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Effect of treating obstructive sleep apnea by tonsillectomy and/or adenoidectomy on obesity in children
1Division of Pediatric Pulmonology, Children's Medical Center, College of Medicine, the State University of New York, Brooklyn 11203, USA.
Insights
Tonsillectomy and/or adenoidectomy for obstructive sleep apnea in children is linked to increased weight and height gain, even in obese patients. This surgery impacts growth metrics significantly in most pediatric cases.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Pediatric Endocrinology
Background:
- Obstructive sleep apnea (OSA) is prevalent in obese children, often linked to enlarged tonsils and adenoids.
- Current understanding suggests OSA treatment normalizes weight in underweight children.
Purpose of the Study:
- To investigate if treating OSA via tonsillectomy and/or adenoidectomy leads to weight normalization in obese children.
- To compare weight changes in obese children with those of normal or underweight children post-surgery.
Main Methods:
- Retrospective cohort study involving 45 children who underwent tonsillectomy and/or adenoidectomy for OSA.
- Weight and height changes were recorded and analyzed, comparing obese/morbidly obese patients with others.
Main Results:
- Post-surgery, 69% of children experienced substantial weight gain; 10 of 17 obese/morbidly obese children showed increased weight.
- Average z scores for weight and height increased significantly (P<.001).
- Body Mass Index (BMI) increased in 62% of patients (P = .004).
Conclusions:
- Tonsillectomy and/or adenoidectomy for pediatric OSA is associated with increased height and weight gain.
- This effect is observed in most children, including those who are obese or morbidly obese.
- The surgical intervention impacts BMI and overall growth in pediatric OSA patients.
Background:
Obstructive sleep apnea is common in obese children who have enlarged tonsils and adenoids.
Objective:
To determine if treatment of obstructive sleep apnea by tonsillectomy and/or adenoidectomy will result in normalization of an obese child's weight, as it does in underweight children, and as it does with other signs and symptoms.
Design:
Retrospective cohort study. We recorded weight and height changes after tonsillectomy and/or adenoidectomy and compared changes of the obese and morbidly obese patients with those of the other patients.
Setting:
A tertiary care inner-city hospital.
Participants:
Children (n = 45) who underwent tonsillectomy and/or adenoidectomy for obstructive sleep apnea in 1994-1995; their mean (+/-SD) age was 4.9+/-2.4 years at operation.
Results:
At the time of surgery, 25 children were of normal weight; 3, underweight; 7, obese; and 10, morbidly obese. Postoperatively, 31 children (69%), including 10 of the 17 who were obese or morbidly obese, had substantial weight gain: the z score +/- SD for weight of the entire group increased from 1.37+/-2.49 to 2+/-2.27 (P<.001). The mean z score +/- SD for height increased from 0.03+/-1.08 to 0.58+/-0.94 (P<.001). The body mass index (BMI or Quetelet index): calculated as weight in kilograms divided by the square of the height in meters increased in 28 patients (62%) (P = .004).
Conclusion:
Treating obstructive sleep apnea by tonsillectomy and/or adenoidectomy is associated with increased gain in height, weight, and body mass index in most children, including the obese and morbidly obese.