Outcome of adenotonsillectomy for obstructive sleep apnea in obese and normal-weight children

Objectives: 1) To evaluate the relative severity of obstructive sleep apnea (OSA) in obese and normal-weight children; 2) to compare changes in respiratory parameters after adenotonsillectomy in obese and normal-weight children. Study Design and Setting: Prospective controlled trial that included children aged 3 to 18 years. All study participants underwent pre- and postoperative polysomnography. Results: The study population included 33 obese children and 39 normal-weight controls. Preoperatively, the median obstructive apnea-hypopnea index (AHI) was 23.4 (range 3.7-135.1) for obese and 17.1 (range 3.9-36.5) for controls (P < 0.001). Postoperatively, the AHI was 3.1 (range 0-33.1) for obese and 1.9 (range 0.1-7.0) for controls (P < 0.01). Twenty-five obese children (76%) and 11 controls (28%) had persistent OSA. Conclusion and Significance: AHI scores are higher in obese than in normal-weight children with OSA. Both groups show a dramatic improvement in AHI after adenotonsillectomy, but persistent OSA is more common in obese children.