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Adenoidectomy can improve obstructive sleep apnoea in young children: systematic review and meta-analysis

Published online by Cambridge University Press:  06 October 2016

L K Reckley*
Affiliation:
Otolaryngology – Head and Neck Surgery, Tripler Army Medical Center, Honolulu, Hawaii, USA
S A Song
Affiliation:
Otolaryngology – Head and Neck Surgery, Tripler Army Medical Center, Honolulu, Hawaii, USA
E T Chang
Affiliation:
Otolaryngology – Head and Neck Surgery, Tripler Army Medical Center, Honolulu, Hawaii, USA
B B Cable
Affiliation:
Otolaryngology – Head and Neck Surgery, Tripler Army Medical Center, Honolulu, Hawaii, USA
V Certal
Affiliation:
Department of Otorhinolaryngology/Sleep Medicine Centre, Hospital CUF, Porto, Portugal Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Portugal
M Camacho
Affiliation:
Otolaryngology – Head and Neck Surgery, Tripler Army Medical Center, Honolulu, Hawaii, USA
*
Address for correspondence: Dr Lauren K Reckley, Otolaryngology – Head and Neck Surgery, Tripler Army Medical Center, 1 Jarrett White Road, Honolulu, HI 96859, USA E-mail: lauren.k.reckley.mil@mail.mil

Abstract

Objective:

To systematically search for studies reporting outcomes for adenoidectomy alone as a treatment for paediatric obstructive sleep apnoea and use the data to perform a meta-analysis.

Methods:

Nine databases, including PubMed and Medline, were systematically searched through to 1 April 2016. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed.

Results:

A total of 1032 articles were screened and 126 full texts were reviewed. Three paediatric studies (47 patients) reported outcomes. Overall, apnoea–hypopnoea index values decreased from 18.1 ± 16.8 to 3.1 ± 5.5 events per hour (28 patients). Random-effects modelling demonstrated a mean difference of −14.43 events per hour (I2 = 23 per cent (low inconsistency)). The apnoea–hypopnoea index standardised mean difference was −1.14 (large magnitude of effect). The largest reduction in apnoea–hypopnoea index was observed in children aged less than 12 months (reduction of 56.6−94.9 per cent). Lowest oxygen saturation values improved from 80.0 ± 9.5 to 85.5 ± 6.0 per cent (13 children).

Conclusion:

