Objective: To determine success rates after adenotonsillectomy for obstructive sleep apnea (OSA); postoperative polysomnogram (PSG) results were compared with preoperative results in children younger than 5 years. Methods: Thirty-four children with a preoperative respiratory disturbance index (RDI) greater than 5 in rapid eye movement (REM) sleep underwent both preoperative and postoperative PSG with at least five of seven parameters recorded. Results: Preoperatively, mean total RDI was 15.5, mean REM RDI was 39.6, and 25 (74%) had severe OSA (REM RDI > 20). Postoperatively, mean total RDI improved to 3 (P < 0.001), mean REM RDI to 7.4 (P < 0.001), and 4 remained severe. Overall 22 (65%) showed REM RDI in the normal range (<5), including all with a preoperative REM RDI less than 30. Conclusion: On PSG criteria, most children with OSA significantly improved after adenotonsillectomy, but a number had persisting abnormalities. Postoperative PSG should be considered to identify unresolved OSA.
Otolaryngology - Head and Neck Surgery Vol. 139, Issue 1, p. 83-86