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Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children

Matin Imanguli1, Seckin O Ulualp2,3

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.

The Laryngoscope
|March 25, 2016
PubMed

Insights

Many children still have obstructive sleep apnea (OSA) after adenotonsillectomy (AT). Obesity, comorbidities, and teenage years increase the risk of residual OSA.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Pediatric Pulmonology

Background:

  • Obstructive sleep apnea (OSA) is a common condition in children.
  • Adenotonsillectomy (AT) is a primary treatment for pediatric OSA.
  • Residual OSA after AT remains a clinical concern.

Purpose of the Study:

  • To determine the prevalence of residual obstructive sleep apnea (OSA) in children post-adenotonsillectomy (AT).
  • To identify risk factors associated with residual OSA following AT.

Main Methods:

  • Retrospective chart review of 169 children with OSA undergoing AT.
  • Analysis of demographic data, medical history, BMI, tonsil/adenoid size, and polysomnography (PSG) results.
  • Residual OSA defined as an apnea-hypopnea index (AHI) > 2.

Main Results:

  • The prevalence of residual OSA was 38% after AT.
  • Higher residual OSA rates were observed in obese (49%) vs. non-obese (27%) children.
  • Increased risk of residual OSA was noted in teenagers (67%), those with comorbidities (44%), and severe OSA (42%).

Conclusions:

  • While most children improve, residual OSA is prevalent after AT.
  • Obesity, comorbidities, and older age are significant risk factors for persistent OSA.
  • The AHI threshold impacts residual OSA prevalence calculations.
Abstract

Keywords:
Obstructive sleep apneachildrenobesitypolysomnography

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