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Obstructive sleep apnea syndrome due to adenotonsillar hypertrophy in infants

Michal Greenfeld1, Riva Tauman, Ari DeRowe

  • 1Pediatric Intensive Care, Sackler Faculty of Medicine, Pediatric Pulmonology and Center for Sleep Disorders, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University, 6 Weizman Street, Tel Aviv 64239, Israel.

International Journal of Pediatric Otorhinolaryngology
|October 11, 2003
PubMed

Insights

Obstructive sleep apnea syndrome (OSAS) in infants due to adenotonsillar hypertrophy (ATH) is more common than previously thought. Early diagnosis and treatment are crucial for improving infant health and development.

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology

Background:

  • Adenotonsillar hypertrophy (ATH) is a primary cause of obstructive sleep apnea syndrome (OSAS) in children.
  • OSAS due to ATH is considered rare in infants, typically affecting children aged 3-6 years.

Purpose of the Study:

  • To investigate the occurrence and characteristics of OSAS caused by ATH in infants under 18 months of age.

Main Methods:

  • A retrospective study of 29 infants (<18 months) diagnosed with OSAS due to ATH via polysomnography (PSG).
  • Data collected included demographics, symptoms, pre/post-operative weight, and developmental assessments.
  • Parental questionnaires were used to gather information on symptoms and outcomes.

Main Results:

  • Snoring was universal; 72% had sleep apnea, 69% frequent movements, 62% mouth breathing, and 38% recurrent awakenings.
  • Infants experienced significant weight loss pre-operatively (67th to 42nd percentile) and weight gain post-operatively (to 59th percentile).
  • Developmental delay was noted in 17% pre-operatively, resolving in 60% post-treatment; symptom recurrence occurred in 26%.

Conclusions:

  • Infantile OSAS due to ATH is a distinct clinical entity in infants.
  • Key features include male predominance, high incidence of preterm infants, failure to gain weight, and a notable recurrence rate post-surgery.
  • Pediatricians and otolaryngologists should recognize "early OSAS" in infants presenting with these symptoms.
Abstract

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