Efficacy of tonsillectomy and adenoidectomy in Asian childhood obstructive sleep apnea/hypopnea syndrome: a case control study.

OBJECTIVE

To evaluate the efficacy of tonsillectomy and adenoidectomy (T & A) in Asian childhood obstructive sleep apnea/hypopnea syndrome (OSAHS).

METHODS

The medical data of the OSAHS patients in the Sleep Center of the Duchess Kent Children's Habilitation Institute from May 1999 to May 2003 were retrospectively reviewed. OSAHS was diagnosed according to the abnormal sleep monitoring results. The clinical outcomes were followed up and compared between the Operation and Non-operation groups (Control) in OSAHS children with adenotonsillar hypertrophy (ATH). Sleep endoscopy was performed for those who had residual OSAHS for the purpose of detecting the underlying causes.

RESULTS

Sixty-one patients were diagnosed with OSAHS. Among the OSAHS patients, 39 were associated with ATH, and 25 of the 39 patients underwent T & A. The desaturation dip rate and minimum saturation in the Operation group were significantly improved after T & A. Six out of 25 (24%) patients in the Operation group had residual OSAHS whereas 11 out of the 13 (85%) patients in the Control group had unchanged or worsening clinical symptoms (OR=15.4, 95%CI 2.7- 87.5). Residual OSAHS after surgery were attributable to obesity, achondroplasia, upper airway structure anomaly and airway dynamic problems.

CONCLUSIONS

T & A was effective in the majority of Asian childhood OSAHS associated with ATH. Upper airway structure or dynamic abnormalities can result in residual OSAHS in parts of children. Further investigation is required to detect the underlying problems.