Adenoidectomy alone has improved obstructive sleep apnoea in children, especially in those aged less than 12 months; however, given the low number of studies, isolated adenoidectomy remains an area for additional research.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Lumeng, JC, Chervin, RD. Epidemiology of pediatric obstructive sleep apnea. Proc Am Thoracic Soc 2008;5:242–52Google Scholar
2 Camacho, M, Certal, V, Abdullatif, J, Zaghi, S, Ruoff, CM, Capasso, R et al. Myofunctional therapy to treat obstructive sleep apnea: a systematic review and meta-analysis. Sleep 2015;1:669–75Google Scholar
3 Certal, VF, Zaghi, S, Riaz, M, Vieira, AS, Pinheiro, CT, Kushida, C et al. Hypoglossal nerve stimulation in the treatment of obstructive sleep apnea: a systematic review and meta-analysis. Laryngoscope 2015;125:1254–64Google Scholar
4 Camacho, M, Certal, V, Capasso, R. Comprehensive review of surgeries for obstructive sleep apnea syndrome. Braz J Otorhinolaryngol 2013;79:780–8Google Scholar
5 Senchak, A, McKinlay, A, Acevedo, J, Swain, B, Tiu, MC, Chen, BS et al. The effect of tonsillectomy alone in adult obstructive sleep apnea. Otolaryngol Head Neck Surg 2015;152:969–73Google Scholar
6 Camacho, M, Liu, SY, Certal, V, Capasso, R, Powell, NB, Riley, RW. Large maxillomandibular advancements for obstructive sleep apnea: an operative technique evolved over 30 years. J Craniomaxillofac Surg 2015;43:1113–18Google Scholar
7 Camacho, M, Certal, V, Brietzke, SE, Holty, JE, Guilleminault, C, Capasso, R. Tracheostomy as treatment for adult obstructive sleep apnea: a systematic review and meta-analysis. Laryngoscope 2014;124:803–11Google Scholar
8 Brietzke, SE, Gallagher, D. The effectiveness of tonsillectomy and adenoidectomy in the treatment of pediatric obstructive sleep apnea/hypopnea syndrome: a meta-analysis. Otolaryngol Head Neck Surg 2006;134:979–84Google Scholar
9 Villa, MP, Malagola, C, Pagani, J, Montesano, M, Rizzoli, A, Guilleminault, C et al. Rapid maxillary expansion in children with obstructive sleep apnea syndrome: 12-month follow-up. Sleep Med 2007;8:128–34Google Scholar
10 Camacho, M, Riaz, M, Capasso, R, Ruoff, CM, Guilleminault, C, Kushida, CA et al. The effect of nasal surgery on continuous positive airway pressure device use and therapeutic treatment pressures: a systematic review and meta-analysis. Sleep 2015;38:279–86Google Scholar
11 Friedman, M, Wilson, M, Lin, HC, Chang, HW. Updated systematic review of tonsillectomy and adenoidectomy for treatment of pediatric obstructive sleep apnea/hypopnea syndrome. Otolaryngol Head Neck Surg 2009;140:800–8Google Scholar
12 Lee, CH, Hsu, WC, Chang, WH, Lin, MT, Kang, KT. Polysomnographic findings after adenotonsillectomy for obstructive sleep apnea in obese and non-obese children: a systemic review and meta-analysis. Clin Otolaryngol 2015. Epub 2015 Oct 5Google Scholar
13 Black, AP, Shott, SR. Is adenoidectomy alone sufficient for the treatment of airway obstruction in children? Laryngoscope 2014;124:67 CrossRefGoogle ScholarPubMed
14 Caldwell, P, Hensley, R, Machaalani, R, Cheng, A, Waters, K. How effective is adenoidectomy alone for treatment of obstructive sleep apnoea in a child who presents with adenoid hypertrophy? J Paediatr Child Health 2011;47:568–71CrossRefGoogle Scholar
15 Moher, D, Liberati, A, Tetzlaff, J, Altman, DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine 2009;6:e1000097 Google Scholar
16 National Institute for Health and Clinical Excellence. Methods for Development of NICE Public Health Guidance. London: National Institute for Health and Clinical Excellence, 2006 Google Scholar
17Review Manager (RevMan), version 5.3 [computer program]. Copenhagen: Nordic Cochrane Centre, Cochrane Collaboration, 2014 Google Scholar
18 Cohen, J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Erlbaum, 1988 Google Scholar
19 Lau, J, Ioannidis, JP, Schmid, CH. Quantitative synthesis in systematic reviews. Ann Intern Med 1997;127:820–6Google Scholar
20 Higgins, JP, Thompson, SG, Deeks, JJ, Altman, DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557–60Google Scholar
21 Robison, JG, Wilson, C, Otteson, TD, Chakravorty, SS, Mehta, DK. Analysis of outcomes in treatment of obstructive sleep apnea in infants. Laryngoscope 2013;123:2306–14Google Scholar
22 Shatz, A. Indications and outcomes of adenoidectomy in infancy. Ann Otol Rhinol Laryngol 2004;113:835–8Google Scholar
23 Shintani, T, Asakura, K, Kataura, A. The effect of adenotonsillectomy in children with OSA. Int J Pediatr Otorhinolaryngol 1998;44:51–8Google Scholar
24 Wang, H, Fu, Y, Feng, Y, Guan, J, Yin, S. Tonsillectomy versus tonsillotomy for sleep-disordered breathing in children: a meta analysis. PloS One 2015;10:e0121500 Google Scholar