Tonsillectomy and Adenoidectomy for Sleep Apnea: Efficacy in Children and Adults

Adenotonsillectomy (T&A) is first-line surgical treatment for pediatric obstructive sleep apnea (OSA) due to adenotonsillar hypertrophy. In adults, role is more selective.

Pediatric Outcomes

• Cure rate (AHI <1): ~75–85% in uncomplicated cases.
• Significant improvement in snoring, sleep architecture, behavior, growth.
• Residual OSA risk: obesity, craniofacial syndromes, severe preoperative AHI.

Adult Outcomes

• T&A alone rarely cures adult OSA (multilevel collapse).
• May improve CPAP tolerance or serve as part of multilevel surgery (UPPP, tongue base, hypoglossal nerve stimulation).

Considerations

Preoperative sleep study (PSG) mandatory. Post-op PSG at 3–6 months to assess cure. Complications: hemorrhage (2–4%), velopharyngeal insufficiency, pain, dehydration.