Adenotonsillectomy revisited: Outcomes in 54 children with sleep disordered breathing after adenotonsillectomy

Background: Adenotonsillectomy (AT) is one of the most common operations in children. Main indications are recurrent infections (RI) and sleep disordered breathing (SDB). Outcome data of non-preselected patients are sparse whereas in highly preselected children with SDB like in the Childhood Adenotonsillectomy Trail (CHAT) a persistence rate of SDB of up to 35% after AT is reported (1). After presentation of the study design and patient selection last year (2) we present now the outcomes in the group of 54 children with SDB 6 months after AT. Method: 100 children without preselection in whom AT was performed were recruited. The cohort was divided on clinical bases into those children in which surgery was indicated for RI (n=46) or SDB (n=54), respectively. At follow-up at 6-months clinical improvement was assessed by questionnaires and children of the SDB group underwent a polygraphy (PG). Results: At 6-months follow-up of children with SDB the PG showed a mean Apnoe/Hypopnoe Index (AHI) of 0,95, reflecting the clinical improvement also reported in the questionaires. Nevertheless in 11 children (20%) of the SDB Group at follow up, the AHI was > 1 indicating persistence of SDB. Risk factors therefore were older age, male sex and higher BMI. Conclusions: As in highly preselected children (like in CHAT) follow up in non-preselected children with SDB after AT is mandatory to not miss failure of improvement after surgery. 1.Marcus et al., N Engl J Med 2013;368:2366-76 2.Heschl et al., Eur Respir J 2015; 46: Suppl. 59, PA3370.