Related Experiment Video

Updated: Sep 2, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

19.9K

Risk Factors for Post-Tonsillectomy Respiratory Events in Children With Severe Obstructive Sleep Apnea

Jorena Lim1, Priyanka Garigipati1, Katie Liu2

  • 1Department of Otolaryngology, Pediatric Otolaryngology Division, UT Southwestern Medical Center and Children's Health Dallas, Dallas, Texas, U.S.A.

The Laryngoscope
|August 6, 2022
PubMed

Insights

Postoperative respiratory events in children with severe obstructive sleep apnea (OSA) are linked to prolonged desaturations and specific comorbidities. Identifying these risk factors, including Black race and neurologic conditions, improves patient safety after tonsillectomy.

Area of Science:

  • Pediatric medicine
  • Sleep medicine
  • Anesthesiology

Background:

  • Severe obstructive sleep apnea (OSA) in children poses risks for postoperative respiratory events.
  • Tonsillectomy is a common procedure for pediatric OSA patients, but carries inherent risks.
  • Identifying specific risk factors is crucial for improving perioperative management.

Purpose of the Study:

  • To identify risk factors for postoperative respiratory events in pediatric patients with severe OSA undergoing tonsillectomy.
  • To determine if factors beyond apnea-hypopnea index (AHI) and oxygen nadir predict respiratory events.

Main Methods:

  • Retrospective cohort study of 887 pediatric patients with severe OSA undergoing tonsillectomy.
  • Comparison of patients who experienced respiratory events versus those who did not.
  • Analysis of potential risk factors including %sleep time with O2 < 90% (tb90), race, comorbidities, and age.

Main Results:

  • 14.8% of patients experienced a respiratory event post-tonsillectomy.
  • Significant risk factors included: %sleep time with O2 < 90% (tb90), Black race, primary neurologic comorbidity, Down syndrome, and younger age.
  • Regression modeling showed increased respiratory events with higher tb90.

Conclusions:

  • Prolonged desaturations (%sleep time with O2 < 90%) and Black race are independent risk factors for postoperative respiratory events.
  • Neurologic comorbidities and Down syndrome are also significant risk factors.
  • Measures of abnormal gas exchange during polysomnography (PSG) may better identify at-risk pediatric OSA patients.
Abstract

Keywords:
AHIOSAadenotonsillectomycomplicationsrisk factors

More Related Videos

CO2-Lasertonsillotomy Under Local Anesthesia in Adults05:07

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

Published on: November 6, 2019

24.8K
Author Spotlight: Traditional Chinese Medicine for Sleep Disorders in Acute COPD &#8212; A Safe, Cost-Effective Approach04:53

Author Spotlight: Traditional Chinese Medicine for Sleep Disorders in Acute COPD — A Safe, Cost-Effective Approach

Published on: October 18, 2024

885

Related Concept Videos

Tonsillitis I: Introduction01:30

Tonsillitis I: Introduction

Tonsillitis is inflammation of the tonsils, which are two lymphoid tissue masses at the back of the throat. This condition can cause discomfort and irritation in the throat.
Etiology
Three primary contributing factors have been identified.
519
Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
169
Chronic Pharyngitis01:23

Chronic Pharyngitis

Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
4.5K
Sleep Apnea01:21

Sleep Apnea

Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
216
Other Pulmonary Disorders01:17

Other Pulmonary Disorders

Respiratory disorders encompass a range of conditions with varying levels of severity. Asthma, marked by chronic airway inflammation and hypersensitivity, is one such condition. It can lead to airway obstruction due to factors like bronchial spasms, mucosal edema, increased mucus secretion, or epithelial damage. Asthma triggers are diverse, ranging from allergens to emotional upset, and treatment focuses on both immediate relief through bronchodilators and long-term inflammation suppression.
899
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
253