Frontiers in Pediatrics (Jan 2023)

Effect of tonsillectomy in a child with obesity and obstructive sleep apnea: A case report and review of the literature

  • Paola Di Filippo,
  • Greta Orlandi,
  • Giampiero Neri,
  • Sabrina Di Pillo,
  • Francesco Chiarelli,
  • Nadia Rossi,
  • Marina Attanasi

DOI
https://doi.org/10.3389/fped.2022.1101267
Journal volume & issue
Vol. 10

Abstract

Read online

Obstructive sleep apnea (OSA) is an increasingly recognized disorder in children. Adenotonsillectomy is the primary surgical treatment for OSA in children with adenotonsillar hypertrophy (ATH). We present the case of an obese 4-year-old boy hospitalized for severe desaturation during sleep and severe ATH. Nasal steroid therapy proved ineffective with persistent symptoms. Polygraphy documented severe OSA with an apnea–hypopnea index (AHI) equal to 11. Tonsillectomy resulted in prompt symptom improvement and a substantial reduction of the AHI (2.2). In this case, tonsillectomy alone resulted effective in treating OSA, despite obesity. We concluded that the presence of obesity should not postpone/exclude surgical treatment of preschool children for whom ATH is the most important cause of OSA.

Keywords