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Updated: Jun 27, 2026

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

Published on: December 6, 2016

Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children: A single-center retrospective

Jianbin Zhang1, Yufeng Zhang2, He Li1

  • 1Department of Otolaryngology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, 441021, China.

American Journal of Otolaryngology
|June 25, 2026
PubMed

Insights

Residual obstructive sleep apnea (OSA) is common after adenotonsillectomy (T&A) in children. Obesity, severe baseline OSA, and asthma are key predictors of incomplete recovery, necessitating careful preoperative counseling and follow-up.

Area of Science:

  • Pediatric Sleep Medicine
  • Otolaryngology
  • Respiratory Medicine

Background:

  • Adenotonsillectomy (T&A) is the primary treatment for pediatric obstructive sleep apnea (OSA).
  • A significant number of children experience residual OSA post-T&A, particularly those with specific clinical presentations.
  • Identifying preoperative predictors of residual OSA is vital for patient management and expectation setting.

Purpose of the Study:

  • To identify preoperative risk factors associated with residual obstructive sleep apnea (OSA) in children following adenotonsillectomy (T&A).
  • To improve the understanding of factors contributing to treatment failure in pediatric OSA.

Main Methods:

  • Retrospective analysis of 642 children (aged 3-14 years) who underwent T&A for OSA.
  • Inclusion of complete preoperative and postoperative polysomnography (PSG) data (6-12 months post-surgery).
  • Logistic regression analysis to determine independent risk factors for residual OSA (defined as AHI ≥ 2 events/h).

Main Results:

  • Overall residual OSA prevalence was 26.8% (172/642 children).
  • Independent risk factors identified: obesity (OR 3.12), severe baseline AHI (OR 1.08 per unit increase), and concurrent asthma (OR 1.95).
  • Multivariate risk assessment showed strong predictive capability (AUC = 0.82).

Conclusions:

  • Residual OSA is prevalent in approximately one-quarter of pediatric patients post-T&A.
  • Obesity, severe baseline disease, and comorbid asthma are significant predictors of incomplete OSA resolution.
  • Targeted preoperative counseling and postoperative PSG surveillance are recommended for high-risk pediatric OSA patients.
Abstract

Keywords:
AdenotonsillectomyChildrenObstructive sleep apneaPolysomnographyResidual diseaseRisk factors

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