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Prevalence of severe obstructive sleep apnea in pediatric adenotonsillectomy patients
Author(s) -
Jiang Nancy,
Muhammad Charise,
Ho Yan,
Del Signore Anthony G.,
Sikora Andrew G.,
Malkin Benjamin D.
Publication year - 2014
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24692
Subject(s) - medicine , polysomnography , tonsillectomy , obstructive sleep apnea , otorhinolaryngology , perioperative , guideline , pediatrics , population , retrospective cohort study , sleep apnea , apnea , surgery , anesthesia , environmental health , pathology
Objectives/Hypothesis To determine the prevalence of severe obstructive sleep apnea (OSA) in a pediatric population who underwent indicated surgery for sleep disordered breathing (SDB). Study Design Retrospective chart review. Methods We reviewed the charts of patients aged 2 to 18 years who underwent tonsillectomy or adenotonsillectomy over a 4‐year period. Indications for preoperative polysomnography (PSG), PSG results, and perioperative complications were recorded. Results Two hundred and thirty‐five patients were included in the final analysis. Of these, 160 patients had preoperative PSG performed. The overall prevalence of severe OSA was 38%. The prevalence in patients for whom preoperative PSG was indicated or for which it should have been advocated according to the American Academy of Otolaryngology—Head and Neck Surgery (AAO‐HNS) clinical practice guideline was 45% and 40%, respectively, whereas the prevalence in patients with no indication for preoperative PSG was 34%. There was no significant difference between groups ( P = 0.39). The overall complication rate was 11%, with the rate being significantly lower ( P = 0.0022) in patients who did not have preoperative PSG performed (0%) when compared to those who did (16%). Conclusions The prevalence of severe OSA in this pediatric population was high. Specifically, a significant percentage of children who would not have received preoperative PSG under the AAO‐HNS recommendations had severe OSA and were consequently admitted for overnight observation. Our results suggest that preoperative PSG should be obtained for all pediatric patients with sleep disordered breathing. Level of Evidence 4. Laryngoscope , 124:1975–1978, 2014