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Prevalence of severe obstructive sleep apnea in pediatric adenotonsillectomy patients

Nancy Jiang1, Charise Muhammad, Yan Ho

  • 1Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

The Laryngoscope
|March 27, 2014
PubMed

Insights

Severe obstructive sleep apnea (OSA) is common in children undergoing surgery for sleep disordered breathing (SDB). Results suggest preoperative polysomnography (PSG) for all pediatric SDB patients may be beneficial.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Surgical Outcomes

Background:

  • Sleep disordered breathing (SDB) significantly impacts pediatric health.
  • Obstructive sleep apnea (OSA) is a common form of SDB in children.
  • Surgical intervention for SDB is frequently indicated in pediatric populations.

Purpose of the Study:

  • To determine the prevalence of severe obstructive sleep apnea (OSA) in pediatric patients undergoing surgery for SDB.
  • To evaluate the utility of preoperative polysomnography (PSG) in identifying severe OSA in this cohort.
  • To assess the association between preoperative PSG and perioperative complications.

Main Methods:

  • Retrospective chart review of 235 pediatric patients (ages 2-18) who underwent tonsillectomy or adenotonsillectomy.
  • Analysis of preoperative PSG indications, results, and perioperative complication rates.
  • Comparison of severe OSA prevalence based on adherence to American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines.

Main Results:

  • Overall prevalence of severe OSA was 38% among the studied pediatric population.
  • Severe OSA prevalence was 45% in patients with indicated preoperative PSG and 40% in those for whom it should have been advocated.
  • Patients who did not undergo preoperative PSG had a significantly lower complication rate (0%) compared to those who did (16%).

Conclusions:

  • The prevalence of severe OSA in pediatric patients undergoing surgery for SDB is high.
  • A substantial number of children with severe OSA did not meet criteria for preoperative PSG under current guidelines.
  • Findings support the recommendation for preoperative PSG in all pediatric patients with SDB to optimize surgical planning and patient safety.
Abstract

Keywords:
OSAPediatricadenotonsillectomyclinical practice guidelineobstructive sleep apneaprevalencetonsillectomy

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