Alternative Approaches to Adenotonsillectomy and Continuous Positive Airway Pressure (CPAP) for the Management of Pediatric Obstructive Sleep Apnea (OSA): A Review
Table 2
Surgical procedures addressing OSA in children other than tonsilloadenoidectomy.
Author (date)
Age (mean age)
Type of procedure
Prior procedure performed
Type of study
Mean pre/post AHI
Rivero and Durr (2017)
<18 years (9.5)
132
Lingual tonsillectomy
T+A
Systematic review and meta-analysis
12.291/5.653 (54% reduction)
Camacho et al. (2017)
<18 years (10.8)
116
Base of tongue reduction (114), tongue suspension (1), and HNS (1)
>90% T+A
Systematic review and meta-analysis
16.9/8.7 for tongue-base reduction (48.5% reduction)
Fray et al. (2018)
<18 years (11.1)
196
Tracheostomy
Not reported
Systematic review and meta-analysis
34.2/0.75 (98% reduction)
Camacho et al. (2016)
1 month to 12.6 years (mean not reported)
138
Supraglottoplasty
Excluded
Systematic review and meta-analysis
20.4/4 (80% reduction) in congenital laryngomalacia 14/3.3 (76% reduction) in sleep-exclusive larnygomalacia
Lee et al. (2016)
2.4 months to 7.4 years (3.7)
121
Supraglottoplasty
AT or lingual tonsillectomy in some patients
Meta-analysis
8.9 mean decrease (mean pre/post not included)
Noller et al. (2018)
<18 years
376
MAD or mandibular advancement surgery
None (excluded)
Systematic review and meta-analysis
41.1/4.5 (89.1% reduction)
T+A: tonsillectomy and adenoidectomy; AT: adenotonsillectomy; MAD: mandibular advancement device.
