Adenotonsillectomy is the most frequently performed surgery in children, in excess of 19 per 10000 in Canada at 115 per 10000 in the Netherlands. In the United States, the rate is about 50 per 10,000. It is the first line of the SDS for the treatment of children. For many children, in this major surgery provides only temporary relief.
"The high rate of recurrence, we observed in both obese and non-obese children pointed out that it is a chronic condition SDB," said Raouf Amin, MD, head of pulmonary medicine in the hospital.
The results were published in the second issue for March of the American Journal of Respiratory and Critical Care Medicine , published by the American Thoracic Society.
The researchers recruited 40 healthy children aged between seven and 13, whose parents and otolaryngologists had jointly agreed adenotonsillectomy surgery for the treatment of nocturnal snoring. The investigators also recruited 30-gender and age-matched children who are not in adenotonsillectomy as a control group. They were polysomnographies on each child at the time of hiring, and then again at six weeks, six months and one year after the operation. Children in the control group had polysomnographies at the same intervals.
While the majority of children with SDB showed significant improvement in their scores AHI six weeks after the surgery, the rate of relapse a year later had no correlation with the six-week score. Children who relapsed were more obese tend to have worse SDB as a starting value, have a fast body mass index (BMI) and to win African-Americans.
"Most post adenotonsillectomy outcome studies have focused on the evaluation of the SDB six to 16 weeks after the surgery. Dissolution of the SDB in this window in the rule as a cure for the disease," remarked Dr. Amin. "We report [ed] for the first time the results of the longitudinal adenotonsillectomy in healthy children, the important influence of BMI gain speed and Afro-American race on repeating the SDB."
Half of the non-obese children, and two-thirds of obese children had an AHI score of more than 3 prior to the operation. A year later, 27 percent of non-obese children and 79 percent of overweight children had AHI score of more than 3, indicating that the operation was significantly more effective to a year in non-obese children.
While the obese children were involved in the baseline were more likely relapse than their peers in non-obese, accelerated win BMI was an independent risk factor for relapse.
"These results underline the differential between the mechanisms disease due to obesity and the result of rapid change in the composition, with body accelerates BMI gain," explains Dr. Amin.
Also had relapsed children, the significantly higher blood pressure at follow-up, as children do not.
"SDB appears to be a chronic disorder that is clearly in the context of other medical problems. View of the speed, the reverse case, we encourage long-term follow-up of children with SDB, the monitoring of BMI win, and reassessment of the children, showing rapid BMI gain, above all those who are African-American, "the researchers concluded.
American Thoracic Society (ATS)
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