The effect of tonsillectomy on obstructive sleep apnea: an overview of systematic reviews
Authors Reckley LK, Fernandez-Salvador C, Camacho M
Received 9 August 2017
Accepted for publication 20 February 2018
Published 4 April 2018 Volume 2018:10 Pages 105—110
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 3
Editor who approved publication: Professor Steven A Shea
Lauren K Reckley, Camilo Fernandez-Salvador, Macario Camacho
Otolaryngology – Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI, USA
Objective: Tonsillectomy with adenoidectomy is a combination surgery that has been used to treat pediatric obstructive sleep apnea (OSA). For adults, tonsillectomy has also been reported as a primary treatment modality when the tissue is hypertrophied. The objective of this study is to provide an overview of published systematic reviews and meta-analyses of tonsillectomy with or without adenoidectomy as used in the treatment of OSA in children and adults.
Data sources: Nine databases, including PubMed/MEDLINE.
Review methods: Databases were searched from their inception through July 9, 2017. The PRISMA statement was followed.
Results: More than 20 recent systematic reviews and meta-analyses were identified regarding tonsillectomy as a treatment modality for OSA. There were four articles that addressed tonsillectomy’s overall success, efficacy, and complications in otherwise healthy pediatric patients. Three studies evaluated tonsillectomy in obese children, and two specifically examined children with Down syndrome. Only one systematic review and meta-analysis discussed tonsillectomy as a treatment for OSA in the adult population.
Conclusion: Tonsillectomy as an isolated treatment modality is rarely performed in pediatric patients with OSA; however, tonsillectomy is commonly performed in combination with adenoidectomy and the combination has demonstrated efficacy as the primary treatment option for most children. In the limited adult data, tonsillectomy alone for OSA has a surprising success rate; yet, more research is required to determine long-term improvement and need for further treatment.
Keywords: tonsillectomy, sleep apnea syndromes, systematic review, review
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