Objectives: Adenoid vegetation and palatine tonsil hypertrophy mainly cause sleep disordered-breathing (SDB) in children. Pediatric SDB is highly improved by adenotonsillectomy. We studied the outcome of adenotonsillecomy using the pre and post-surgery polysomnography (PSG).
Methods: An adenotonsillectomy was carried out on a total of 39 children with SDB from February 2009 to September 2012. All patients were under 12 years of age at surgery. In accordance with the AASM2007 scoring manual, the obstructive apnea-hypopnea index (OAHI), cummulative percentage at an SpO₂ below 90% (CT90%) and Lowest SpO₂ (Low-SpO₂) were measured, and the outcome of adenotonsillectomy was determined by comparison of the preoperative and postoperative results of PSG.
Result : The average value of OAHI was preoperatively 22.5±2.63/h, and postoperatively 1.3±0.17/h. There were 17 cases of “healed”, 21 cases of “improved”, and 1 case of “exacerbated”. Over 90% of children with SDB were healed or improved by adenotonsillectomy. However, adenoid regrowth caused a recurrence of SDB in one case, in which adenoidectomy was performed again one year after adnotonsillectomy. PSG after the second surgery showed “healed”.
Conclusions : It was thought that adenotonsillectomy for children with SDB could mostly improve the breathing during sleep with the exclusion of maxillofacial anomalies and obesity. However, adenoid re-growth could occur in some of children with SDB after adenoidectomy. The follow-up of one year after surgery should be considered.