According to study results published online in JAMA Otolaryngol Head Neck Surg., Nearly one in five toddlers undergoing adenotonsillectomy as a therapy for OSA still had significant symptoms afterward the procedure. 

To conduct the study, lead researcher Fuad Baroody, MD and colleagues at the University of Chicago reviewed the medical records at a tertiary academic children’s hospital involving children younger than three years who had OSA documented by polysomnogram (PSG) and underwent T&A during the period October 1, 2002, through June 30, 2010. Some of these children had both preoperative and postoperative PSGs.

A total of 283 patients took part in the study. Of those, 70 children younger than three who had the procedure as well as pre- and post-operative polysomnography studies, 15 had apnea-hypopnea index (AHI) scores greater than 5 at the later evaluation, indicating moderate to severe residual sleep apnea, according to Fuad Baroody, MD and colleagues at the University of Chicago.

The study also found that the majority of children showed marked improvement in sleep apnea symptoms, with 30% of the children showing no symptoms at the post-operative evaluation and 49% having only mild residual sleep apnea.

“The most consistent predictor of residual OSA after adenotonsillectomy was the severity of pre-operative OSA,” Baroody and colleagues wrote in a released statement. Among children who had moderate to severe residual apnea, the pre-operative mean AHI score was 55 (SD 50), compared with 29 (SD 36, P=0.02) in those with no or mild post-operative symptoms.

Factors such as obesity and arterial oxygen saturation at baseline were not predictive of residual symptoms, the researchers found.