Evaluation of adenotonsillectomy outcome for obstructive sleep apnea syndrome in children, by pre and postoperative polysomnography

Abstract

We evaluated, using objective data from pre- and postoperative polysomnography (PSG) data, the outcome of adenotonsillectomy for obstructive sleep apnea syndrome (OSAS) in children in our sleep unit. Retrospectively study was conducted including 55 healthy children (3–12 years of age) with OSAS, diagnosed on the basis of polysomnography as having an apnea hypopnea index (AHI) of 3 or greater, who underwent adenotonsillectomy between January 2010 and January 2013. Postoperative polysomnography was performed at least 3 months after surgery. Scores from pre- and postoperative polysomnography were compared using statistical analysis software. For all children, the preoperative AHI value was higher than the postoperative value. The mean preoperative AHI was 22.8 with 58.1% (32) with severe OSAS (AHI > 10). The mean postoperative AHI was 2.9. Pathological residual apnea/hypopnea index (defined in this study as residual AHI > 3), was found in 34.5% (19). 68.4% of these children, with pathological residual index, had preoperative severe OSAS. 6 children (31.6%), with preoperative AHI 3–10, had pathological residual apnea/hypopnea index postoperatively. Adenotonsillectomy improves respiratory parameters, measured by polysomnography, in the majority of children but does not resolve OSAS in all children of this group of patients. High preoperative AHI is associated with persistence of pathological residual apnea/hypopnea index after adenotonsillectomy. Sleep Unit – HUMValdecilla.