Adenotonsillectomy vs Watchful Waiting in Pediatric Mild to Moderate Obstructive Sleep Apnea

Is adenotonsillectomy (ATE) more effective than watchful waiting (WW) for treating children aged between 2 to 4 years with mild to moderate obstructive sleep apnea (OSA), 3 years after randomization?In this randomized clinical trial, 48 of 60 children (80%) (ATE n = 23, WW n = 16, crossovers n = 9) completed polysomnography and questionnaires. The per protocol analysis showed no differences between the ATE and WW groups, but 13 of 31 (42%) in the WW group underwent ATE, mainly children with moderate OSA and tonsil hyperplasia.ATE may be effective for young children with mild to moderate OSA, whereas children with mild OSA and small tonsils could be recommended WW.

Corresponding Author: Isabella Sjölander, MD, PhD, Department of Surgical Science, Uppsala University, Uppsala, Sweden (isabella.sjolander@uu.se).

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