CURRENT ISSUE
NOVEMBER 2014
KINDLE EDITION



SEARCH JOURNAL ARCHIVES


SEARCH PUBMED


MANUSCRIPT SUBMISSIONS


SUBSCRIBE TO SLEEP

CONTINUING MEDICAL EDUCATION


ADVERTISE WITH US


ABOUT SLEEP

ABSTRACT SUPPLEMENTS


ACCEPTED PAPERS
Bookmark and Share         RSS Feed

VOLUME 37, ISSUE 01

TREATMENT OUTCOMES OF ADENOTONSILLECTOMY FOR CHILDREN WITH OSA
Treatment Outcomes of Adenotonsillectomy for Children with Obstructive Sleep Apnea: A Prospective Longitudinal Study

http://dx.doi.org/10.5665/sleep.3310

Yu-Shu Huang, MD1,6; Christian Guilleminault, DM, MD, DBiol2,6; Li-Ang Lee, MD3; Cheng-Hui Lin, MD4; Fan-Ming Hwang, PhD5

1Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and College of Medicine, Taoyuan, Taiwan; 2Stanford University Sleep Medicine Division, Stanford, CA; 3Department of Otolaryngology and Sleep Center, Chang Gung Memorial Hospital and College of Medicine, Taoyuan, Taiwan; 4Department of Cranio-Facial Center and Sleep Center, Chang Gung Memorial Hospital and College of Medicine, Taoyuan, Taiwan; 5Department of Education, National Chia-Yi University, Chiayi, Taiwan; 6Department of Clinical Psychology College of Medicine, FU JEN Catholic University, Taipei, Taiwan



  Expand  Table of Contents    
Text size:  

Objective:

To evaluate the efficacy of adenotonsillectomy (AT) in the treatment of children with obstructive sleep apnea (OSA) in a 3-y prospective, longitudinal study with analysis of risk factors of recurrence of OSA.

Study Design:

An investigation of children (6 to 12 y old) with OSA documented at entry and followed posttreatment at 6, 12, 24, and 36 mo with examination, questionnaires, and polysomnography.

Multivariate generalized linear modeling and hierarchical linear models analysis were used to determine contributors to suboptimal long-term resolution of OSA, and Generalized Linear Models were used for analysis of risk factors of recurrence.

Results:

Of the 135 children, 88 terminated the study at 36 months post-AT. These 88 children (boys = 72, mean age = 8.9 ± 2.7 yersus boys 8.9 ± 2.04 y, girls: 8.8 ± 2.07 y; body mass index [BMI] = 19.5 ± 4.6 kg/m2) had a preoperative mean apnea-hypopnea index (AHI0) of 13.54 ± 7.23 and a mean postoperative AHI at 6 mo (AHI6) of 3.47 ± 8.41 events/h (with AHI6 > 1 = 53.4% of 88 children). A progressive increase in AHI was noted with a mean AHI36 = 6.48 ± 5.57 events/h and AHI36 > 1 = 68% of the studied group. Change in AHI was associated with changes in the OSA-18 questionnaire.

The residual pediatric OSA after AT was significantly associated with BMI, AHI, enuresis, and allergic rhinitis before surgery. From 6 to 36 mo after AT, recurrence of pediatric OSA was significantly associated with enuresis, age (for the 24- to 36-mo period), postsurgery AHI6 (severity), and the rate of change in BMI and body weight.

Conclusions:

Adenotonsillectomy leads to significant improvement in apnea-hypopnea index, though generally with incomplete resolution, but a worsening over time was observed in 68% of our cases.

Citation:

Huang YS; Guilleminault C; Lee LA; Lin CH; Hwang FM. Treatment outcomes of adenotonsillectomy for children with obstructive sleep apnea: a prospective longitudinal study. SLEEP 2014;37(1):71-76.

Expand  Table of Contents
View SLEEP 2011 Poster Presentations Online