Adenotonsillectomy Outcomes in Treatment of Obstructive Sleep Apnea in Children

Abstract

AT leads to significant improvements in indices of sleep-disordered breathing in children. However, residual disease is present in a large proportion of children after AT, particularly among older (>7 yr) or obese children. In addition, the presence of severe OSAS in nonobese children or of chronic asthma warrants post-AT nocturnal polysomnography, in view of the higher risk for residual OSAS.

Impact of Adenotonsillectomy on Insulin Resistance and Lipoprotein Profile in Nonobese and Obese Children

“…OSA, Body Habitus, and Impact of T&A Similar to previous studies, 30 more overweight children were at greater risk of residual OSA post-T&A. However, children with more significant residual OSA were less likely to gain weight after surgery compared with children with mild or no OSA.…”

“…In other studies examining metabolic changes in children with OSA following T&A, obesity, 30,41 AHI, 41 and older age 30,41 at diagnosis were associated with greater likelihood of persistent OSA…”

Sleep pathology characterization in sickle cell disease: Case–control study

“…7 These facts are related to: (1) an adenotonsilar hypertrophy in these children related to compensatory lymphoid tissue hyperplasia due to functional asplenia and chronic infections 8 ; (2) chronic hemolysis that increases extramedulary hematopoiesis and can alter the bone facial structure. 9 During sleep, children with SCD have transient periods of hypoxemia (accompanied by hypercapnia and acidosis) that causes sickling of the erythrocytes.…”

PAP Therapy's Effect on Cardiometabolic Risk Markers in Pediatric Patients

“…T&A is generally the first-line treatment for OSA in children 18 ; however, not all children with OSA have adenotonsillar hypertrophy, and therefore T&A is not always the appropriate therapeutic modality. Even among those who do have adenotonsillar hypertrophy and undergo T&A, residual OSA persists in a significant proportion of children following the surgery, 19 especially in obese children, 14,20 and therefore so may its sequelae. Thus, it is crucial to also examine the metabolic impact of the other mainstay of therapy, CPAP.…”