Evaluation of treatment outcome after adenotonsillectomy in children with adenotonsillar hypertrophy and obstructive sleep disordered breating

Abstract

Background: newlineObstructive sleep apnea (OSA) is a sleep disorder marked by prolonged partial upper airway blockage or intermittent complete obstruction, disrupting breathing and normal sleep patterns. This study aimed to assess the efficacy of adenotonsillectomy as a treatment for obstructive sleep apnea in children exhibiting adenotonsillar hypertrophy. Additionally, the research sought to evaluate the impact of the procedure on cardiac and pulmonary parameters. newlineMethods: newlineThis prospective study was conducted in the department of Otorhinolaryngology at Chettinad Hospital and Research Institute, Kelambakkam, for 18 months. Sixty children with adenotonsillar hypertrophy having symptoms of OSA were selected for the study. Children between 5 to 16 years with adenotonsillar hypertrophy have symptoms of obstructive sleep apnea, such as snoring, mouth breathing, cognitive impairment, daytime sleepiness, nocturnal enuresis, and obese children are included in the study. In addition, children below five years and above 16 years, newlineResults: newlineAmong the participants, 55% (33) were males, and 45% (27) were females. According to the adenoid examination, we have observed that 26.7% (16) patients had newline1/3 to 2/3 of choana blockade (grade II), 66.7% (40) of participants had to grade more than 2/3 of choana blockade (grade III), and 6.7% (4) had completely blocked choana (grade IV). 19 (100%) cases of moderate and 31(91.2%) cases of severe pre-operative have shifted to mild OSA score after surgery, while 3 (5%) severe operative case OSA score shifted to the moderate category after surgery. So, these shifting are significant (plt0.0001). There were 40 cases of more than 2/3 of choana, 14 of which had a moderate OSA score and 23 of which had a severe OSA score. Following surgery, the OSA score of 14 moderate cases became mild. On the other hand, 21 severe cases returned to mild, while 2 cases became moderate. The differences were highly significant (p lt 0.0001). There was a total of 4 severe cases of adenoids completely blocking choana. Following Surgery OSA of 3 severe cases improved to the mild range, and one case became normal. The differences were significant. newlineConclusion: newlineWe conclude the cases of severe and moderate PSG values have a significantly better quality of life following adenotonsillectomy with an improved score. Thus, we infer that adenotonsillectomy plays surgical management. However, because this study was conducted on a small sample size, a larger population-based study is required to validate the findings further. newlineKeywords: Obstructive sleep apnea, Adenotonsillectomy, Oropharyngeal, Adenotonsillar hypertrophy. newline