(016) Adenoidectomy for the Treatment of Pediatric Sleep Disordered Breathing

Introduction: Pediatric obstructive sleep disordered breathing (SDB) due to adenoid and/or palatine tonsil hypertrophy poses significant quality of life (QOL) detriments to patients and their caregivers. QOL studies for SDB have focused primarily on adenotonsillectomy, while QOL changes after adenoidectomy alone for SDB have been infrequently studied. The purpose of this project is to expand upon a previous pilot study to determine whether adenoidectomy alone improves QOL for SDB, and to measure the magnitude of that improvement using validated instruments.

Methods: This is an observational, prospective cohort study with two groups: otherwise healthy pediatric patients who underwent either adenotonsillectomy or adenoidectomy alone from 2/2021 to 10/2022 for SDB in a pediatric ENT practice. The surgery performed was based on clinical assessment of relative tonsil and adenoid size. (Tonsils were removed if ≥ 3+, preserved if ≤ 2+.) Parents completed a validated QOL survey pre and postoperatively at 3, 6 and 12 months. QOL survey analysis is ongoing.

Results: 74 patients were added to a 29-patient pilot study (new total n=103; adenoidectomy alone n=46; adenotonsillectomy n=53). Post-op overall QOL improved significantly in both groups. Adenoidectomy alone saw the same improvement in overall QOL at all follow up time points (p < 0.001) as did adenotonsillectomy, with no statistical difference between the two groups.

Conclusions: Our study indicates that adenoidectomy alone can provide an equal improvement in QOL for pediatric patients with SDB compared to adenotonsillectomy. Pre-op patient selection is crucial in deciding which procedure to perform. With a larger sample size and a longer follow up period, the current study results strongly support our earlier preliminary finding that suggests adenoidectomy alone is a reasonable surgical option for children with SDB for whom palatine tonsils are not enlarged.