Updated systematic review of tonsillectomy and adenoidectomy for treatment of pediatric obstructive sleep apnea/hypopnea syndrome
Abstract
OBJECTIVE: Perform an updated systematic review and meta-analysis to determine the cure rate of tonsillectomy and adenoidectomy (T&A) for pediatric obstructive sleep apnea/hypopnea syndrome (OSAHS). METHODS: A systematic review was performed to identify English-language studies that evaluate the treatment of pediatric (age < 20 years) OSAHS patients with T&A using polysomnography as a metric of cure. Twenty-three studies fit the inclusion criteria and a meta-analysis was performed to determine the overall success. Meta-analysis was also performed to determine the success in obese and comorbid populations vs cohorts of healthy children. RESULTS: The meta-analysis included 1079 subjects (mean sample size of 42 patients) with a mean age of 6.5 years. The effect measure was the percentage of pediatric patients with OSAHS who were successfully treated (k = 22 studies) with T&A based on preoperative and postoperative PSG data. Random-effects model estimated the treatment success of T&A was 66.3 percent, when cure was defined per each individual study. When "cure" was defined as an apnea-hypopnea index (AHI) of <1 (k = 9 studies), random-effects model estimate for OSAHS treatment success with T&A was 59.8 percent. Postoperative mean AHI was significantly decreased from preoperative levels. CONCLUSIONS: Contrary to popular belief, meta-analysis of current literature demonstrates that pediatric sleep apnea is often not cured by T&A. Although complete resolution is not achieved in most cases, T&A still offers significant improvements in AHI, making it a valuable first-line treatment for pediatric OSAHS.
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Adenotonsillectomy is curative in 25% to 75% of pediatric obstructive sleep apnea patients.
“However, some studies 8 9 10 have reported that adenotonsillectomy is curative in 25% to 75% of the patients.”
From Mandibular Advancement Appliances in Pediatric Obstructive Sleep Apnea: An Umbrella Review (2023) · cites this paper as [9]
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- Authors
- Friedman, M., Wilson, M., Lin, H., & Chang, H.
- Affiliations
- Rush University Medical Center (US)
- Advocate Illinois Masonic Medical Center (US)
- Chang Gung University (TW)
- National Sun Yat-sen University (TW)
- Corresponding author
- Friedman, Michael
- Venue
- Otolaryngology–Head and Neck Surgery
- Publisher
- Wiley
- Published
- 2009-06
- Volume
- 140
- Issue
- 6
- Pages
- 800-808
- ISSN
- 0161-6439 (ISSN-L)
- 0194-5998
- 1097-6817
- OpenAlex
- W2022573597
- Cited by
- 465
- References
- 41
- Citations by year
- 2026: 15 · 2025: 13 · 2024: 19 · 2023: 33 · 2022: 23 · 2021: 34 · 2020: 35 · 2019: 34 · 2018: 28 · 2017: 26 · 2016: 40 · 2015: 36 · 2014: 35 · 2013: 30 · 2012: 32
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Otolaryngology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Keywords
- adenotonsillectomy, surgical cure rate, apnea-hypopnea index, polysomnography, childhood obesity, first-line therapy
- MeSH terms
- Adenoidectomy, Child, Humans, Obesity, Tonsillectomy, Models, Statistical, Comorbidity, Polysomnography, Evidence-Based Medicine, Sleep Apnea, Obstructive
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