Efficacy and safety of adenotonsillectomy for pediatric obstructive sleep apnea in Prader-Willi syndrome.

OBJECTIVES: We performed a retrospective analysis in a tertiary care children's hospital to evaluate the efficacy and safety of adenotonsillectomy for the treatment of pediatric obstructive sleep apnea (OSA) in Prader-Willi syndrome (PWS).

METHODS: We studied all PWS patients who underwent adenotonsillectomy to treat OSA from January 1, 2004, to December 31,2005. The main outcome measures were 1) preoperative and postoperative full overnight polysomnography and 2) postoperative complications.

RESULTS: Three PWS patients were identified, including female twins and 1 boy. All patients had preoperative evidence of OSA without central apnea. Resolution of OSA after adenotonsillectomy was variable. The patient with the highest body mass index and tonsil size had the least residual OSA after adenotonsillectomy. No perioperative complications or adverse events were observed.

CONCLUSIONS: Adenotonsillectomy did not consistently improve OSA in this population of patients with PWS. No perioperative complications were noted. Postoperative polysomnography should be considered for evaluation of possible residual OSA, as additional interventions may be warranted.