Clin Exp Otorhinolaryngol.  2015 Sep;8(3):256-260. 10.3342/ceo.2015.8.3.256.

Long-term Subjective and Objective Outcomes of Adenotonsillectomy in Korean Children With Obstructive Sleep Apnea Syndrome

• Choi JH
• Oh JI
• Kim TM
• Yoon HC
• Park IH
• Kim TH
• Lee HM
• Lee SH
• Lee SH

• KMID: 2117521
• DOI: http://doi.org/10.3342/ceo.2015.8.3.256

Abstract

OBJECTIVES
Adenotonsillar hypertrophy is the most common etiology in pediatric obstructive sleep apnea syndrome (OSAS), and adenotonsillectomy is the mainstay of treatment modalities. This study evaluates the long-term effectiveness of adenotonsillectomy in children with OSAS.
METHODS
Subjective symptoms evaluated with a 7-point Likert scale and objective respiratory disturbances evaluated by polysomnography were compared before and after adenotonsillectomy.
RESULTS
A total of 17 children with OSAS aged 4-15 years (mean age, 6.65+/-3.02 years; male:female, 13:4) completed the study. The mean follow-up period was 57 months (range, 30 to 98 months). Significant changes were found in apnea-hypopnea index (from 12.49+/-12.96 to 1.96+/-2.01, P<0.001), apnea index (from 5.64+/-7.57 to 0.53+/-0.78, P=0.006), minimum SaO2 (from 81.88+/-14.36 to 92.76+/-4.31, P=0.003), snoring (from 43.28+/-70.63 to 10.70+/-13.72, P=0.042), and arousal index (from 19.58+/-7.57 to 11.36+/-3.99, P=0.006) after adenotonsillectomy. Significant changes were also found after surgery in most of symptoms including snoring, witnessed apnea, morning headache, mouth breathing, gasping during sleep, restless sleep, nasal obstruction, and difficulty with morning arousal. Long-term surgical cure rate and response rate were 47.1% (8/17) and 70.6% (12/17), respectively.
CONCLUSION
Most of subjective OSAS symptoms and objective respiratory disturbances improved continuously about 5 years after adenotonsillectomy in children with OSAS. However, close follow-up and a sufficient observation period are necessary because of the risk for long-term incomplete resolution.

Keyword

Child; Obstructive Sleep Apnea; Tonsillectomy; Adenoidectomy; Treatment

MeSH Terms

Adenoidectomy
Apnea
Arousal
Child*
Follow-Up Studies
Headache
Humans
Hypertrophy
Mouth Breathing
Nasal Obstruction
Polysomnography
Sleep Apnea, Obstructive*
Snoring
Tonsillectomy

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