Adenotonsillectomy for sleep-disordered breathing in a predominantly obese pediatric population

David H. Burstein, Alison Jackson, Jeremy Weedon, Katharina D. Graw-Panzer, Samir Fahmy, Nira A. Goldstein

Research output: Contribution to journalArticle

4 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)525-529
Number of pages5
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume77
Issue number4
DOIs
StatePublished - Apr 2013
Externally publishedYes

Fingerprint

Sleep Apnea Syndromes
Apnea
Pediatrics
Population
Polysomnography
Child Behavior
Checklist
Natural History

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 journalArticle

Burstein, David H. ; Jackson, Alison ; Weedon, Jeremy ; Graw-Panzer, Katharina D. ; Fahmy, Samir ; Goldstein, Nira A. / Adenotonsillectomy for sleep-disordered breathing in a predominantly obese pediatric population. In: International Journal of Pediatric Otorhinolaryngology. 2013 ; Vol. 77, No. 4. pp. 525-529.
@article{ad972717521247b78ab5da777b1cb49d,
title = "Adenotonsillectomy for sleep-disordered breathing in a predominantly obese pediatric population",
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).",
keywords = "Adenotonsillectomy, Efficacy, Obstructive sleep apnea, Polysomnography, Sleep-disordered breathing",
author = "Burstein, {David H.} and Alison Jackson and Jeremy Weedon and Graw-Panzer, {Katharina D.} and Samir Fahmy and Goldstein, {Nira A.}",
year = "2013",
month = "4",
doi = "10.1016/j.ijporl.2012.12.029",
language = "English (US)",
volume = "77",
pages = "525--529",
journal = "International Journal of Pediatric Otorhinolaryngology",
issn = "0165-5876",
publisher = "Elsevier Ireland Ltd",
number = "4",

}

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 -