Older Age, Obesity Risk Factors for Residual OSA in Children

by Samara E. Kuehne •

What is the prevalence of residual obstructive sleep apnea (OSA) in children undergoing adenotonsillectomy (AT), and what are the risk factors for the condition?

BOTTOM LINE
The majority of children had improvement in OSA after AT. Teenagers, children with obesity or neurological disorder/developmental disability/craniofacial abnormalities, and severe OSA have a high risk of residual OSA.

Background: A wide variety of factors including an age younger than 3 years age or older than 7 years,

Setting: Tertiary care children’s hospital.

Method: Children with OSA who had AT were reviewed. Data pertaining to demographics, past medical history, body mass index, tonsil and adenoid size, and polysomnography were obtained. Residual OSA was defined as AHI greater than 2.

Synopsis: One hundred sixty-nine children with OSA underwent polysomnography before and after AT. The prevalence of residual OSA was 38%. The prevalence of residual OSA in obese patients (49%) was higher than that of nonobese patients (27%). Patients with neurological/developmental/craniofacial abnormalities had higher prevalence of residual OSA (44%) than in patients without comorbidities (33%). The prevalence of residual OSA in patients with severe OSA (42%) was higher than patients with moderate (29%) or mild OSA (0%). Teenage patients (67%) had a higher prevalence of residual OSA than toddlers (27%), preschoolers (33%), and middle childhood groups (29%).

Citation: Imanguli M, Ulualp SO. Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children. Laryngoscope. 2016;126:2624–2629.