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Asthma outcomes after adenotonsillectomy: A systematic review
Nikita Kohli1, Dana DeCarlo2, Nira A Goldstein1
1Department of Otolaryngology, State University of New York Downstate Medical Center, 450 Clarkson Ave Box 126, Brooklyn, NY 11203, USA.
International Journal of Pediatric Otorhinolaryngology
|October 13, 2016
Summary
Adenotonsillectomy in children with obstructive sleep apnea significantly reduces asthma severity markers. This surgical intervention shows a definitive association with improved asthma outcomes, including fewer symptoms and exacerbations.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Pulmonology
- Pediatric Allergy and Immunology
Background:
- Adenoidectomy and adenotonsillectomy are debated for their impact on pediatric asthma.
- Some theories suggest surgery may increase asthma risk, while others propose a shared mechanism for upper and lower airway diseases.
- Upper airway inflammation may link asthma and upper airway conditions.
Purpose of the Study:
- To systematically review asthma outcomes in children following adenoidectomy or adenotonsillectomy.
- To assess the impact of these surgeries on asthma severity markers in pediatric patients with obstructive sleep apnea.
Main Methods:
- Systematic review of PubMed, EMBASE, and CINAHL databases.
- Inclusion criteria: pediatric subjects (≤18 years) with asthma undergoing adenoidectomy/adenotonsillectomy for obstructive sleep apnea.
- Included case studies and database studies; excluded those with >1 year follow-up, craniofacial syndromes, or significant comorbidities.
Main Results:
- Four studies were included in the qualitative synthesis.
- Adenotonsillectomy in asthmatic children correlated with decreased asthma severity.
- Significant reductions observed in respiratory medication use, ER visits, asthma symptoms, and exacerbations.
Conclusions:
- Systematic review indicates clinically significant reductions in asthma severity markers post-adenotonsillectomy in pediatric patients.
- Data suggest a definitive association between adenotonsillectomy and improved asthma outcomes.
- Further prospective trials are needed to establish a causal relationship.
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