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Adenotonsillectomy for obstructive sleep apnoea in children

  • Review
  • Intervention

Authors


Abstract

Background

Current treatment of sleep apnoea in children consists of largely surgical based treatments. Adenotonsillectomy is the most commonly used intervention to treat sleep apnoea in children.

Objectives

To determine the efficacy of adenotonsillectomy in the treatment of obstructive sleep apnoea in children.

Search strategy

The Cochrane Airways Group Specialised Register was searched with pre-specified terms. Searches were current as of August 2005.

Selection criteria

Randomised trials recruiting children with a diagnosis of obstructive sleep apnoea.

Data collection and analysis

Two reviewers examined the search results and collected data from the studies in terms of their characteristics before deciding which ones would be included in the review.

Main results

A total of 207 references were identified from electronic searching. Twenty-five studies were retrieved, but none met the inclusion criteria of the review. Due to the absence of randomised trial data, no results could be ascertained.

Authors' conclusions

At present there is still debate as to the criteria required to diagnose significant obstructive sleep apnoea in children. Also the natural history of the condition has not been fully delineated. There is an absence of randomised controlled trials investigating the efficacy of treatment of confirmed obstructive sleep apnoea with adenotonsillectomy in children. Research is required before recommendations for the treatment of obstructive sleep apnoea in children can be formulated. The quality of research in this area could be improved with the use of sleep studies at baseline to determine the extent of severity of sleep apnoea in children who are recruited to studies in this area. Long-term follow up is also required in order to explore the effect of adenotonsillectomy on paediatric sleep apnoea.

Plain language summary

Adenotonsillectomy for obstructive sleep apnoea in children

Sleep apnoea is the reduction of airflow at the nose and mouth during sleep. The current treatment of choice is adenotonsillectomy (the removal of the adenoids and tonsils), due to its perceived efficacy, cost effectiveness and the relative size of adenoid and tonsil tissue in children. This review did not find any evidence from randomised trials to support the use of adenotonsillectomy for sleep apnoea in children. There is some debate as to the diagnosis of obstructive sleep apnoea in children and further research would need to undertake extensive diagnostic tests to make an appropriate diagnosis.

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