Adenoidectomy for Obstructive Sleep Apnea in Children

Abstract Adenotonsillectomy is the recommended treatment for children with obstructive sleep apnea syndrome (OSAS). Since adenoidectomy alone may be associated with significantly lower morbidity, mortality, and cost, we aimed to investigate whether adenoidectomy alone is a reasonable and appropriate treatment for children with OSAS. Five-hundred fifteen consecutive children diagnosed with moderate-to-severe OSAS (apnea-hypopnea index >5) based on polysomnography and who underwent adenoidectomy or adenotonsillectomy were reevaluated after 17-73 months (mean 41) for residual or recurrent obstructive sleep apnea syndrome using a validated questionnaire (Pediatric Sleep Questionnaire, PSQ). Failure of obstructive sleep apnea syndrome resolution was defined as a positive mean PSQ score ≥0.33. Contribution of age, obesity, tonsil size, and obstructive sleep apnea syndrome severity at baseline to adenoidectomy or adenotonsillectomy failure was examined. Positive PSQ score occurred in 15% of the entire sample and was not influenced by age or gender. No difference in failure rate was observed between adenoidectomy and adenotonsillectomy for children who were not obese with apnea-hypopnea index