Systematic review of effects of adenotonsillectomy on cardiovascular parameters in children with obstructive sleep apnea

Objective. To systematically review current studies on the effects of adenotonsillectomy (TandA) for obstructive sleep apnea (OSA) on cardiovascular parameters in children. Data Sources. PubMed database. Review Methods. A comprehensive PubMed MeSH search was done between 1970 and 2012. Results. Fourteen articles were included. The total number of children was 418. The mean sample size was 30 (range, 1-62), and the mean age of the sample population was 6 years (range, 2-10 years). Criteria used for the diagnosis of OSA ranged from full-night polysomnography (PSG) to clinical parameters. Three studies had results from preoperative and postoperative PSG. Cardiovascular parameters studied included blood pressure, heart rate, cardiac morphology, and cardiac function. All studies reported an improvement in cardiovascular parameters and OSA symptoms after surgery. Three studies reported improvement in blood pressure, 6 reported improvement in mean pulmonary artery pressures, 7 reported improvement in echocardiographic findings, and 1 reported a decrease in pulse rate and pulse rate variability after TandA for OSA. Conclusion. There is evidence that cardiovascular morbidities associated with OSA are potentially reversible. TandA may have a significant role in reversing the cardiovascular sequelae of OSA. However, there is a paucity of well-designed and powered studies to address this issue.