Adenotonsillectomy and obstructive sleep apnea in children: A prospective survey

Prospective survey of children up to 14 years of age with OSA submitted to adenotonsillectomy. Clinical evaluation, with questionnaires and clinical scales evaluating facial structures including tonsils and Mallampati scales and otolaryngologic evaluation; nocturnal polysomnography and repeat evalua...

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Bibliographic Details
Published in:Otolaryngology-head and neck surgery 2007-02, Vol.136 (2), p.169-175
Main Authors: Guilleminault, Christian, Huang, Yu-shu, Glamann, Christine, Li, Kasey, Chan, Allison
Format: Article
Language:English
Subjects:
Adenoids - surgery
Adolescent
Child
Child, Preschool
Female
Humans
Infant
Male
Oxygen Consumption
Polysomnography
Prospective Studies
Regression Analysis
Sleep Apnea, Obstructive - physiopathology
Sleep Apnea, Obstructive - surgery
Tonsillectomy
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Summary:Prospective survey of children up to 14 years of age with OSA submitted to adenotonsillectomy. Clinical evaluation, with questionnaires and clinical scales evaluating facial structures including tonsils and Mallampati scales and otolaryngologic evaluation; nocturnal polysomnography and repeat evaluation three to five months postsurgery. Of 207 successively seen children, 199 had follow-up polysomnography, and 94 had still abnormal sleep recording. Multivariate analysis indicates that Mallampati scale score 3 and 4, retro-position of mandible, enlargement of nasal inferior turbinates at +3 (subjective scale 1 to 3), and deviated septum were significantly associated with persistence of abnormal polysomnography (with high 95% CI for Mallampati scale and deviated septum). Mallampati scale scores are resultant of several facial factors involving maxilla, mandible, and oral versus oral breathing but add information on risk of partial response to adenotonsillectomy. Adenotonsillectomy may not resolve obstructive sleep apnea in children.
ISSN:0194-5998
1097-6817
DOI:10.1016/j.otohns.2006.09.021