Long-term persistence of obstructive sleep apnoea-hypopnoea syndrome in children treated with adenotonsillectomy. Analysis of prognostic factors

• Published in: Acta otorrinolaringologica espanola Vol. 63; no. 2; p. 85
• Main Authors: Esteller Moré, Eduard, Santos Acosta, Paola, Segarra Isern, Francesc, Lopez Diu, Roser, Matiño Soler, Eusebi, Ademà Alcover, Joan Manel, Estivill Sancho, Eduard
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.03.2012
• Subjects: Adenoidectomy; Adolescent; Anthropometry; Child; Child, Preschool; Comorbidity; Female; Follow-Up Studies; Humans; Infant; Male; Obesity - epidemiology; Polysomnography; Prognosis; Prospective Studies; Severity of Illness Index; Sleep Apnea Syndromes - epidemiology; Sleep Apnea Syndromes - surgery; Sleep Apnea, Obstructive - epidemiology; Sleep Apnea, Obstructive - surgery; Snoring; Tonsillectomy; Treatment Failure
• ISSN: 1988-3013
• DOI: 10.1016/j.otorri.2011.08.004

Treatment of obstructive sleep apnoea-hypopnoea syndrome in children with adenotonsillectomy is effective but has a moderate rate of persistent disease. To analyse the rate of persistence of sleep apnoea-hypopnoea syndrome in a group of adenotonsillectomy-treated paediatric patients and to assess the possible prognostic factors. Prospective study of 80 patients aged between 2 and 13 years who had obstructive sleep apnoea-hypopnoea syndrome, treated with adenotonsillectomy. All patients had been followed up clinically and by polysomnography for 1 year after surgery. We analysed the epidemiological and clinical factors that could negatively affect the outcome of surgery. The median age was 5.25 ± 2.05 years and the mean apnoea-hypopnoea index (AHI) was 8.13 ± 6.06. One year after surgery, all clinical parameters improved significantly and the mean AHI was 2.50. Persistent disease (AHI≥3) was present in 21 of the patients (26.3%). The comparative analysis of clinical and epidemiological factors between the group of non-persistence and persistence did not obtain statistically-significant differences in age, sex, tonsillar size, Friedman degree or severity of preoperative disease. The only significant factor was that patients without persistence were more obese. The results of our study about the persistence of obstructive sleep apnoea-hypopnoea syndrome after adenotonsillectomy are significant enough to recommend follow-up with polysomnography, especially in high-risk groups. In the series presented here, we were not able to demonstrate these risk factors. Our results are probably conditioned by the characteristics of the population studied: Low age, low obesity rate and less severe levels of apnoea-hypopnoea index.