The effectiveness of tonsillectomy and adenoidectomy in the treatment of pediatric obstructive sleep apnea/hypopnea syndrome: a meta-analysis

Otolaryngol Head Neck Surg. 2006 Jun;134(6):979-84. doi: 10.1016/j.otohns.2006.02.033.


Objective: Present and evaluate the currently available literature reporting on the effectiveness of adenotonsillectomy (T/A) in treating obstructive sleep apnea/hypopnea syndrome (OSAHS) in uncomplicated pediatric patients.

Study design and setting: Systematic review of the literature and meta-analysis of the reduction of the polysomnogram (PSG)-measured Apnea Hypopnea Index (AHI events/hour) resulting from T/A and the overall success rate of T/A in normalizing PSG measurements (%).

Results: Fourteen studies met the inclusion criteria. Mean sample size was 28. All were case series (level 4 evidence). The summary change in AHI was a reduction of 13.92 events per hour (random effects model 95% CI 10.05-17.79, P < 0.001) from T/A. The summary success rate of T/A in normalizing PSG was 82.9% (random effects model 95% CI 76.2%-89.5%, P < 0.001).

Conclusion/significance: T/A is effective in the treatment of OSAHS. However, success rates are far below 100%, which could have far-reaching pediatric public health consequences.

Ebm rating: B-2a.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adenoidectomy*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Palate, Soft
  • Sleep Apnea, Obstructive / surgery*
  • Tonsillectomy*
  • Treatment Outcome