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Persistent sleep apnea after adenotonsillectomy in pediatric patients with head and neck burns

Robert E Africa1, Amber M Dunmire1, Austin L Johnson1

  • 1Department of Otolaryngology-Head and Neck Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA.

American Journal of Otolaryngology
|December 8, 2024
PubMed

Insights

Pediatric patients with burns to the face, head, or neck face a higher risk of persistent sleep disordered breathing (SDB) or obstructive sleep apnea (OSA) after adenotonsillectomy. This study highlights the increased risk following thermal injury to these sensitive areas.

Area of Science:

  • Otorhinolaryngology
  • Sleep Medicine
  • Burn Surgery

Background:

  • Burns to the face, head, or neck can impact airway structures.
  • Adenotonsillectomy is a common procedure for airway issues.
  • The link between burn injury and post-adenotonsillectomy sleep disorders is not well-established.

Purpose of the Study:

  • To investigate if burns to the face, head, or neck increase the risk of persistent sleep disordered breathing (SDB) or obstructive sleep apnea (OSA) after adenotonsillectomy.
  • To compare SDB/OSA persistence rates in pediatric patients who underwent adenotonsillectomy after a burn injury versus those who had the surgery before the injury.

Main Methods:

  • Utilized the TriNetX database for patient data.
  • Compared two cohorts: adenotonsillectomy after burn injury (Cohort 1) and adenotonsillectomy before burn injury (Cohort 2).
  • Assessed persistent SDB/OSA using relative risk (RR) and 95% confidence intervals (CI), with propensity score matching for analysis.

Main Results:

  • Eighty-three pediatric patients were analyzed (51 in Cohort 1, 32 in Cohort 2).
  • Cohort 1 showed a significantly higher rate of persistent SDB/OSA (RR: 2.45; 95% CI: 1.50-4.02).
  • Post-matching, Cohort 1 still demonstrated a significant increase in persistent SDB/OSA (RR: 1.9; 95% CI: 1.15-3.14).

Conclusions:

  • Pediatric patients with face, head, or neck burns have a higher incidence of persistent SDB or OSA following adenotonsillectomy.
  • Burn injury to the head and neck region appears to be a risk factor for developing persistent sleep-disordered breathing post-surgery.
  • Further research may be warranted to explore mechanisms and management strategies.
Abstract

Keywords:
AdenotonsillectomyBurnCorrosionObstructive sleep apneaPediatric otolaryngologySleep disordered breathing

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