Ambulatory tonsillectomy for children with severe obstructive sleep apnea without risk factors

• Published in: American journal of otolaryngology 2020-07, Vol.41 (4), p.102467-102467, Article 102467
• Main Authors: Kong, Derek K., Kong, Amanda M., Wasserman, Isaac, Villavisanis, Dillan F., Hackett, Alyssa M.
• Format: Article
• Language: English
• Subjects: Adolescent; Age; Ambulatory Surgical Procedures - methods; Apnea; Body mass index; Child; Child, Preschool; Children; Children & youth; Clinical practice guidelines; Complications; Data analysis; Extubation; Female; Head and neck; Hospitals; Humans; Hypoxemia; Male; Medical records; Monitoring, Physiologic; Obesity; Obstructive sleep apnea; Otolaryngology; Patients; Pediatrics; Polysomnography; Postoperative Period; Retrospective Studies; Risk analysis; Risk Factors; Severity of Illness Index; Sleep; Sleep apnea; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - surgery; Sleep disorders; Surgery; Tonsillectomy - methods
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2020.102467

Recommendations for polysomnography (PSG) in pediatric sleep disordered breathing (SDB) vary between the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the American Academy of Pediatrics (AAP). We determined the rates of preoperative PSG in children without risk factors outlined in the AAO-HNS Clinical Practice Guidelines and described the postoperative course of those patients following T&A. Patients aged 3–17 undergoing T&A for SDB or OSA who did not have an indication for preoperative PSG were included. We conducted retrospective review to describe the rate, type, and timing of respiratory complications for patients with and without PSG following T&A, and discuss cases where disposition was changed due to PSG results. 1135 patients without risk factors underwent T&A for SDB or OSA. 196 (17%) had a preoperative PSG, of whom 85 (43.3%) had AHI >10 and 38 (24.8%) had an O2 nadir