(343) Obesity, Adenoid Regrowth, and Pediatric Obstructive Sleep Apnea: Treatment Implications

Introduction: The prevalence of pediatric obstructive sleep apnea (OSA) has risen in tandem with the growing prevalence of childhood obesity with marked impacts on behavioral and neurocognitive development. This study examines the role of obesity as a risk factor for adenoid tissue regrowth necessitating revision adenoidectomy for treatment of refractory OSA.

Methods: This retrospective cohort study consists of patients < 18 years with a known diagnosis of OSA and who underwent initial adenoid removal surgeries (adenoidectomy or adenotonsillectomy) between 2012 and 2017 at a tertiary academic practice. Only patients seen in follow-up for a minimum of 2 years post-primary surgery or who underwent a revision surgery were included in further analysis. Data recorded include demographics, comorbidities, and need for additional adenoid removal. Preliminary data were analyzed by Spearman correlation, Pearson’s test, and Wilcoxon’s test with statistical significance set a priori at p< 0.05.

Results: Preliminary results for a subcohort of 230 patients (62% male) who underwent primary surgery between 2012 and 2014 demonstrate adenotonsillar hypertrophy (ATH) as the most common indication for primary surgery (97%). OSA and ATH were the most common indications for second surgery (92%). Non-obese patients were 4.94 +/- 2.49 years at the time of second surgery, and obese patients were 7.56 +/- 3.82 (p < 0.001). Continued analysis of the full cohort will focus on more fully understanding the impact of obesity on the need for revision adenoidectomy.

Conclusions: Preliminary study results suggest pediatric patients with obesity require revision adenoidectomy at an older age than non-obese children. Investigating the etiology of this difference may inform future treatment protocols for OSA and adenoid hypertrophy in this population.