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Adenotonsillectomy in children with sickle cell disease and obstructive sleep apnea

Annie N Farrell1, Steven L Goudy2, Marianne E Yee3

  • 1Emory University School of Medicine, 1648 Pierce Drive NE, Atlanta, GA, 30307, USA.

International Journal of Pediatric Otorhinolaryngology
|July 1, 2018
PubMed

Insights

Tonsillectomy and adenoidectomy (T&A) effectively treats obstructive sleep apnea (OSA) in children with sickle cell disease (SCD). This procedure significantly reduced apnea-hypopnea index and emergency room visits, improving patient outcomes.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Hematology
  • Sleep Medicine

Background:

  • Obstructive sleep apnea (OSA) is common in children, and potentially more severe in those with sickle cell disease (SCD).
  • Understanding the risks and benefits of surgical intervention for OSA in this vulnerable population is crucial.

Purpose of the Study:

  • To evaluate the therapeutic effects and complications of tonsillectomy and adenoidectomy (T&A).
  • To assess the impact of T&A on OSA severity and healthcare utilization in pediatric patients with SCD.

Main Methods:

  • Retrospective review of 132 pediatric patients with SCD who underwent T&A between 2010 and 2016.
  • Analysis of pre- and post-operative laboratory values, perioperative course, hospital admissions, and polysomnography data.
  • Evaluation of emergency room visit frequency before and after surgery.

Main Results:

  • T&A was performed on 132 children with SCD, with 72.7% receiving pre-operative transfusions to optimize hemoglobin levels.
  • Post-operative polysomnography showed a significant decrease in the Apnea-Hypopnea Index (AHI) and improvement in oxygen saturation nadir.
  • Complications occurred in 11.4% of cases, and post-operative emergency room visits decreased significantly.

Conclusions:

  • Tonsillectomy and adenoidectomy (T&A) is a safe and effective treatment for obstructive sleep apnea (OSA) in children with sickle cell disease (SCD).
  • The procedure leads to significant improvements in sleep study parameters and reduces the need for emergency care.
Abstract

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