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Adenotonsillectomy and obstructive sleep apnea in children: a prospective survey.

Guilleminault, Christian; Huang, Yu-shu; Glamann, Christine; Li, Kasey; Chan, Allison.
Otolaryngol Head Neck Surg; 136(2): 169-75, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17275534

OBJECTIVE:

Prospective survey of children up to 14 years of age with OSA submitted to adenotonsillectomy.

METHODS:

Clinical evaluation, with questionnaires and clinical scales evaluating facial structures including tonsils and Mallampati scales and otolaryngologic evaluation; nocturnal polysomnography and repeat evaluation three to five months postsurgery.

RESULTS:

Of 207 successively seen children, 199 had follow-up polysomnography, and 94 had still abnormal sleep recording. Multivariate analysis indicates that Mallampati scale score 3 and 4, retro-position of mandible, enlargement of nasal inferior turbinates at +3 (subjective scale 1 to 3), and deviated septum were significantly associated with persistence of abnormal polysomnography (with high 95% CI for Mallampati scale and deviated septum).

CONCLUSION:

Mallampati scale scores are resultant of several facial factors involving maxilla, mandible, and oral versus oral breathing but add information on risk of partial response to adenotonsillectomy.

SIGNIFICANCE:

Adenotonsillectomy may not resolve obstructive sleep apnea in children.