Outcome of adenotonsillectomy for severe obstructive sleep apnea in children

To study changes in sleep behavior and quality of life in children after adenotonsillectomy for severe obstructive sleep apnea identified by a respiratory distress index ≥ 30. Children enrolled in the study underwent adenotonsillectomy and had both pre- and post-operative polysomnography. Caregivers also completed an OSA-18 quality of life survey prior to polysomnography and within 6 months of surgery. Paired Student's t-tests were used to compare pre- and post-operative scores. The study population included 29 children. The mean age was 7.1 years (range 1.4-17.0). The most common comorbidities were obesity, asthma and allergic disease. The mean pre-operative RDI was 63.9 and the mean post-operative RDI was 14.2 (P <. 0001). The mean total OSA-18 score before surgery was 77.6 and after surgery was 33.2. The differences in pre- and post-operative OSA-18 total scores and domain scores were significant (P <. 0001). Children with severe OSA who undergo adenotonsillectomy show a significant improvement in RDI and in quality of life over a period of several months after surgery. However, OSA does not resolve in the majority of these children and post-operative PSG is recommended to identify those who may require additional therapy.