Adenotonsillectomy for obstructive sleep-disordered breathing in childhood: The Chania community oximetry-based study

Polysomnography is the gold standard for evaluating the efficacy of adenotonsillectomy (AT) in children with obstructive sleep-disordered breathing (SDB), but it is not available in all settings. We hypothesized that AT is associated with reduction in the proportion of children with oxygenation abnormalities in nocturnal oximetry (Ox). Methods: 4-10 year-old children with SDB (snoring >3 nights/week) and tonsillar size >2+ were randomized to AT immediately after recruitment (AT group) or to observation (no AT group). The AT group had Ox preoperatively and 3 months postoperatively; the no AT group had Ox upon recruitment and 3 months later. Main outcomes were: i) change in proportion of children with McGill oximetry score =1 (normal); ii) proportion of subjects who achieved a desaturation index-ODI (≥3% SpO 2 drop) of Results: Preliminary analysis of data from the first 161 participants is presented . Pairs of Ox with quality recordings were obtained in 114 subjects (AT group: n=57; no AT group: n=57). The frequency of normal McGill score increased from 68.4% in the first Ox (pre-op) to 89.5% in the second Ox (post-op) in the AT group and from 75.4% to 84.2% in the no AT group (P>0.05). In the initial Ox, 52.6% of children in the AT group (pre-op) and 49.1% in the no AT group had ODI ≥3.5/h. In the follow-up Ox, the abnormal ODI normalized ( Conclusion: ODI ≥3.5/h is a satisfactory measure of the efficacy of AT as treatment for SDB.