  RESULTS
  Forty-three children demonstrated OSA on PSG, and they were included in the study. The preoperative mean AHI was 9.18 (± 6.17) that improved postoperatively to 2.72 (± 3.80) with its normalization in 72% of patients. Also, significant improvement of arousal index, minimum oxygen saturation, desaturation index, and peak end-tidal CO2was achieved postoperatively.
  
  
  CONCLUSIONS
  Adenotonsillectomy is an effective method for the treatment of OSA in children with DS. However, the condition may persist in some children who usually have airway narrowing at multiple levels.
authors.affiliation: a Department of Otolaryngology, Faculty of Medicine , Cairo University , Cairo , Egypt.
authors.forename: Mosaad
authors.initials: M
authors.lastname: Abdel-Aziz
authors.affiliation: a Department of Otolaryngology, Faculty of Medicine , Cairo University , Cairo , Egypt.
authors.forename: Khaled
authors.initials: K
authors.lastname: Azooz
authors.affiliation: b Department of Otolaryngology, Faculty of Medicine , Beni Suef University , Beni Suef , Egypt.
authors.forename: Nader
authors.initials: N
authors.lastname: Naguib
authors.affiliation: b Department of Otolaryngology, Faculty of Medicine , Beni Suef University , Beni Suef , Egypt.
authors.forename: Ramez
authors.initials: R
authors.lastname: Reda
authors.affiliation: b Department of Otolaryngology, Faculty of Medicine , Beni Suef University , Beni Suef , Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Kamel
mesh_terms: D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000601:surgery*; D014068:Tonsillectomy
keywords: Down syndrome; adenotonsillar hypertrophy; adenotonsillectomy; obstructive sleep apnea