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Outcome of adenotonsillectomy in children with Down syndrome and obstructive sleep apnoea
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Objective: To evaluate the outcome of adenotonsillectomy (AT) in a cohort of children with Down syndrome (DS) and obstructive sleep apnoea (OSA). Design: Retrospective, cross-sectional study. Setting: Tertiary care centre. Patients: Children with DS and OSA, without previous upper airway (UA) surgery. Interventions: AT and full overnight polysomnography. Main outcome results: A significant improvement of the obstructive apnoea-hypopnoea index (oAHI) after AT was obtained. No differences in sleep efficiency or sleep fragmentation were found postoperatively. Almost half of the children had persistent OSA (oAHI ≥5/hour). Results: Data are presented as median (lower–upper quartile). Thirty-four children were included, median age 4.0 years (2.7–5.8), body mass index (BMI) z-score 0.81 (−0.46–1.76), and oAHI 11.4/hour (6.5–22.7). The majority presented with severe OSA (58.9%). AT was performed in 22 children, tonsillectomy in 10 and adenoidectomy in two. Postoperatively, a significant improvement of the oAHI was measured from 11.4/hour (6.5–22.7) to 3.6/hour (2.1–9.5) (p=0.001), with a parallel increase of the minimum oxygen saturation (p=0.008). Children with initially more severe OSA had significantly more improvement after UA surgery (p=0.001). Persistent OSA was found in 47.1% of the children. Conclusions: AT results in a significant improvement of OSA in children with DS without a change in sleep efficiency or sleep stage distribution. Severe OSA was associated with a larger reduction of OSA severity. Almost half of the children had persistent OSA, which was not correlated to age, gender or BMI z-score.
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Persistent OSA after adenotonsillectomy has been reported in children with severe OSA, obesity, Down syndrome, craniofacial, genetic, and neuromuscular disorders.
“This study2116 and several others have reported persistent OSA after T&A in children with severe OSA, obesity, Down syndrome, craniofacial, genetic, and neuromuscular disorders.2117,2119”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [2119]
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Metadata
- Authors
- Maris, M., Verhulst, S., Wojciechowski, M., Van de Heyning, P., & Boudewyns, A.
- Affiliations
- University of Antwerp (BE)
- Corresponding author
- Boudewyns, An
- Venue
- Archives of Disease in Childhood
- Publisher
- BMJ
- Published
- 2016-08-02
- Volume
- 102
- Issue
- 4
- Pages
- 331-336
- ISSN
- 0003-9888 (ISSN-L)
- 1468-2044
- OpenAlex
- W2480922264
- Semantic Scholar
- 96c6489cc08001a342ffff17b242d258677e951d
- Cited by
- 65
- References
- 32
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 5 · 2023: 9 · 2022: 9 · 2021: 8 · 2020: 7 · 2019: 2 · 2018: 7 · 2017: 9
- FWCI
- 4.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Disease in Childhood (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Fonds Wetenschappelijk Onderzoek (1842113N)
- Vlaamse regering
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- adenotonsillectomy, Down syndrome, obstructive sleep apnea, children, apnea-hypopnea index, upper airway surgery, sleep efficiency, oxygen saturation, tonsillectomy, adenoidectomy
- MeSH terms
- Adenoidectomy, Child, Child, Preschool, Chronic Disease, Cross-Sectional Studies, Down Syndrome, Female, Humans, Male, Postoperative Care, Preoperative Care, Retrospective Studies, Tonsillectomy, Treatment Outcome, Polysomnography, Sleep Apnea, Obstructive
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