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J Pediatr. 2006 Dec;149(6):803-8.

Persistence of obstructive sleep apnea syndrome in children after adenotonsillectomy.

Author information

1
Kosair Children's Hospital Research Institute and the Department of Pediatrics, Division of Pediatric Sleep Medicine, University of Louisville, Louisville, Kentucky, USA.

Abstract

OBJECTIVE:

To investigate the relative contribution of various risk factors to the surgical outcome of adenotonsillectomy for obstructive sleep apnea syndrome in children.

STUDY DESIGN:

Children (n = 110; mean age, 6.4 +/- 3.9 years) underwent two polysomnographic evaluations before and after adenotonsillectomy. In addition, 22 control children were studied. History for allergy and family history of sleep-disordered breathing was taken before each polysomnographic evaluation.

RESULTS:

Significant changes in sleep stage percentages and sleep fragmentation were found in the postsurgery study compared with the presurgery study; 25% of the children had apnea/hypopnea index (AHI) </=1, 46% had AHI >1 and <5, and 29% had AHI >/=5 in the postsurgery study. The frequency of subjects with AHI </=1 after surgery was significantly lower among obese subjects (P < .05). Comparison between the children who had AHI </=1 after surgery and 22 control children showed complete normalization of sleep architecture after surgery.

CONCLUSIONS:

Adenotonsillectomy yields improvements in respiratory abnormalities in children with obstructive sleep apnea syndrome. Complete normalization occurs in only 25% of the patients. Obesity and AHI at diagnosis are the major determinant for surgical outcome. When normalization of respiratory measures occurs after surgery, normalization of sleep architecture will also ensue.

PMID:
17137896
DOI:
10.1016/j.jpeds.2006.08.067
[Indexed for MEDLINE]

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