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Use of Oximetry to Determine Need for Adenotonsillectomy for Sleep-Disordered Breathing

Chariton E Papadakis1, Konstantinos Chaidas2,3, Theognosia S Chimona1

  • 1Ear, Nose, and Throat Department, Chania General Hospital, Chania, Greece.

Pediatrics
|August 9, 2018
PubMed

Insights

Adenotonsillectomy (T/A) significantly improves nocturnal hypoxemia in children with sleep-disordered breathing (SDB) and abnormal oximetry. This surgery offers a better resolution rate for hypoxemia compared to watchful waiting.

Area of Science:

  • Pediatrics
  • Otolaryngology
  • Sleep Medicine

Background:

  • Sleep-disordered breathing (SDB) is common in children with snoring and tonsillar hypertrophy.
  • Nocturnal hypoxemia can be assessed using oximetry.
  • Adenotonsillectomy (T/A) is a common surgical intervention for SDB.

Purpose of the Study:

  • To evaluate the efficacy of T/A in improving hypoxemia indices in children with SDB.
  • To compare T/A outcomes with a control group undergoing watchful waiting.

Main Methods:

  • A randomized controlled study involving children aged 4-10 years with SDB.
  • Oximetry was performed at baseline and 3-month follow-up.
  • Two groups: immediate T/A group and a control group with a 3-month waiting period.

Main Results:

  • The T/A group showed a trend toward improved McGill oximetry scores (MOS >1 to MOS=1), though not statistically significant (70.6% vs 47.6%, P=.14).
  • Significantly more children in the T/A group achieved an oxygen desaturation index (ODI3) <2 episodes/hour compared to the control group (43.8% vs 5.3%, P<.001).

Conclusions:

  • An ODI3 ≥3.5 episodes per hour indicates a higher likelihood of nocturnal hypoxemia resolution after T/A for SDB.
  • T/A is an effective intervention for improving nocturnal hypoxemia in children with SDB.

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