Health Scan: Pediatric sleep apnea does not always require big repair operation

By JUDY SIEGEL-ITZKOVICH
Sleep (photo credit: ING IMAGE/ASAP)
Sleep
(photo credit: ING IMAGE/ASAP)
 The surgical removal of tonsils can be avoided in children suffering from moderate-to-serious sleep apnea just by taking out their adenoids – that mass of lymphatic tissue behind the nasal cavity where the nose blends into the throat. So says Dana-Dwek Children’s Hospital Prof. Ya’acov Sivan of Tel Aviv Sourasky Medical Center.
“Today, the tonsils are removed, but we have found that in at least some of the children, only the adenoids need be taken out, resulting in a simpler operation.” He and his colleagues published their findings in the Journal of Clinical Sleep Medicine. The smaller operation means less risk to the child and a faster recovery, said Sivan, who heads the hospital’s lung institute.
They examined 515 children who suffered from moderate- to-serious momentary disruptions of breathing during sleep and followed them up after surgery either for the adenoids alone or those as well as their tonsils.
They found that in most cases, their apnea stopped when only the adenoids were moved.
Between 10% and 15% of children snore, and 2% to 4% of all children suffer from sleep apnea because their upper respiratory tract is blocked by polyps. It is most common between the ages of two and seven.
Sivan explained that sleep apnea in children can cause harm in both the short and long term, as they are at risk for learning disorders, difficulty concentrating, poor behavior at school, mood changes, hyperactivity and forgetfulness.
They also suffer more often from illness and are taken to their doctors more frequently. Even cardiac complications can result, he said.
Removal of adenoids is a “small operation” with only rare complications, but when the tonsils are removed as well, the hospitalization is longer, pain is greater and complications can even endanger life.
“I expect that our conclusions will lead to initiatives abroad that will study the matter and bring about new thinking among doctors,” said Sivan. Adopting the recommendations will lead to cost savings, less pain, complications and shorter hospitalization, he concluded.

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