Skip to main content Accessibility help

Short-term weight gain after adenotonsillectomy in children with obstructive sleep apnoea: systematic review

  • M Van (a1), I Khan (a1) and S S M Hussain (a1)



Children with obstructive sleep apnoea commonly undergo adenotonsillectomy as first-line surgical treatment. This paper aimed to investigate whether this intervention was associated with weight gain after surgery in the paediatric population with obstructive sleep apnoea.


Two independent researchers systematically reviewed the literature from 1995 to 2014 for studies on patients who underwent adenotonsillectomy with weight-based measurements before and after surgery. The databases used were Ovid Medline, Embase and PubMed.


Six papers satisfied all inclusion criteria. Four of these papers showed a significant weight increase and the others did not. The only high quality, randomised, controlled trial showed a significant increase of weight gain at seven months follow up, even in patients who were already overweight before their surgery.


The current evidence points towards an association between adenotonsillectomy and weight gain in patients with obstructive sleep apnoea in the short term.


Corresponding author

Address for correspondence: Professor S S Musheer Hussain, Department of Otorhinolaryngology, Head and Neck Surgery, Ninewells Hospital, Dundee DD1 9SY, Scotland, UK E-mail:


Hide All

Presented orally at the ENT Scotland Annual Summer Meeting, 8 May 2015, Dunblane, Scotland, UK.



