Polysomnographic outcome of adenotonsillectomy for obstructive sleep apnea in children under 5 years old.

Abstract

To determine success rates after adenotonsillectomy for obstructive sleep apnea (OSA); postoperative polysomnogram (PSG) results were compared with preoperative results in children younger than 5 years. Thirty-four children with a preoperative respiratory disturbance index (RDI) greater than 5 in rapid eye movement (REM) sleep underwent both preoperative and postoperative PSG with at least five of seven parameters recorded. Preoperatively, mean total RDI was 15.5, mean REM RDI was 39.6, and 25 (74%) had severe OSA (REM RDI > 20). Postoperatively, mean total RDI improved to 3 (P < 0.001), mean REM RDI to 7.4 (P < 0.001), and 4 remained severe. Overall 22 (65%) showed REM RDI in the normal range (<5), including all with a preoperative REM RDI less than 30. On PSG criteria, most children with OSA significantly improved after adenotonsillectomy, but a number had persisting abnormalities. Postoperative PSG should be considered to identify unresolved OSA.