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Obstructive sleep apnea in 2-6 year old children referred for adenotonsillectomy

Britt Øverland1, Hanne Berdal2, Harriet Akre3,4

  • 1Pediatric and Adult Sleep Disorder Clinic, Lovisenberg Diaconal Hospital, Postboks 4970, Nydalen, 0440, Oslo, Norway. brov@lds.no.

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
|June 8, 2019
PubMed

Insights

Obstructive sleep apnea (OSA) is highly prevalent in children needing adenotonsillectomy. Standard questionnaires and physical exams are insufficient for diagnosing OSA or its severity in this pediatric group.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Pediatric Surgery

Background:

  • Adenotonsillectomy is a common pediatric surgery for recurrent infections or obstructive sleep apnea (OSA).
  • Disagreement exists on the necessity of polysomnography (sleep studies) to diagnose OSA before adenotonsillectomy.
  • Previous studies on using questionnaires and physical exams for OSA identification have yielded conflicting results.

Purpose of the Study:

  • To determine the prevalence of OSA in children referred for adenotonsillectomy.
  • To assess the effectiveness of questionnaires and physical examinations in identifying OSA in this population.

Main Methods:

  • Prospective cohort study involving 100 children aged 2-6 years undergoing adenotonsillectomy.
  • Evaluated polysomnography, otorhinological examination, Friedman tonsillar size, Mallampati score, Pediatric Sleep Questionnaire (PSQ), and OSA-18.
  • Analyzed sensitivity and specificity of PSQ and OSA-18 for OSA detection.

Main Results:

  • A high prevalence of OSA was found in 87% of children, with 52% having moderate to severe OSA.
  • The PSQ and OSA-18 showed insufficient sensitivity and specificity for reliable OSA detection.
  • Age, tonsillar size, and Mallampati score had weak associations with OSA severity.

Conclusions:

  • Pediatric OSA is highly prevalent in children referred for adenotonsillectomy.
  • Current questionnaires and clinical assessments lack the sensitivity to accurately detect OSA or its severity.
  • Further research may be needed to identify more reliable diagnostic tools for pediatric OSA.
Abstract

Keywords:
AdenotonsillectomyObstructive sleep apneaPediatrics

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