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Adenoidectomy Without Tonsillectomy for Pediatric Obstructive Sleep Apnea

Stephen R Chorney1,2, Karen B Zur1,2

  • 1Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 22, 2020
PubMed

Insights

Adenoidectomy may improve obstructive sleep apnea (OSA) in young children with large adenoids. However, younger children may require a tonsillectomy later. Further research is needed.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Pediatric Surgery

Background:

  • Obstructive sleep apnea (OSA) is a common condition in children.
  • Adenoid hypertrophy is a frequent cause of pediatric OSA.
  • The efficacy of adenoidectomy for OSA in very young children requires further investigation.

Purpose of the Study:

  • To evaluate the effectiveness of adenoidectomy in improving obstructive sleep apnea (OSA) in young children.
  • To identify factors associated with OSA improvement or the need for further intervention after adenoidectomy.

Main Methods:

  • A case series with chart review was conducted at a tertiary children's hospital.
  • Included were children under 3.5 years with large adenoids, small tonsils, and documented OSA via polysomnogram (PSG).
  • Outcomes including repeat PSG, need for tonsillectomy, and adenoid regrowth were analyzed.

Main Results:

  • Of 71 children, 36.6% had a repeat PSG post-adenoidectomy.
  • The apnea-hypopnea index decreased in 77.0% of those with repeat PSG, with a significant reduction in moderate to severe OSA.
  • Younger age predicted the need for subsequent tonsillectomy, and adenoid regrowth was noted in one case.

Conclusions:

  • Adenoidectomy can be an effective treatment for OSA in young children with significant adenoid hypertrophy and small tonsils.
  • Younger children undergoing adenoidectomy may have a higher likelihood of requiring a subsequent tonsillectomy.
  • Further prospective studies with comprehensive PSG data are warranted to confirm these findings.
Abstract

Keywords:
adenoidectomyobstructive sleep apneapediatricspolysomnogramtonsillectomy

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