Abstract
Abstract Introduction Adenoid recurrence in children after adenotonsillectomy can be an etiology for obstructive sleep apnea (OSA). The aim of this study was to assess the role of x-ray soft tissue neck (XR-STN) in evaluating adenoid recurrence from a sleep physician perspective and to assess the polysomnographic findings of pre and post revision adenoidectomy. Methods This was a single center retrospective study that included children <18 years old with a history of adenotonsillectomy who underwent sleep study that confirmed the diagnosis of OSA and had XR- STN to evaluate for adenoidal tissue recurrence at the University of Louisville/Norton Pediatric Sleep Disorders clinic from July 2012 to September 2020. XR-STN level of adenoidal obliteration, baseline and post revision adenoidectomy PSG data were analyzed. Results A total of 160 subjects were included in the study with a mean age of 9.71±3.5 years, 59.4% were male, 54.4% were Caucasians, and the mean z-score was 1.77±1.15. XR-STN was normal in 39.4% of the subjects and it showed mild, moderate, and complete adenoidal obliteration in 20.6%, 32.5% and 7.5% of the subjects, respectively. Multiple regression analysis showed that the total AHI, the mean for the moderate and complete adenoidal obliteration are significantly higher than children with no obstruction (p-value=000). However, mild obliteration, Z score, age, gender, and race were not significantly associated with an increased total AHI. Pre- and post- adenoid revision PSGs were available in 20 subjects and they showed significant improvement in AHI (10.4±12.9 vs. 21.1±23.9, p=0.04), arousal index (15.4 ±10.6 vs. 21.1± 14.9, p=0.04), and nadir SaO2 (86.7%±8.1 vs. 76.58% ±18.44, p=0.04). Conclusion Soft tissue neck x-ray was useful in assessing adenoid recurrence in our study. Revision adenoidectomy resulted in an overall improvement in several PSGs parameters of OSA. Pediatric sleep physicians may consider XR-STN in the evaluation of children with OSA with a previous history of adenotonsillectomy. Support (if any) None
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