Adenotonsillectomy for Obstructive Sleep Apnea Syndrome in Young Children

Abstract

To determine, in a series of children younger than 6 years undergoing adenotonsillectomy for treatment of clinical obstructive sleep apnea syndrome (OSAS), the effect of age on prevalence of postoperative respiratory complications. The primary objective was to define a practice standard for postoperative hospital admission.

Pre-operative overnight pulse oximetry to predict high dependency unit intervention in children undergoing adenotonsillectomy for obstructive sleep apnoea

“…In our study, 26 per cent of patients experienced significant desaturations in the post-operative period. This is in keeping with the literature, where quoted figures range from 6.4 per cent 8 to 27 per cent 9 . Our figure is at the higher end of this range, and this may reflect the fact that our institution is a tertiary referral centre treating higher risk cases.…”

Review of the Utility of Extended Recovery Room Observation after Adenotonsillectomy

“…Some of the most cited risk factors include age younger than 2-3 years old, severe OSA, craniofacial abnormalities, extremes of weight, black race, and cardiac, pulmonary, or neuromuscular diseases. [1][2][3][4][6][7][8]16,17 However, similar to our findings, respiratory compromise is unlikely even among these high-risk patients. [2][3][4][5][6][7][8][9][10] Previous studies suggested that most postoperative respiratory complications occur within a few hours of surgery.…”

“…[1][2][3][4][6][7][8]16,17 However, similar to our findings, respiratory compromise is unlikely even among these high-risk patients. [2][3][4][5][6][7][8][9][10] Previous studies suggested that most postoperative respiratory complications occur within a few hours of surgery. 3,8,13 Friedman et al conducted a prospective study aimed at identifying high-risk patients who require overnight admission after T/AT, and proposed that a child with no known preexisting oxygen requirements who is off oxygen 3 h after surgery can be safely discharged home regardless of baseline comorbidities and severity of AHI.…”

“…Numerous studies investigated the preoperative risk factors that are associated with postoperative respiratory distress to accurately identify patients at risk. Some of the most cited risk factors include age younger than 2–3 years old, severe OSA, craniofacial abnormalities, extremes of weight, black race, and cardiac, pulmonary, or neuromuscular diseases 1–4,6–8,16,17 . However, similar to our findings, respiratory compromise is unlikely even among these high‐risk patients 2–10 .…”

The use of medical treatment to optimise respiratory function prior to adenotonsillectomy for sleep disordered breathing in the under 3 age group: Our experience in one hundred and forty two children

“…However, our results compare favourably with published respiratory complication rates following surgery for sleep disordered breathing in which preoperative steroids and antibiotics are not given (Fig. ) 3,9,10 . Statham et al.…”