Improvements in Sleep Disordered-Breathing after Surgical Removal of Adenoids and/or Tonsils

Introduction: Sleep disordered-breathing, with snoring as a problem in this category, is caused by elevated upper airways resistance, which is usually due to airways narrowing or collapse. Adenoid and tonsils, as lymphoid components of nasopharynx and oropharynx respectively, can narrow airways while hypertrophied and this may cause obstruction. In this study we aimed to investigate that how effectively the surgical removal of these components would improve sleep disordered-breathing. Materials and Methods: Ninety-six children, all positive for snoring and/ or mouth breathing due to adenotonsillar hypertrophy that have indication of adenoidectomy or tonsillectomy entered to the study. A VAS (visual analogue scale) with scoring from 0 (for no snoring) to 10 (severe snoring that can be heard from next room) was used for snoring evaluation while mouth-breathing was evaluated based on the frequency of presence (0 for negative, 1 for occasional and 2 if it is permanent). The patients were assessed for their symptoms once at the pre-op visit and twice at three weeks and three months after operation and the results were compared. Their baseline-characteristics, presenting symptoms, the surgical procedures, complications and days of hospitalization were also taken into account. Results: With a mean age of 5.84 (SD=1.2) and a 1.6:1 male to female ratio, the surgical removal of adenoids/tonsils could significantly improve both snoring and mouth-breathing (p=0.023) and (p=0.037) at 3 months after operation, averagely making a six unit improvement in snoring scores and reducing mouth-breathing from over 70% positive cases to less than 34%. Of course improvement of snoring happened sooner (p=0.031 at 3 weeks for snoring, but mouth breathing needed more time to reduced (p=0.247 at 3 weeks). Conclusion: Surgical removal of adenoids/tonsils in symptomatic patients can significantly improve both snoring and mouth-breathing in sleep disorderedbreathing children.