Is it necessary to perform a follow-up study after adenotonsillectomy in all children with moderate-severe obstructive sleep apnoea?

Autor: Del-Río Camacho G; Servicio de Pediatría, Hospital Universitario Fundación Jiménez Díaz, Madrid, España; Unidad Multidisciplinar de Sueño, Hospital Universitario Fundación Jiménez Díaz, Madrid, España. Electronic address: vevirio@hotmail.com., Torre Francisco R; Servicio de Pediatría, Hospital Universitario Fundación Jiménez Díaz, Madrid, España., Rodríguez Catalán J; Servicio de Pediatría, Hospital Universitario Fundación Jiménez Díaz, Madrid, España., Sanabria Brossart J; Servicio ORL, Hospital Universitario Fundación Jiménez Díaz, Madrid, España; Unidad Multidisciplinar de Sueño, Hospital Universitario Fundación Jiménez Díaz, Madrid, España., López Gómez R; Servicio de Pediatría, Hospital Universitario Fundación Jiménez Díaz, Madrid, España., Troncoso Acevedo F; Unidad Multidisciplinar de Sueño, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
Jazyk: English; Spanish; Castilian
Zdroj: Acta otorrinolaringologica espanola [Acta Otorrinolaringol Esp (Engl Ed)] 2021 Aug 27. Date of Electronic Publication: 2021 Aug 27.
DOI: 10.1016/j.otorri.2021.06.002
Abstrakt: Hypertrophy of adenotonsillar tissue is the most common cause of OSAS in otherwise healthy children, and therefore adenotonsillectomy is the first line treatment. Scientific societies recommend nocturnal follow-up PSG to assess for residual OSAS in children with preoperative evidence for moderate to severe OSAS, obesity, craniofacial anomalies that obstruct the upper airway and neurological disorders, based on the increasing trend of publications reporting residual OSAS after adenotonsillectomy. Follow-up PSG values in children with a pre-operative diagnosis of severe OSAS were analysed retrospectively, and compared to the parents' impression after ENT surgery. The study population included 41 healthy children with severe OSAS and adenotonsillar surgery. The percentage of children with normal PSG parameters (AHI <2/h) after adenotonsillectomy was 80.48%. A very good correlation was observed between the parents' perception after treatment and the follow-up PSG parameters, specifically when the parents perceived that the patient had shown «complete resolution» (no snoring or apnoea), 90.62% of the children had an AHI <2/h in the follow-up PSG, the maximum residual AHI being 2.6/h. In healthy children with no underlying pathology, the information provided by the parents on clinical progression after surgery could be useful and might enable the selection of those patients who require a follow-up study, avoiding overload in sleep units.
(Copyright © 2021 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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