Chronic Despite Surgery

Adenotonsillectomy is the most commonly performed surgery in children, ranging from about 19 per 10,000 in Canada to 115 per 10,000 in the Netherlands. In the U.S., the rate is about 50 per 10,000. It is the first line of treatment for SDB in children. For many kids, undergoing this major surgery provides only temporary relief.

The researchers recruited 40 healthy children between seven and 13 whose parents and otolaryngologists had jointly agreed upon adenotonsillectomy surgery to treat nightly snoring. The investigators also recruited 30 sex- and age-matched children who were not undergoing adenotonsillectomy as a control group. They performed polysomnographies on each child at time of recruitment, and again at six weeks, six months, and a year following surgery. Children in the control group had polysomnographies at the same intervals.

While the majority of children with SDB showed significant improvement in their Apnoe-Hypopnoe-Index (AHI) scores six weeks after surgery, the rate of relapse one year later had no correlation with the six-week score. Children who relapsed were more likely to be more obese, have worse SDB at baseline, have an accelerated body mass index (BMI) gain, and to be African-American.

Half of the non-obese children, and two-thirds of the obese children had an AHI score of greater than three prior to surgery. A year later, 27 percent of the non-obese children and 79 percent of obese children had AHI score of greater than three, indicating that the surgery was significantly more effective at a year in non-obese children.; Source: American Thoracic Society