Tonsillectomy As a Treatment of Obstructive Sleep Apnea in Adults With Tonsillar Hypertrophy

• Published in: The Laryngoscope 2000-09, Vol.110 (9), p.1556-1559
• Main Authors: Verse, Thomas, Kroker, Béatrice A., Pirsig, Wolfgang, Brosch, Sibylle
• Format: Article
• Language: English
• Subjects: Adult; adults; Biological and medical sciences; Body Mass Index; Female; Humans; Hypertrophy - complications; Hypertrophy - pathology; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Miscellaneous. Technology; Non tumoral diseases; Obstructive sleep apnea; Otorhinolaryngology. Stomatology; Palatine Tonsil - pathology; Palatine Tonsil - surgery; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Polysomnography; Prospective Studies; Severity of Illness Index; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - etiology; Sleep Apnea, Obstructive - surgery; snoring; tonsillar hypertrophy; tonsillectomy; Tonsillectomy - methods; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1097/00005537-200009000-00029

Objectives High surgical success rates for adenotonsillectomy in children with sleep‐related breathing disorders have been described in various studies. The purposes of the present study were to observe how often a substantial tonsillar hypertrophy is associated with obstructive sleep apnea (OSA) in adults and to evaluate the efficiency of a bilateral tonsillectomy. Study Design Data from a prospective study with 11 adults who underwent tonsillectomy as single treatment for sleep‐related breathing disorders were evaluated based on the severity level of their preoperative apnea‐hypopnea index (AHI). Material and Methods Within 3 years, 11 patients with a substantial tonsillar hypertrophy underwent attended polysomnography in the sleep laboratory. Tonsillectomy was performed, and postoperative complications and polysomnographic findings were reviewed. Follow‐up time was 3 to 6 months. Results Nine of 11 patients (81.8%) were diagnosed with OSA. Five of these patients exhibited severe OSA, four patients had mild OSA, and two patients were simple snorers with an AHI below 10. The surgical response rates (defined as decrease in the postoperative AHI ≥50% and a postoperative AHI of less than 20) were 80.0% in severe apneics and 100% in mild apneics. No serious complications occurred. Conclusions Substantial tonsillar hypertrophy can rarely cause OSA in adults. In the carefully selected patient a tonsillectomy should be considered an effective and safe surgical option for the treatment of this disorder.