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Zafer Soultan, MD; Stephen Wadowski, MD; Madu Rao, MD; Richard E. Kravath, MD

Arch Pediatr Adolesc Med. 1999;153:33-37.

Background  Obstructive sleep apnea is common in obese children who have enlarged tonsils and adenoids.

Objective  To determine if treatment of obstructive sleep apnea by tonsillectomy and/or adenoidectomy will result in normalization of an obese child's weight, as it does in underweight children, and as it does with other signs and symptoms.

Design  Retrospective cohort study. We recorded weight and height changes after tonsillectomy and/or adenoidectomy and compared changes of the obese and morbidly obese patients with those of the other patients.

Setting  A tertiary care inner-city hospital.

Participants  Children (n=45) who underwent tonsillectomy and/or adenoidectomy for obstructive sleep apnea in 1994-1995; their mean (±SD) age was 4.9 ± 2.4 years at operation.

Results  At the time of surgery, 25 children were of normal weight; 3, underweight; 7, obese; and 10, morbidly obese. Postoperatively, 31 children (69%), including 10 of the 17 who were obese or morbidly obese, had substantial weight gain: the z score ± SD for weight of the entire group increased from 1.37 ± 2.49 to 2 ± 2.27 (P<.001). The mean z score ± SD for height increased from 0.03 ± 1.08 to 0.58 ± 0.94 (P<.001). The body mass index (BMI or Quetelet index): calculated as weight in kilograms divided by the square of the height in meters increased in 28 patients (62%) (P=.004).

Conclusion  Treating obstructive sleep apnea by tonsillectomy and/or adenoidectomy is associated with increased gain in height, weight, and body mass index in most children, including the obese and morbidly obese.

From the Division of Pediatric Pulmonology, Children's Medical Center, College of Medicine, the State University of New York, Health Science Center at Brooklyn, Brooklyn, NY.

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