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Synchronous airway lesions in children younger than age 3 years undergoing adenotonsillectomy

Jeffrey C Rastatter1, James W Schroeder, Adam French

  • 1Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. jrastatter@childrensmemorial.org

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|April 16, 2011
PubMed

Insights

Synchronous airway lesions (SALs) are common in young children undergoing surgery for sleep-disordered breathing (SDB). Tracheal cobblestoning was the most frequent finding, but few SALs required intervention.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Pulmonology
  • Sleep Medicine

Background:

  • Sleep-disordered breathing (SDB) is a common condition in children.
  • Adenoidectomy and adenotonsillectomy are frequent surgical interventions for pediatric SDB.
  • The presence of synchronous airway lesions (SALs) in young children undergoing these procedures is not well-characterized.

Purpose of the Study:

  • To determine the prevalence of SALs in children younger than 3 years old undergoing adenoidectomy or adenotonsillectomy for SDB.
  • To assess the rate of SALs requiring intervention.
  • To evaluate the predictive value of the respiratory distress index (RDI) for SALs.

Main Methods:

  • A case series with chart review was conducted at a tertiary care pediatric hospital.
  • One hundred ten children aged 3 years or younger with SDB underwent adenoidectomy or adenotonsillectomy and full-airway evaluation (laryngoscopy, bronchoscopy).
  • Data collected included the prevalence of SALs and the need for intervention.

Main Results:

  • Sixty-seven percent of children had at least one SAL.
  • Four children required surgical intervention for a SAL.
  • No significant difference in RDI was found between children with and without SALs, nor between age groups (18-36 months vs. <18 months).

Conclusions:

  • There is a high incidence of SALs in children under 3 with SDB.
  • Tracheal cobblestoning was the most common SAL.
  • RDI from polysomnography was not predictive of SAL presence.
Abstract

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