Surgical management of obstructive sleep apnea in infants and young toddlers

Joseph S. Brigance, R. Christopher Miyamoto, Peter Schilt, Derek Houston, Jennifer L. Wiebke, Deborah Givan, Bruce H. Matt

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Objective: Review surgical management of obstructive sleep apnea (OSA) in infants and young toddlers compared with a medically treated group. Study Design: Case series with chart review of children younger than 24 months treated at a tertiary pediatric hospital between 2000 and 2005. Subjects and Methods: Surgical treatment included adenotonsillectomy, adenoidectomy, and tonsillectomy. Polysomnography results, comorbidities, and major complications were recorded. The change in apnea-hypopnea index (AHI) before and after treatment was analyzed. Logistic regression analysis reviewed effects of comorbidities and OSA severity on complications. Results: A total of 73 children met inclusion criteria. The surgical treatment group (AHI) improved posttreatment: mean AHI change was 9.6 (95% CI, 5.8-13.4). The medical treatment group did not improve posttreatment: mean AHI change was -3.0 (95% CI, -15.1 to 9.1). The difference in AHI change between surgical and medical groups was 12.56 (95% CI, 2.7-22.4). An independent t test found this difference to be statistically significant (P = 0.01). Eleven (18%) patients suffered significant postoperative surgical complications; 55 surgical patients and 8 medical patients had comorbidities. There were no long-term morbidities or mortalities. Conclusions: AHI in the surgically treated group significantly improved. The complication rate for a tertiary pediatric hospital population that included patients with multiple comorbidities was acceptable.

Original languageEnglish (US)
Pages (from-to)912-916
Number of pages5
JournalOtolaryngology - Head and Neck Surgery
Volume140
Issue number6
DOIs
StatePublished - Jun 1 2009

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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