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Tonsil surgery is an effective treatment for pediatric obstructive sleep apnea irrespective of underlying

Julia Virkkunen1, Turkka Kirjavainen2, Johanna Nokso-Koivisto1

  • 1Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

International Journal of Pediatric Otorhinolaryngology
|June 2, 2026
PubMed

Insights

Tonsil surgery effectively treats obstructive sleep apnea (OSA) in children, even those with underlying health issues. This study shows significant improvements in OSA after tonsillectomy or tonsillotomy, regardless of tonsil size.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Surgical Outcomes

Background:

  • Obstructive sleep apnea (OSA) significantly impacts children's health, particularly those with comorbidities.
  • Tonsillar hypertrophy is a common cause of pediatric OSA, but surgical outcomes in complex cases require further evaluation.

Purpose of the Study:

  • To assess the efficacy of tonsil surgery in managing pediatric obstructive sleep apnea (OSA) among children with predisposing comorbidities.
  • To compare the effectiveness of tonsillotomy versus tonsillectomy in improving OSA parameters in this population.

Main Methods:

  • Retrospective review of 33 children under 16 with comorbidities undergoing tonsil surgery for OSA.
  • Pre- and postoperative polysomnography (PSG) data collected within two years of surgery at Helsinki University Hospital.
  • Analysis included obstructive apnea-hypopnea index (OAHI) changes and correlation with tonsil size.

Main Results:

  • A significant reduction in median OAHI from 17.7 to 1.9 post-surgery (p < 0.0001).
  • Both tonsillotomy and tonsillectomy groups showed similar, significant improvements in PSG parameters.
  • Tonsil size showed a weak correlation with OAHI reduction (R²=0.11, p=0.035).
  • 40% of children requiring ventilatory support postoperatively were able to discontinue it.

Conclusions:

  • Tonsillar surgery is effective in alleviating OSA in most children, including those with comorbidities.
  • Significant OSA improvement can be achieved even with relatively small tonsils in children with comorbidities.
  • Tonsillotomy demonstrates comparable effectiveness to tonsillectomy in improving PSG parameters for pediatric OSA.
Abstract

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