Risk factors for post-operative complications in Chinese children with tonsillectomy and adenoidectomy for obstructive sleep apnea syndrome

• Published in: Sleep & breathing Vol. 16; no. 3; pp. 909 - 911
• Main Authors: Ma, Alison L. T., Lam, Yuen-yu, Wong, Siu-fong, Ng, Daniel K., Chan, Chung-hong
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.09.2012; Springer; Springer Nature B.V
• Subjects: Adenoidectomy; Adolescent; Biological and medical sciences; Body Mass Index; Child; Child, Preschool; Children & youth; China; Comorbidity; Dentistry; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Female; Fundamental and applied biological sciences. Psychology; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Infant; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Nervous system (semeiology, syndromes); Neurology; Otorhinolaryngology; Pediatrics; Pneumology/Respiratory System; Polysomnography; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Recurrence; Retrospective Studies; Risk Factors; Short Communication; Sleep apnea; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - surgery; Sleep. Vigilance; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Tonsillectomy; Tonsillitis; Vertebrates: nervous system and sense organs; China; Sleep apnea; Tonsillectomy; Obstructive; Child; Adenoidectomy; Human; Nervous system diseases; Sleep apnea syndrome; Respiratory disease; Sleep disorder; Sleep; Risk factor; Chinese; Complication; Sleep wake cycle; Neurological disorder
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-011-0561-6

Purpose Tonsillectomy and adenoidectomy (T&A) is commonly performed in children with obstructive apnea syndrome (OSAS). It was our hospital practice to observe all patients post T&A in the pediatric intensive care unit. We aim to describe the post-operative complications after tonsillectomy and adenoidectomy in children with OSAS and to identify risk factors for these complications. Method Medical records of patients from 1 to 16 years old with OSAS and T&A done in this department were retrieved for analysis from April 1999 to July 2006. Information of the individual patients including the demographic data, polysomnography data, and presence of post-operative complications were recorded and analyzed. Results A total of 86 patient records were analyzed (M/F = 69:17). The mean BMI z score was 1.13 ± 1.53, and 36% of patients were classified as obese with z  > 1.96. The median apnea–hypopnea index (AHI) before T&A was 9.8 episodes/h. Only six patients had post-operative desaturation. No bleeding complications were reported in our cohort. It was found that patients with desaturation after T&A had significantly higher mean BMI z score than children without desaturation ( p  = 0.014). There was otherwise no significant difference between the age, sex, AHI score, and the history of allergic rhinitis or asthma between the two groups. Conclusion Our results showed that most children with OSAS underwent T&A without complications. The respiratory complication rate was 7%, and desaturation was the most common post-operative complication. Children with higher BMI z score were more likely to have desaturation after T&A ( p  = 0.014). Hence, careful monitoring with pulse oximeter after T&A should be offered to those who are obese.