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Adenotonsillectomy in children with syndromic craniosynostosis: a systematic review and meta-analysis

Petcharat Saengthong1,2,3, Busarakum Chaitusaney4,5,6, Prakobkiat Hirunwiwatkul4,5,6

  • 1Department of Otorhinolaryngology Head and Neck Surgery, Police General Hospital, 492/1 Rama 1 Road, Patumwan, Bangkok, Thailand. cherrytu@hotmail.com.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|April 19, 2019
PubMed

Insights

Adenotonsillectomy may benefit children with syndromic craniosynostosis and obstructive sleep apnea (OSA). While the apnea-hypopnea index (AHI) showed no significant change, the oxygen desaturation index (ODI) improved significantly after the procedure.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Craniofacial Surgery

Background:

  • Obstructive sleep apnea (OSA) is a common comorbidity in children with syndromic craniosynostosis.
  • Adenotonsillectomy is a potential treatment for OSA, but its efficacy in this specific population is not well-established.

Purpose of the Study:

  • To systematically review and meta-analyze the effectiveness of adenotonsillectomy in treating OSA in children with syndromic craniosynostosis.
  • To evaluate changes in the apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) post-adenotonsillectomy.

Main Methods:

  • A systematic review and meta-analysis of studies reporting AHI or ODI in syndromic craniosynostosis patients undergoing adenotonsillectomy.
  • Searches were conducted across PubMed, SCOPUS, Ovid Medline, and Web of Science databases up to June 22nd, 2018.

Main Results:

  • Three retrospective studies involving 24 patients met the inclusion criteria.
  • Pooled analysis showed a non-significant reduction in AHI (5.00 events/hour).
  • A statistically significant reduction in ODI was observed (8.5/hour).

Conclusions:

  • Adenotonsillectomy demonstrates potential benefits for OSA treatment in syndromic craniosynostosis children, particularly evidenced by ODI improvement.
  • While ODI reached statistical significance, AHI did not.
  • Further multi-center studies are warranted to confirm these findings.
Abstract

Keywords:
AdenotonsillectomyApertCraniosynostosisCrouzonPfeifferSleep apnea

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