Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children

Stradling, John; Thomas, Gary W.; Warley, A; Williams, P. R.; Freeland, A. P.

doi:10.1016/0140-6736(90)90068-g

Cited by 389 publications

(299 citation statements)

References 22 publications

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“…AT has been reported to accelerate weight [6][7][8][9][10][11][12][13][14] in children with baseline failure to thrive (FTT), 1,3,4,15 normal weight patients, 9,11,14,[16][17][18][19][20] obese individuals, 9,13,16,21,22 and infants. 10 The majority of studies also have demonstrated an increase in the height growth rate after AT for OSAS, 3,6,11,17,23,24 but other studies reported no significant differences. 9,12 Whereas accelerated weight gain post-AT is likely beneficial in the setting of baseline FTT, an exaggerated increase in adiposity in overweight children could increase their risk for OSAS recurrence and obesity-related morbidity.…”

Section: (Continued On Last Page)mentioning

confidence: 99%

Growth After Adenotonsillectomy for Obstructive Sleep Apnea: An RCT

et al. 2014

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BACKGROUND AND OBJECTIVES: Adenotonsillectomy for obstructive sleep apnea syndrome (OSAS) may lead to weight gain, which can have deleterious health effects when leading to obesity. However, previous data have been from nonrandomized uncontrolled studies, limiting inferences. This study examined the anthropometric changes over a 7-month interval in a randomized controlled trial of adenotonsillectomy for OSAS, the Childhood Adenotonsillectomy Trial. METHODS: A total of 464 children who had OSAS (average apnea/hypopnea index [AHI] 5.1/hour), aged 5 to 9.9 years, were randomized to Early Adenotonsillectomy (eAT) or Watchful Waiting and Supportive Care (WWSC). Polysomnography and anthropometry were performed at baseline and 7-month follow-up. Multivariable regression modeling was used to predict the change in weight and growth indices. RESULTS: Interval increases in the BMI z score (0.13 vs 0.31) was observed in both the WWSC and eAT intervention arms, respectively, but were greater with eAT (P < .0001). Statistical modeling showed that BMI z score increased significantly more in association with eAT after considering the influences of baseline weight and AHI. A greater proportion of overweight children randomized to eAT compared with WWSC developed obesity over the 7-month interval (52% vs 21%; P < .05). Race, gender, and follow-up AHI were not significantly associated with BMI z score change. CONCLUSIONS: eAT for OSAS in children results in clinically significant greater than expected weight gain, even in children overweight at baseline. The increase in adiposity in overweight children places them at further risk for OSAS and the adverse consequences of obesity. Monitoring weight, nutritional counseling, and encouragement of physical activity should be considered after eAT for OSAS.

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Section: (Continued On Last Page)mentioning

confidence: 99%

Growth After Adenotonsillectomy for Obstructive Sleep Apnea: An RCT

et al. 2014

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“…These procedures have shown positive results in reverting the physical effects of OSDs. [16][17][18][19] Adenoidectomy/adenotonsillectomy not only revert the organic changes caused by OSDs, but also have shown their value in improving the quality of life of children and the perception of this quality by their caretakers. Recent papers are evidence of this important theme.…”

Section: Resultsmentioning

confidence: 99%

“…[12][13][14][15] Thus adenoidectomy or adenotonsillectomy are the procedures of choice for treating OSDs in the pediatric population; these procedures effectively control nocturnal symptoms, relieving physical repercussions and normalizing the polysomnographic test. [16][17][18][19] Although the objective improvement of this condition has been well documented, there have been few reports about subjective improvements in the quality of life of children and the degree of satisfaction of their parents following adenotonsillectomy; the subjective improvement remains presumed.…”

Section: Introductionmentioning

confidence: 99%

Resultados na qualidade de vida em longo prazo de crianças submetidas à adenoidectomia/adenotonsilectomia por distúrbios obstrutivos do sono

Júnior

Silva

Freitas

2008

Rev. Bras. Otorrinolaringol.

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Obst ructive Sleep Disorders (OSD) affect mostly the pediatric population. Within this group, its main etiology is adenotonsillar hyperplasia, being adenoidectomy or adenotonsillectomy the best treatment option for quality of life improvement. Aim: To asses quality of life of children with OSD after adenoidectomy/adenotonsillectomy. Method: A prospective study was carried out with 48 children, between 2 and 11 years, with clinical manifestations of OSD and obstructive adenotonsillar hyperplasia. The OSA18 questionnaire was answered by the parents to evaluate their children's quality of life before surgery; at about thirty days and at least eleven months after the procedure. A higher score meant a worse quality of life. Results: Before surgery, the average OSA18 score was 82.83(SD=12.57), with an average global score for quality of life of 6.04(SD=1.66). Within thirty days after surgery, the average OSA18 score was 34.3 (SD=9.95) with an average global score of 9.6(SD=0.81), both showing significant reduction (p< 0.001). Thirty-four children (70.83%) were re-evaluated between 11 and 30 months (average=16.85; SD=5.16). The average OSA18 score was 35.44 (SD=19.95) with an average global score of 9.28 (SD=1.78). The postoperative evaluations weren't significantly different. Conclusion: surgery improves the quality of life of children with OSD, and such improvement maintains for the long run.

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“…The aim of such studies is to document the number of episodes of increased upper airway resistive load and the presence of sleep disturbance. It has been used to clarify the diagnosis, particularly in borderline cases and to compare the effects of treatment on the measured variables [1,50,51]. Common measurements which may be included are the ECG, submental electromyogram (EMG), nasal/oral air flow, respiratory movement or effort, pulse oximetry (S p O 2 ), transcutaneous oxygen partial pressure, end-tidal carbon dioxide partial pressure (P E H CO 2 ), anterior tibialis EMG and video photography during natural or druginduced sleep [6,11].…”

Section: Investigationsmentioning

confidence: 99%

“…Polysomnographic studies have been undertaken to follow up these children several weeks after surgery [51].…”

Section: Postoperative Managementmentioning

confidence: 99%

Obstructive sleep apnoea syndrome in children

Warwick

Mason

1998

Anaesthesia

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SummaryObstructive sleep apnoea syndrome in children is a complex disorder characterised by repeated nocturnal episodes of increased upper airway resistive load. It is most commonly associated with adenotonsillar hypertrophy and more children are now presenting for adenotonsillectomy. These children may pose different anaesthetic problems to those having surgery for recurrent infection alone and anaesthetic morbidity and mortality has been reported. In addition, due to the varied symptomatology of the condition, children with unrecognised obstructive sleep apnoea syndrome may present for incidental surgery. This is of importance as patients with undiagnosed obstructive sleep apnoea syndrome may experience additional peri-operative morbidity when undergoing incidental surgery. This article aims to review the aetiology, pathophysiology, clinical presentation and anaesthetic management of children with obstructive sleep apnoea syndrome.

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Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children

Cited by 389 publications

References 22 publications

Growth After Adenotonsillectomy for Obstructive Sleep Apnea: An RCT

Growth After Adenotonsillectomy for Obstructive Sleep Apnea: An RCT

Resultados na qualidade de vida em longo prazo de crianças submetidas à adenoidectomia/adenotonsilectomia por distúrbios obstrutivos do sono

Obstructive sleep apnoea syndrome in children

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