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The Effects of Adenotonsillectomy for Obstructive Sleep Apnea on Growth Trajectory in Children With Obesity

Ryota Kashiwazaki1, Alexandria M Jensen2, Matthew Haemer3

  • 1Department of Otolaryngology, Seattle Children's Hospital, Seattle, Washington, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 5, 2023
PubMed

Insights

Adenotonsillectomy (T&A) did not significantly alter children's obesity trajectories. However, participation in a multidisciplinary weight management program (MWMP) post-surgery is crucial for healthier growth in children with severe obesity.

Area of Science:

  • Pediatric Endocrinology
  • Otolaryngology
  • Obesity Medicine

Background:

  • Childhood obesity and obstructive sleep apnea (OSA) are significant health concerns.
  • Adenotonsillectomy (T&A) is a common procedure for OSA, but its impact on weight trajectory in obese children is not fully understood.

Purpose of the Study:

  • To analyze the body mass index (BMI) growth trajectory of children with obesity before and after T&A.
  • To investigate the role of multidisciplinary weight management programs (MWMP) in influencing these trajectories.

Main Methods:

  • Retrospective review of 177 children with obesity and OSA who underwent T&A.
  • Analysis of BMI as a percentage of the 95th percentile (%BMIp95) using linear mixed effects models.
  • Exploration of factors including baseline obesity class, time, and MWMP participation.

Main Results:

  • Higher baseline obesity class (II and III) and time were significantly associated with %BMIp95.
  • Children with obesity class III who did not attend postoperative MWMP visits showed a significantly higher %BMIp95 trajectory post-surgery.
  • Preoperative MWMP visits did not significantly impact postoperative growth.

Conclusions:

  • The effect of T&A on weight trajectory is dependent on obesity class and engagement with an MWMP.
  • Integrated care between otolaryngologists and MWMPs may enhance outcomes for children with OSA and obesity.
Abstract

Keywords:
%BMIp95BMI z scorechildgrowthnutritionobesityobstructive sleep apneaobstructive sleep disordered breathingpediatricsleep-disordered breathingtonsillectomyweightweight gain

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