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KMID : 0361020070500080667
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Korean Journal of Otolaryngology - Head and Neck Surgery
2007 Volume.50 No. 8 p.667 ~ p.671
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Effect of Adenotonsillectomy on Pediatric Obstructive Sleep Apnea
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Park Jung-June
Shim Hyun-Joon
Choi Sun-Myung
Yoon Sang-Won
Shin Hong-Beom
Kim Eui-Joong
Koo Young-Jin
Ahn Young-Min
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Abstract
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Background and Objectives: Adenotonsillar hypertrophy is the leading cause for obstructive sleep apnea (OSA) in children. However, clinical improvement after adenotonsillectomy has not been confirmed objectively in Korean children. We evaluated the effects of adenotonsillectomy on polysomnography (PSG) in children with OSA.
Subjects and Methiod:Fifteen children (age range 3 to 13) who had macroscopic adenotonsillar hypertrophy and a respiratory disturbance index (RDI) greater than 1 on preoperative PSG were enrolled in this study and underwent adenotonsillectomy. All children underwent preoperative and postoperative PSG at 10 weeks after adenotonsillectomy. In addition, the care-givers of each child were asked to check the deficit hyperactivity disorder rating scale-IV (ADHD RS-IV) before and 8 weeks after surgery. Scores from the preoperative and postoperative PSG and ADHD RS-IV were compared using the paired samples t-test.
Results:The improvements in RDI, apneahypoapnea index, apnea index, arousal index, lowest O2 saturation and snoring time on postoperative PSG were significant (p<0.05). About 67% (10 of 15) patients were successfully treated with surgery, but 33% (5 of 15) children had RDI greater than 1 after surgery. ADHD RS-IV score showed significant improvement (p<0.05).
Conclusion:This study suggests that adenotonsillectomy is effective in the treatment of childhood OSA, but dose not have perfect results. The presence of residual OSA after surgery in a large number of patients is a significant probability that deserves more studies and intervention
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KEYWORD
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Obstructive sleep apnea, Child, Polysomnography, Tonsillectomy, Adenoidectomy
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