Outcomes and Quality of Life following Adenotonsillectomy for Sleep-Disordered Breathing in Children

Abstract

Purpose: To summarize current knowledge of the outcome of adenotonsillectomy (T&A) for the treatment of sleep-disordered breathing (SDB) in children. Results: The success rate of T&A for SDB as measured on the basis of objective criteria using polysomnography ranges from 79 to 92%. Dramatic improvements in quality of life after T&A for SDB have been shown in a number of studies and these improvements are maintained up to 2 years after surgery. Significant improvements that are maintained in the long term are also seen in behavioral and neurocognitive parameters following T&A for SDB. Not surprisingly, total health care costs are reduced by one third following T&A mostly because of a reduction in upper respiratory tract infections. Conclusions: T&A is associated with improvements in polysomnography, behavior and quality of life in children with SDB. Improved health in these children leads to a reduction in health care utilization.

Recognizing and Managing Obstructive Sleep Apnea in Primary Care

“…69 Tonsillectomy/adenoidectomy is, however, indicated for the treatment of OSA in children. 70 Surgical procedures for OSA in patients with identifiable upper airway or craniofacial abnormalities include removal of • The most effective oral appliance is the mandibular advancement device, which is fitted to the maxillary and mandibular dentition and moves the position of the lower jaw forward increasing pharyngeal size and advancing the base of the tongue, thus reducing airway instability…”

Indications for tonsillectomy stratified by the level of evidence

“…Further publications were not mentioned. SBD as indication for TE with potential benefit in the long-term was shortly described with only few studies cited by the authors [104], [105], [477], [481], [482]. Hemorrhagic tonsillitis as indication for TE was suggested but not supported by citations.…”

Coblation tonsilloadenoidectomy - treatment of choice for very small children

“…(2,6,13) All of this was confirmed in our case: improved weight and height gain and better quality of life for this little girl. (2,6,13,15) …”