Abstract
Objectives: The decision to perform adenotonsillectomy in the pediatric population is frequently determined by clinical history and examination findings without formal polysomnography. Polysomnography (PSG) has been proposed as a means to determine which children would benefit from surgery as well as to predict respiratory compromise requiring postoperative intervention or inpatient observation. Past studies have identified that PSG may identify at-risk patients, specifically in the 3-year-old and younger group. We retrospectively investigated the effect of preoperative PSG on the postoperative management of pediatric patients 3 years old and younger undergoing adenotonsillectomy.
Methods: A retrospective chart review was performed for all patients 3 years of age and younger who had undergone adenotonsillectomy for upper airway obstruction or obstructive sleep apnea (OSA) from July 1997 to July 2002 at the Children's Hospital of Wisconsin. Patients who had preoperative PSG were age-matched with patients who had undergone the same procedure without preoperative PSG. Postoperative courses including complications, interventions, and hospital days were compared.
Results: 305 patients were identified. Thirty-seven patients had preoperative PSG prior to their surgery. Postoperative management was based upon postoperative clinical findings or established protocols of the individual pediatric otolaryngologists. No correlation between PSG results and postoperative course was identified.
Conclusions: The role of PSG in upper airway obstruction and OSA remains controversial. Results from this study suggest there is no significant correlation with PSG findings and postoperative management following adenotonsillectomy. PSG findings did not change established postoperative management protocols and were not predictive of postoperative course.