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Risk factors for residual mouth breathing in children who had completely resolved obstructive sleep apnea after adenotonsillectomy

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Abstract

Purpose

Adenotonsillectomy is the first-line treatment for pediatric obstructive sleep apnea (OSA). However, although completely resolved OSA after adenotonsillectomy, some children still showed persistence of mouth breathing. Therefore, we attempted to identify risk factors for residual mouth breathing in children with OSA after successful adenotonsillectomy.

Materials and methods

This study retrospectively enrolled children who underwent adenotonsillectomy as a treatment of OSA. Additionally, children who showed apnea–hypopnea index ≥ 1 on 1-year postoperative polysomnography or adenoid regrowth on one-year postoperative lateral cephalogram were excluded. The presence of allergic rhinitis, septal deviation, dentofacial abnormalities, the size of tonsil and adenoid was also evaluated in all enrolled children. Dentofacial abnormalities were defied as a high palatal arch, macroglossia, retrognathia, micrognathia, and overcrowding of teeth which assessed by dentists.

Results

A total of 62 children were enrolled (no residual mouth-breathing group, n = 18 and residual mouth-breathing group, n = 44) in this study. There were no significant differences in demographic factors, physical examination, and sleep parameters, except age and preoperative adenoid size. On the multiple logistic regression analysis, we found that older age, large adenoid size, and presence of dentofacial abnormalities significantly correlated with residual mouth breathing (adjusted coefficient estimates = 0.3890, 2.3611, and 2.8615, respectively) after successful adenotonsillectomy.

Conclusions

Older age, large adenoid size, and presence of dentofacial abnormalities in children with OSA may be the risk factors for residual mouth breathing after successfully resolved OSA.

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Acknowledgements

We would like to thank Editage (https://www.editage.co.kr) for English language editing.

Funding

There was no funding for this study.

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon, Gangwon-do, Republic of Korea

    Jiseon Bae & Dong-Kyu Kim

  2. Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital (24253), 77, Sakju-ro, Chuncheon-si, Gangwon-do, Republic of Korea

    Dong-Kyu Kim

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  1. Jiseon Bae
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Correspondence to Dong-Kyu Kim.

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This article does not contain any animal studies conducted by the authors. The study was conducted in accordance with the guidelines of the Helsinki Declaration and its subsequent amendments.

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Informed consent was not needed; it is a retrospective study.

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Bae, J., Kim, DK. Risk factors for residual mouth breathing in children who had completely resolved obstructive sleep apnea after adenotonsillectomy. Eur Arch Otorhinolaryngol 277, 2913–2919 (2020). https://doi.org/10.1007/s00405-020-06122-4

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  • DOI: https://doi.org/10.1007/s00405-020-06122-4

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