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The effect of tonsillectomy on obstructive sleep apnea: an overview of systematic reviews

Lauren K Reckley1, Camilo Fernandez-Salvador1, Macario Camacho1

  • 1Otolaryngology - Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI, USA.

Nature and Science of Sleep
|April 20, 2018
PubMed

Insights

Tonsillectomy combined with adenoidectomy effectively treats pediatric obstructive sleep apnea (OSA). While tonsillectomy alone shows promise for adults with OSA, more research is needed for long-term outcomes.

Area of Science:

  • Otolaryngology
  • Sleep Medicine
  • Surgical Outcomes

Background:

  • Obstructive sleep apnea (OSA) is a common condition affecting both children and adults.
  • Tonsillectomy with adenoidectomy is a standard surgical approach for pediatric OSA.
  • Tonsillectomy alone has been considered for adult OSA, particularly with hypertrophied tonsils.

Purpose of the Study:

  • To systematically review and synthesize findings from existing systematic reviews and meta-analyses on tonsillectomy for OSA treatment.
  • To evaluate the efficacy and safety of tonsillectomy, with or without adenoidectomy, in pediatric and adult OSA populations.

Main Methods:

  • A comprehensive search of nine databases, including PubMed/MEDLINE, was conducted.
  • Systematic reviews and meta-analyses published up to July 9, 2017, were included.
  • The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guided the review process.

Main Results:

  • Over 20 systematic reviews and meta-analyses were identified concerning tonsillectomy for OSA.
  • Pediatric studies focused on overall efficacy, complications, and specific populations (obese children, children with Down syndrome).
  • Limited data exists for adult OSA, with only one systematic review addressing tonsillectomy as a primary treatment.

Conclusions:

  • Combined tonsillectomy and adenoidectomy is an effective primary treatment for most children with OSA.
  • Isolated tonsillectomy is rarely used in children but shows a surprising success rate in limited adult data.
  • Further research is necessary to ascertain long-term benefits and treatment needs for adults undergoing tonsillectomy for OSA.
Abstract

Keywords:
reviewsleep apnea syndromessystematic reviewtonsillectomy

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