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Severity of childhood obstructive sleep apnea and hypertension improved after adenotonsillectomy

Li-Ang Lee1, Hsueh-Yu Li2, Yu-Sheng Lin3

  • 1School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan Department of Otolaryngology, Sleep Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan Department of Otolaryngology, Xiamen Chang Gung Hospital, Xiamen, China 5738@cgmh.org.tw.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|December 19, 2014
PubMed

Insights

Adenotonsillectomy improved childhood obstructive sleep apnea (OSA) and reduced hypertension rates. However, severe OSA and hypertension require ongoing blood pressure management post-surgery.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Pediatric Cardiology

Background:

  • Childhood obstructive sleep apnea (OSA) is associated with significant comorbidities, including hypertension.
  • Adenotonsillectomy is a primary treatment for pediatric OSA, but its impact on associated conditions like hypertension requires further investigation.

Purpose of the Study:

  • To evaluate the effectiveness of adenotonsillectomy in improving obstructive sleep apnea (OSA) and hypertension in children.
  • To assess changes in apnea-hypopnea index (AHI) and blood pressure (BP) post-surgery.

Main Methods:

  • A case series of 50 consecutive pediatric patients with OSA undergoing plasma knife-assisted adenotonsillectomy.
  • Assessment of body mass index z score, AHI, systolic BP, and diastolic BP at baseline and at least 6 months postoperatively.
  • Statistical analysis using nonparametric tests with bootstrap approach.

Main Results:

  • Adenotonsillectomy significantly reduced the median apnea-hypopnea index (AHI) from 9.8 to 1.6 (P<.001).
  • The overall hypertension rate decreased significantly from 34% to 14% (P=.006).
  • Significant reductions in systolic and diastolic blood pressure were observed in children with preoperative hypertension (P=.038 and P=.005, respectively).

Conclusions:

  • Adenotonsillectomy effectively reduces OSA severity and hypertension rates in children.
  • While surgical intervention improves OSA, persistent hypertension in severe cases necessitates continued blood pressure management.
  • The reduction in AHI alone may not fully resolve hypertension, highlighting the multifactorial nature of this comorbidity.
Abstract

Keywords:
adenotonsillectomychildrenhypertensionobstructive sleep apneaoutcome

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