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Follow-up of children with obstructive sleep apnea syndrome treated with adenotonsillectomy

Filomena Ianniello, Danila D'Onofrio, Maria Chiara Paolino, Rosa Castaldo, Alceo Crescenzi, Alessandra Tabarrini, Silvia Miano, Marco Del Pozzo, Maria Pia Villa
European Respiratory Journal 2011 38: p2195; DOI:
Filomena Ianniello
NESMOS Department, Pediatric Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, University la Sapienza, Rome, Italy
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Danila D'Onofrio
NESMOS Department, Pediatric Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, University la Sapienza, Rome, Italy
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Maria Chiara Paolino
NESMOS Department, Pediatric Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, University la Sapienza, Rome, Italy
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Rosa Castaldo
NESMOS Department, Pediatric Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, University la Sapienza, Rome, Italy
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Alceo Crescenzi
NESMOS Department, Pediatric Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, University la Sapienza, Rome, Italy
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Alessandra Tabarrini
NESMOS Department, Pediatric Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, University la Sapienza, Rome, Italy
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Silvia Miano
NESMOS Department, Pediatric Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, University la Sapienza, Rome, Italy
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Marco Del Pozzo
NESMOS Department, Pediatric Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, University la Sapienza, Rome, Italy
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Maria Pia Villa
NESMOS Department, Pediatric Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, University la Sapienza, Rome, Italy
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Abstract

Background: Hypertrophy of adenotonsillar tissue is an undisputed contributor to the development of OSAS in otherwise healthy children. A multicenter retrospective study shows the surgery approach has a resolution rate of about 27%. So it will be important to identify children who will not resolve OSAS after adenotonsillectomy (AT) in order to plan an appropriate and integrated treatment for them.

Aim: To evaluate the role of AT in the outcome of children with OSAS.

Methods: Children affected by adenotonsillar hypertrophy, who underwent adenotonsillectomy for moderate-severe OSAS, were enrolled, from 2008 to 2009. All children underwent a complete clinical examination and overnight polysomnographic study before AT and after 12 months of follow-up.

Results: We included 21 children (mean age 4.09±1.76; M/F 17/4), with a mean body mass index –BMI- of 15.86±2.4 kg/m2, with a mean apnea hyponea index (AHI) of 15.08±8.8 ev/hr. Twelve children (57.1%) had malocclusions. After one year, 13 children showed a complete resolution of disease (61.9%) (AHI 0.3±0.3 ev/hr), while 8 children (38.1%) had a residual disease (AHI 2.6±1.1 ev/hr). Children with a residual disease had a higher BMI at baseline (16.5±3.7kg/m2 vs 15.4±1.1 kg/m2, p<0.05) and a higher prevalence of malocclusions compared to those with a complete resolution (7/8, vs 5/13, X2=4.86, p<0.05). Stepwise multiple linear regression analysis identify malocclusion as the most important variable influencing the outcome (R2=0.24).

Conclusions: Although AT is the gold standard in children with OSAS and adenotonsillar hypertrophy, treatment of malocclusions need to be added to achieve a complete resolution of the disease.

  • © 2011 ERS
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Follow-up of children with obstructive sleep apnea syndrome treated with adenotonsillectomy
Filomena Ianniello, Danila D'Onofrio, Maria Chiara Paolino, Rosa Castaldo, Alceo Crescenzi, Alessandra Tabarrini, Silvia Miano, Marco Del Pozzo, Maria Pia Villa
European Respiratory Journal Sep 2011, 38 (Suppl 55) p2195;

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Follow-up of children with obstructive sleep apnea syndrome treated with adenotonsillectomy
Filomena Ianniello, Danila D'Onofrio, Maria Chiara Paolino, Rosa Castaldo, Alceo Crescenzi, Alessandra Tabarrini, Silvia Miano, Marco Del Pozzo, Maria Pia Villa
European Respiratory Journal Sep 2011, 38 (Suppl 55) p2195;
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