Adenotonsillectomy and CPAP achieve similar improvements in apnea-hypopnea index among children with obstructive sleep apnea and Down syndrome or mucopolysaccharidoses, although the benefits from continuous positive airway pressure are more immediate, researchers said.
Dr. Shyam Sudhakar Sudarsan and colleagues from the Madras ENT Research Foundation in Chennai, India, performed a prospective, randomized comparative study in 124 syndromic children aged 6-12 years.
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The benefits of adenotonsillectomy and CPAP were similar in children with OSA and Down syndrome.
They found that children in both arms of the study achieved a mean apnea-hypopnea index of just over 1 at 12 months after randomization, with no statistically significant difference between CPAP and adenotonsillectomy.
"A striking observation from values of CPAP group was that, the child, if tolerant of a nasal mask/CPAP, showed statistically significant improvement by 6 months itself and this was maintained over a period of time," the authors wrote (Int. J. Pediatr. Otorhinolaryngol. 2014;78:1526-33).
"But in T&A [adenotonsillectomy] group, the improvement was gradual and statistically significant over a period of time," the authors said, suggesting that adenotonsillectomy in this group of high-risk children should be viewed as "beneficial rather than uniformly curative" for obstructive sleep apnea.
There were no conflicts of interest declared.