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Pediatric Otolaryngology

Age-Related Differences for Children Undergoing Adenotonsillectomy for Very Severe OSA

Sunday, October 1, 2023
1:54 PM - 2:00 PM East Coast USA Time
Location: 207CD

    Presenting Author(s)

  • Jonathan R. Korpon, MD

    Resident
    University of Texas Southwestern Medical Center, Department of Otolaryngology
    Dallas, TX, United States

    • Co-Author(s)

  • Helene Dabbous, MD

    Fellow
    University of Texas Southwestern Medical Center, Department of Otolaryngology
    Dallas, TX, United States

  • RM

    Ron B. Mitchell, MD

    Vice-Chairman, Professor
    University of Texas Southwestern Medical Center, Department of Otolaryngology
    Dallas, Texas, United States

  • Romaine F. Johnson, MD, MPH

    Professor
    Univ of Texas Southwestern Med Ctr
    DALLAS, TX, United States

  • Stephen R. Chorney, MD, MPH

    Assistant Professor, Department of Otolaryngology - Head & Neck Surgery
    University of Texas Southwestern Medical Center
    Dallas, TX, United States

    • Senior Author(s)

  • Yann-Fuu Kou, MD

    Assistant Professor
    University of Texas Southwestern Medical Center, Department of Otolaryngology
    Dallas, TX, United States

Disclosure(s):
Jonathan R. Korpon, MD: No relevant relationships to disclose.
Ron B. Mitchell, MD: No relevant relationships to disclose.
Romaine F. Johnson, MD, MPH: No relevant relationships to disclose.
Introduction: Children with very severe obstructive sleep apnea (OSA) have been previously poorly characterized. Our objective is to compare age-related differences in children undergoing adenotonsillectomy (T&A) for very severe OSA

Methods: Retrospective review of children age < 18 with polysomnogram (PSG)-confirmed OSA from 2020-2021. Very severe OSA was defined as an AHI > 30. Demographic data, post-operative complications and post-operative PSG parameters were analyzed. Patients who did not undergo T&A or a follow-up PSG were excluded.

Results: A total of 102 children with very severe OSA were included. Sixty-one (60%) were male, forty-one (40%) female. Thirty-six (36%) were African-American, thirty-four (33%) Hispanic , twenty-six (26%) were Caucasian, and six were of other ethnicity. Twelve (12%) were aged 0-2, 37(36%) were aged 2-5, 31 (30%) were aged 5-12, and 22 (22%) were aged 12-18. There were higher rates of neuromuscular disease (42%, p=0.007) and craniofacial disease (25%, p=0.05) in the 0–2 year-old group. There was a higher BMI z-score in children age 12-18 compared to age 2-5 (3.1 vs 0.6, p < 0.001). The length of hospital stay was higher in children age 0-2 compared to 12-18 (2.1 vs 1.0, p=0.03). Children ages 2-5 years had the largest reduction in AHI post-T&A and 1-2 year olds saw the least (80.1 vs 37.1% p=0.15). Those aged 5-12 had a 55.2% reduction and those aged 13-18 experienced a 69.9% reduction in AHI. Using the definition of AHI < 5 as a criteria for cure, children ages 2-5 years had the highest rate of post-T&A AHI < 5 and children 0-2 the lowest (76% vs 42%, p=0.06).

Conclusions: Amongst children with very severe OSA, the majority were male. African-American and Hispanic children made up the majority of our cohort. Younger kids tended to have higher rates of neuromuscular and craniofacial disease. Older kids tended to be more obese. The 2-5 age group saw the largest improvement in AHI and other sleep parameters.