Abstract
Objectives: To determine the efficacy of adenotonsillectomy (T&A) in the treatment of pediatric sleep-disordered breathing, and to determine the natural history in untreated children. Methods: The charts of children aged 1-12 who underwent polysomnography (PSG) between 1/2006 and 6/2009 were reviewed to identify children with positive studies. Children not treated by T&A were recruited and matched by age, time since initial PSG, and apnea-hypopnea index (AHI) to children who underwent T&A. All participants were evaluated by a clinical assessment score (CAS-15), follow-up PSG, and the Child Behavior Checklist (CBCL). Results: Sixteen matched pairs completed the study. Ten (63%) T&A patients were overweight or obese compared with 14 (88%) untreated patients. There was a greater median improvement in AHI in the surgical group compared to the nonsurgical group (10.3 vs. 6.5, p=0.044). Although the T&A children were more likely to have a follow-up AHI < 5 (81% vs. 69%) and <1 (44% vs. 25%), these results were not significant. The T&A group had significantly lower mean (SD) scores on the CAS-15 [8.9(6.1) vs. 29.4(16.2), p<0.001] and the CBCL total problem score [43.9(8.7) vs. 58.9(13.0), p<0.001]. Younger age at presentation (rho = -0.76, p<0.001), initial AHI (0.87, p<0.001), and initial AI (0.63, p=0.05) were correlated with change in AHI among T&A subjects. Conclusions: T&A was more effective in reducing AHI than no surgery. Median AHI improved in the nonsurgical group, and 4/16 (25%) untreated patients were cured (AHI < 1).
| Original language | English (US) |
|---|---|
| Pages (from-to) | 525-529 |
| Number of pages | 5 |
| Journal | International Journal of Pediatric Otorhinolaryngology |
| Volume | 77 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2013 |
| Externally published | Yes |
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Keywords
- Adenotonsillectomy
- Efficacy
- Obstructive sleep apnea
- Polysomnography
- Sleep-disordered breathing
ASJC Scopus subject areas
- Otorhinolaryngology
- Pediatrics, Perinatology, and Child Health
Cite this
Adenotonsillectomy for sleep-disordered breathing in a predominantly obese pediatric population. / Burstein, David H.; Jackson, Alison; Weedon, Jeremy; Graw-Panzer, Katharina D.; Fahmy, Samir; Goldstein, Nira A.
In: International Journal of Pediatric Otorhinolaryngology, Vol. 77, No. 4, 04.2013, p. 525-529.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Adenotonsillectomy for sleep-disordered breathing in a predominantly obese pediatric population
AU - Burstein, David H.
AU - Jackson, Alison
AU - Weedon, Jeremy
AU - Graw-Panzer, Katharina D.
AU - Fahmy, Samir
AU - Goldstein, Nira A.
PY - 2013/4
Y1 - 2013/4
N2 - Objectives: To determine the efficacy of adenotonsillectomy (T&A) in the treatment of pediatric sleep-disordered breathing, and to determine the natural history in untreated children. Methods: The charts of children aged 1-12 who underwent polysomnography (PSG) between 1/2006 and 6/2009 were reviewed to identify children with positive studies. Children not treated by T&A were recruited and matched by age, time since initial PSG, and apnea-hypopnea index (AHI) to children who underwent T&A. All participants were evaluated by a clinical assessment score (CAS-15), follow-up PSG, and the Child Behavior Checklist (CBCL). Results: Sixteen matched pairs completed the study. Ten (63%) T&A patients were overweight or obese compared with 14 (88%) untreated patients. There was a greater median improvement in AHI in the surgical group compared to the nonsurgical group (10.3 vs. 6.5, p=0.044). Although the T&A children were more likely to have a follow-up AHI < 5 (81% vs. 69%) and <1 (44% vs. 25%), these results were not significant. The T&A group had significantly lower mean (SD) scores on the CAS-15 [8.9(6.1) vs. 29.4(16.2), p<0.001] and the CBCL total problem score [43.9(8.7) vs. 58.9(13.0), p<0.001]. Younger age at presentation (rho = -0.76, p<0.001), initial AHI (0.87, p<0.001), and initial AI (0.63, p=0.05) were correlated with change in AHI among T&A subjects. Conclusions: T&A was more effective in reducing AHI than no surgery. Median AHI improved in the nonsurgical group, and 4/16 (25%) untreated patients were cured (AHI < 1).
AB - Objectives: To determine the efficacy of adenotonsillectomy (T&A) in the treatment of pediatric sleep-disordered breathing, and to determine the natural history in untreated children. Methods: The charts of children aged 1-12 who underwent polysomnography (PSG) between 1/2006 and 6/2009 were reviewed to identify children with positive studies. Children not treated by T&A were recruited and matched by age, time since initial PSG, and apnea-hypopnea index (AHI) to children who underwent T&A. All participants were evaluated by a clinical assessment score (CAS-15), follow-up PSG, and the Child Behavior Checklist (CBCL). Results: Sixteen matched pairs completed the study. Ten (63%) T&A patients were overweight or obese compared with 14 (88%) untreated patients. There was a greater median improvement in AHI in the surgical group compared to the nonsurgical group (10.3 vs. 6.5, p=0.044). Although the T&A children were more likely to have a follow-up AHI < 5 (81% vs. 69%) and <1 (44% vs. 25%), these results were not significant. The T&A group had significantly lower mean (SD) scores on the CAS-15 [8.9(6.1) vs. 29.4(16.2), p<0.001] and the CBCL total problem score [43.9(8.7) vs. 58.9(13.0), p<0.001]. Younger age at presentation (rho = -0.76, p<0.001), initial AHI (0.87, p<0.001), and initial AI (0.63, p=0.05) were correlated with change in AHI among T&A subjects. Conclusions: T&A was more effective in reducing AHI than no surgery. Median AHI improved in the nonsurgical group, and 4/16 (25%) untreated patients were cured (AHI < 1).
KW - Adenotonsillectomy
KW - Efficacy
KW - Obstructive sleep apnea
KW - Polysomnography
KW - Sleep-disordered breathing
UR - http://www.scopus.com/inward/record.url?scp=84875592446&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84875592446&partnerID=8YFLogxK
U2 - 10.1016/j.ijporl.2012.12.029
DO - 10.1016/j.ijporl.2012.12.029
M3 - Article
C2 - 23352338
AN - SCOPUS:84875592446
VL - 77
SP - 525
EP - 529
JO - International Journal of Pediatric Otorhinolaryngology
JF - International Journal of Pediatric Otorhinolaryngology
SN - 0165-5876
IS - 4
ER -