Adenotonsillectomy in Obese Children with Obstructive Sleep Apnea Syndrome: Magnetic Resonance Imaging Findings and Considerations

volume of the nasopharynx and oropharynx (2.9 ± 1.3 versus 4.4 ± 0.9 cm 3 , P < 0.001, and 3.2 ± 1.2 versus 4.3 ± 2.0 cm 3 , P < 0.01, respectively), reduced tonsils (11.3 ± 4.3 versus 1.3 ± 1.4 cm 3 , P < 0.001), but had no effect on the adenoid, lingual tonsil, or retropharyngeal nodes. A small significant increase in the volume of the soft palate and tongue was also noted (7.3 ± 2.5 versus 8.0 ± 1.9 cm 3 , P = 0.02, and 88.2 ± 18.3 versus 89.3 ± 24.4 cm 3 , P = 0.005, respectively). Conclusions: This is the first report to quantify volumetric changes in the upper airway in obese children with OSAS after adenotonsillectomy showing significant residual adenoid tissue and an increase in the volume of the tongue and soft palate. These findings could explain the low suc- cess rate of AT reported in obese children with OSAS and are important considerations for clinicians treating these children.