TABLE X.B.
Evidence on adenotonsillectomy for pediatric OSA
| Study | Year | LOE | Study design | Study groups | Clinical endpoints | Conclusion |
|---|---|---|---|---|---|---|
| Marcus et al.2054 | 2013 | 1b | RCT | Children with OSA followed up for 7-months: 1. T&A 2. Observation |
PSG, behavior, quality of life, symptoms, neurobehavioral outcomes | Improvement in both groups. Significantly greater improvement in the surgical group. No improvement in neurobehavioral outcomes in either group |
| Bhattacharjee et al.2116 | 2010 | 2b | Observational cohort | Children with OSA with before and after T&A PSG data | Resolution of OSA | Significant improvement in AHI but resolution in only 27% |
| Chinnadurai et al.2053 | 2017 | 1a | SR of RCTs | Children with OSA with T&A versus observation | Improvement/resolution of OSA | T&A compared to observation leads to short-term improvement in sleep outcomes in children with OSA |
| Venekamp et al.2115 | 2015 | 1a | SR of RCTs | Children with OSA with T&A vs. observation or CPAP | Improvement/resolution of OSA | T&A compared to observation or CPAP leads to benefits in PSG parameters quality of life, symptoms and behavior |
| Trosman et al.2120 | 2016 | 3a | Observational cohort | Children with mild OSA | PSG | T&A compared to observation leads to a significantly greater improvement in AHI especially in non-obese, non-syndromic children |
| Volsky et al.2121 | 2014 | 3b | Observational cohort | Children with mild OSA | OSA-18 quality of life scores | Quality of life significantly improves in children with mild OSA after T&A with less improvement with observation |
| Kheirandish-Gozal et al.2123 | 2014 | 3b | Observational cohort | Children with mild OSA treated with intranasal corticosteroid and oral montelukast | PSG in subset; symptoms | Beneficial effects in >80% of children |
| Liming et al.2125 | 2019 | 2b | SR of observational cohorts | Children with mild OSA treated with intranasal corticosteroid and oral montelukast | PSG | Treatment with montelukast and intranasal steroids or montelukast alone is beneficial for short-term management of mild pediatric OSA |
Abbreviations: T&A, tonsillectomy with or without adenoidectomy; SR, systematic review.