Hide All
1American Thoracic Society. Standards and indications for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med 1996;153:866–78
2Brouillette, RT, Fernbach, SK, Hunt, CE. Obstructive sleep apnea in infants and children. J Pediatr 1982;100:3140
3Bar, A, Tarasiuk, A, Segev, Y, Phillip, M, Tal, A. The effect of adenotonsillectomy on serum insulin-like growth factor-I and growth in children with obstructive sleep apnea syndrome. J Pediatr 1999;135:7680
4Vontetsianos, HS, Davris, SE, Christopoulos, GD, Dacou-Voutetakis, C. Improved somatic growth following adenoidectomy and tonsillectomy in young children. Possible pathogenetic mechanisms. Hormones (Athens) 2005;4:4954
5Jeyakumar, A, Fettman, N, Armbrecht, ES, Mitchell, R. A systematic review of adenotonsillectomy as a risk factor for childhood obesity. Otolaryngol Head Neck Surg 2011;144:154–8
6Wang, Y, Lobstein, T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006;1:1125
8Amin, R, Anthony, L, Somers, V, Fenchel, M, McConnell, K, Jefferies, J et al. Growth velocity predicts recurrence of sleep-disordered breathing 1 year after adenotonsillectomy. Am J Respir Crit Care Med 2008;177:654–9
9Aydogan, M, Toprak, D, Hatun, S, Yuksel, A, Gokalp, AS. The effect of recurrent tonsillitis and adenotonsillectomy on growth in childhood. Int J Pediatr Otorhinolaryngol 2007;71:1737–42
10Conlon, BJ, Donnelly, MJ, McShane, DP. Tonsillitis, tonsillectomy and weight disturbance. Int J Pediatr Otorhinolaryngol 1997;42:1723
11Czechowicz, JA, Chang, KW. Analysis of growth curves in children after adenotonsillectomy. JAMA Otolaryngol Head Neck Surg 2014;140:491–6
12Hashemian, F, Farahani, F, Sanatkar, M. Changes in growth pattern after adenotonsillectomy in children under 12 years old. Acta Med Iran 2010;48:316–19
13Hsu, WC, Kang, KT, Weng, WC, Lee, PL. Impacts of body weight after surgery for obstructive sleep apnea in children. Int J Obes (Lond) 2013;37:527–31
14Kiris, M, Muderris, T, Celebi, S, Cankaya, H, Bercin, S. Changes in serum IGF-1 and IGFBP-3 levels and growth in children following adenoidectomy, tonsillectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2010;74:528–31
15Nieminen, P, Lopponen, T, Tolonen, U, Lanning, P, Knip, M, Lopponen, H. Growth and biochemical markers of growth in children with snoring and obstructive sleep apnea. Pediatrics 2002;109:e55
16Smith, DF, Vikani, AR, Benke, JR, Boss, EF, Ishman, SL. Weight gain after adenotonsillectomy is more common in young children. Otolaryngol Head Neck Surg 2013;148:488–93
17Soultan, Z, Wadowski, S, Rao, M, Kravath, RE. Effect of treating obstructive sleep apnea by tonsillectomy and/or adenoidectomy on obesity in children. Arch Pediatr Adolesc Med 1999;153:33–7
18Wijga, AH, Scholtens, S, Wieringa, MH, Kerkhof, M, Gerritsen, J, Brunekreef, B et al. Adenotonsillectomy and the development of overweight. Pediatrics 2009;123:1095–101
19Katz, ES, Moore, RH, Rosen, CL, Mitchell, RB, Amin, R, Arens, R et al. Growth after adenotonsillectomy for obstructive sleep apnea: an RCT. Pediatrics 2014;134:282–9
20Karalok, ZS, Akdag, M, Turhan, M, Uzun, G, Ozdem, S, Dinc, O et al. Leptin and ghrelin levels in children before and after adenoidectomy or adenotonsillectomy. Horm Res Paediatr 2014;81:20–4
21Huang, YS, Guilleminault, C, Lee, LA, Lin, CH, Hwang, FM. Treatment outcomes of adenotonsillectomy for children with obstructive sleep apnea: a prospective longitudinal study. Sleep 2014;37:71–6
22Jabbari Moghaddam, Y, Golzari, SE, Saboktakin, L, Seyedashrafi, MH, Sabermarouf, B, Gavgani, HA et al. Does adenotonsillectomy alter IGF-1 and ghrelin serum levels in children with adenotonsillar hypertrophy and failure to thrive? A prospective study. Int J Pediatr Otorhinolaryngol 2013;77:1541–4
23Kang, JM, Auo, HJ, Yoo, YH, Cho, JH, Kim, BG. Changes in serum levels of IGF-1 and in growth following adenotonsillectomy in children. Int J Pediatr Otorhinolaryngol 2008;72:1065–9
24Roemmich, JN, Barkley, JE, D'Andrea, L, Nikova, M, Rogol, AD, Carskadon, MA et al. Increases in overweight after adenotonsillectomy in overweight children with obstructive sleep-disordered breathing are associated with decreases in motor activity and hyperactivity. Pediatrics 2006;117:e2008
25World Health Organization. Growth Reference data for 5-19 year olds (2007). In: [10 November 2015]
26Bland, RM, Bulgarelli, S, Ventham, JC, Jackson, D, Reilly, JJ, Paton, JY. Total energy expenditure in children with obstructive sleep apnoea syndrome. Eur Respir J 2001;18:164–9
27De Serres, LM, Derkay, C, Sie, K, Biavati, M, Jones, J, Tunkel, D et al. Impact of adenotonsillectomy on quality of life in children with obstructive sleep disorders. Arch Otolaryngol Head Neck Surg 2002;128:489–96
28Mitchell, RB, Kelly, J, Call, E, Yao, N. Long-term changes in quality of life after surgery for pediatric obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 2004;130:409–12
29Saaresranta, T, Polo, O. Sleep-disordered breathing and hormones. Eur Respir J 2003;22:161–72
30Issa, FG, Sullivan, CE. The immediate effects of nasal continuous positive airway pressure treatment on sleep pattern in patients with obstructive sleep apnea syndrome. Electroencephalogr Clin Neurophysiol 1986;63:1017


Short-term weight gain after adenotonsillectomy in children with obstructive sleep apnoea: systematic review

  • M Van (a1), I Khan (a1) and S S M Hussain (a1)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed