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Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children
Author(s) -
Imanguli Matin,
Ulualp Seckin O.
Publication year - 2016
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.25979
Subject(s) - medicine , obstructive sleep apnea , polysomnography , adenoid , pediatrics , craniofacial , obesity , body mass index , apnea–hypopnea index , apnea , sleep apnea , surgery , psychiatry
Objectives/Hypothesis To determine the prevalence of residual obstructive sleep apnea (OSA) in children who had adenotonsillectomy (AT) and to identify the risk factors for residual OSA after AT. Study Design Retrospective chart review. Methods Children with OSA who had AT at a tertiary care children's hospital were reviewed. Data pertaining to demographics, past medical history, body mass index, tonsil and adenoid size, and polysomnography were obtained. Residual OSA was defined as apnea hypopnea index (AHI) greater than 2. The rate of residual OSA and risk factors for residual OSA were assessed. Results One hundred sixty‐nine children with OSA underwent polysomnography before and after AT. The prevalence of residual OSA was 38%. The prevalence of residual OSA in obese patients (49%) was higher than that of nonobese patients (27%) ( P = .02). Patients with neurological/developmental/craniofacial abnormalities had higher prevalence of residual OSA (44%) than patients without comorbidities (33%) ( P < .05). The prevalence of residual OSA in patients with severe OSA (42%) was higher than patients with moderate (29%) or mild OSA (0%) ( P = .03). Teenage patients (67%) had a higher prevalence of residual OSA than toddlers (27%), preschooler (33%), and middle childhood groups (29%) ( P = .03). Conclusions The majority of children had improvement in OSA after AT. The choice of AHI threshold used to define residual OSA influenced the prevalence of residual OSA. Teenagers and children with obesity, comorbidities including neurological/developmental/craniofacial abnormalities alone or in combination with asthma, or severe OSA have a high risk of residual OSA. Level of Evidence 4 Laryngoscope , 126:2624–2629, 2016