Results of tonsillectomy for obstructive sleep apnea syndrome in adults with tonsillar hypertrophy

High surgical success rates for adenotonsillectomy in children with obstructive sleep apnea (OSAS) have been described in various studies. The purpose of this study was to evaluate the efficiency of bilateral tonsillectomy. Data from a retrospective study with eight adults (six males, two females; average age 29.0 years old; average body mass index, 27.3 +/- 5.3 kg/m(2)) who underwent tonsillectomy for OSAS were evaluated based on the severity level of the preoperative apnea-hypopnea index (AHI). Within 1.0 year, eight patients with a substantial tonsillar hypertrophy underwent attended polysomunography. Tonsillectomy was performed, and postoperative complications and polysomunographic findings were reviewed. The severity of OSAS was rated mild with an AHI of 10-29, moderate with an AHI of 30-49, and severe with an AHI of equal to or greater than 50. Four of eight patients exhibited severe OSAS, three patients had moderate OSAS, and one patient was of mild OSAS. The surgical response rates (defined as decrease in the postoperative AHI greater than or equal to 50%) were 75% in severe apneics and 100% in moderate or mild apneics. No serious complications occurred. In the carefully selected patient, a tonsillectomy should be considered an effective and safe surgical option for the treatment of OSAS. (C) 2003 Elsevier B.V. All rights reserved.