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Polysomnographic outcomes of revision adenoidectomy in children with obstructive sleep apnea and recurrent/residual adenoidal hypertrophy

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Abstract

Introduction

Recurrent/residual adenoidal hypertrophy after adenotonsillectomy in children can result in obstructive sleep apnea (OSA). We aimed to assess the polysomnographic (PSG) outcomes of revision adenoidectomy in children with recurrent/residual adenoidal hypertrophy and OSA.

Methods

This was a single-center retrospective study that included children with sleep studies that confirmed OSA and known history of adenotonsillectomy who were diagnosed with adenoidal hypertrophy and subsequently underwent revision adenoidectomy. Pre- and postoperative PSG variables of revision adenoidectomy were included in the analysis.

Results

A total of 20 children were included in the study. The cohort included 13 males and 7 females with a mean age of 7.8 years (± 3.6 years). The mean BMI z score was 1.96 [1.31, 2.43]. The median duration from adenotonsillectomy performance was 2.3 years [1.4, 4.0]. Overall, revision adenoidectomy resulted in significant improvements in multiple respiratory parameters, including AHI 6.6 [1.4, 13. 7] vs 14.8 [7.4, 20.7], p = 0.02; oxygen desaturations nadir 88.0 [84.0, 93.0] vs 80.0 [72.2, 88.9], p = 0.01; supine AHI 8.6 [1.5, 14.3] vs 17.6 [8.3, 30.2], p = 0.02; and arousal index 12.2 [9.6, 15.7] vs 18.9 [13.4, 24.9], p = 0.04.

Conclusions

Children with recurrent/residual adenoidal hypertrophy after adenotonsillectomy who undergo revision adenoidectomy experience improvements in respiratory event, gas exchange, and arousal index.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

AASM:

American Academy of Sleep Medicine

AHI:

Apnea hypopnea index

BMI:

Body mass index

CAI:

Central apnea index

EEG:

Electroencephalogram

EKG:

Electrocardiogram

ENT:

Ear nose and throat

GERD:

Gastroesophageal reflux disorder

OSA:

Obstructive sleep apnea

PAP:

Positive airway pressure

PSG:

Polysomnogram

REM:

Rapid eye movements

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Acknowledgements

The authors would like to thank Andrea Shewmaker for supporting some of the data collection for this study.

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Authors and Affiliations

  1. Department of Pediatrics, University of Louisville and Norton Children Medical Group, 9880 Angies Way Suite, Louisville, KY, 300, USA

    Egambaram Senthilvel

  2. Norton Children’s Research Institute, affiliated with University of Louisville School of Medicine, Louisville, KY, USA

    Yana B Feygin

  3. Division of Pulmonary Critical Care and Sleep Medicine, Department of Medicine, University of Louisville, Louisville, KY, 40241, USA

    Quang L Nguyen

  4. Division of Pulmonary Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA

    Karim El-Kersh

Authors
  1. Egambaram Senthilvel
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  2. Yana B Feygin
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  3. Quang L Nguyen
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  4. Karim El-Kersh
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Quang L Nguyen. Data were analyzed by Yana B Feygin. The first draft of the manuscript was written by Egambaram Senthilvel. All authors read, edited, and approved the final manuscript.

Corresponding author

Correspondence to Egambaram Senthilvel.

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Ethics approval

This retrospective chart review study involving human participant were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of the University of Louisville and Norton Healthcare approved this study.

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For this type of study, formal consent is not required.

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The authors declare no competing interests.

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Senthilvel, E., Feygin, Y.B., Nguyen, Q.L. et al. Polysomnographic outcomes of revision adenoidectomy in children with obstructive sleep apnea and recurrent/residual adenoidal hypertrophy. Sleep Breath 28, 887–893 (2024). https://doi.org/10.1007/s11325-023-02951-9

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