Obstructive Sleep Apnea Resolution in Hypopnea- versus Apnea-Predominant Children after Adenotonsillectomy

• Published in: Otolaryngology-head and neck surgery 2016-10, Vol.155 (4), p.670-675
• Main Authors: Tang, Alice L., Cohen, Aliza P., Benke, James R., Stierer, Kevin D., Stanley, James, Ishman, Stacey L.
• Format: Article
• Language: English
• Subjects: Adenoidectomy; adenotonsillectomy; Adolescent; Child; Child, Preschool; Female; Humans; Infant; Male; OSA; persistent OSA; Polysomnography; Risk Factors; sleep apnea; Sleep Apnea, Obstructive - surgery; sleep study; Tonsillectomy; Treatment Outcome
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1177/0194599816652387

Objective Given that 30% to 40% of children have persistent obstructive sleep apnea (OSA) after adenotonsillectomy, we evaluated whether children with hypopnea-predominant OSA were more likely to have complete disease resolution after adenotonsillectomy than those with apnea-predominant disease. We also identified risk factors that might modify the relationship between disease resolution and polysomnographic event type (ie, hypopnea vs apnea). Study Design Case series with chart review. Setting Tertiary pediatric hospital. Subjects/Methods Consecutive 1- to 18-year-old typically developing children diagnosed with OSA from March 2011 to December 2012 underwent adenotonsillectomy and completed pre- and postoperative polysomnography within 1 year of surgery. Results Fifty-eight children were included (27 female; mean ± SD: age, 5.6 ± 3.1 years; body mass index z score, 1.1 ± 1.7). Overall, adenotonsillectomy resulted in significant improvement in obstructive apnea-hypopnea index (oAHI) from 23.3 ± 40.0 to 4.3 ± 8.2 events per hour (P < .001), obstructive apnea index (5.1 ± 7.4 to 0.4 ± 0.8, P < .001), and obstructive hypopnea index (oHI; 18.1 ± 37.5 to 3.7 ± 8.1, P < .001). There was complete response (oAHI