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Perioperative Delta Weight and Pediatric Obstructive Sleep Apnea Resolution after Adenotonsillectomy

Quynh-Chi L Dang1, Seckin Ulualp1, Ron B Mitchell1

  • 1Department of Otolaryngology, Head and Neck Surgery, Southwestern Medical Center at Dallas, University of Texas, Dallas, Texas, U.S.A.

The Laryngoscope
|March 29, 2024
PubMed

Insights

Weight gain after adenotonsillectomy for pediatric obstructive sleep apnea (OSA) is linked to poorer treatment outcomes. Counseling on weight management before surgery is recommended for children with OSA.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Obstructive Sleep Apnea Research

Background:

  • Adenotonsillectomy is the primary treatment for pediatric obstructive sleep apnea (OSA).
  • Post-operative weight gain following this procedure is a recognized clinical observation.

Purpose of the Study:

  • To investigate the correlation between peri-adenotonsillectomy weight changes and the resolution rates of pediatric OSA.
  • To determine if increased weight gain around the time of surgery impacts treatment success.

Main Methods:

  • Retrospective cohort study of 250 pediatric patients (ages 2-17).
  • Analysis of polysomnography data and body mass index (BMI) changes from electronic health records.
  • Statistical analysis including univariate and multivariate logistic regression.

Main Results:

  • Weight gain around adenotonsillectomy significantly predicts residual OSA.
  • Each 1-kg weight increase elevates the odds of residual OSA (AHI >5) by 6.0% and severe OSA (AHI >10) by 8%.
  • Higher pre-operative apnea-hypopnea index (AHI), Black/African American race, and male sex were also associated with incomplete OSA resolution.

Conclusions:

  • Increased peri-adenotonsillectomy weight gain is associated with higher rates of residual pediatric OSA.
  • Pre-operative counseling on weight management strategies is crucial for patients and families undergoing adenotonsillectomy.
Abstract

Keywords:
adenotonsillectomychildrenobesityobstructive sleep apneatonsillectomyweight gain

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