Skip to main content
Log in

Tonsillectomy and Adenoidectomy For Obstructive Sleep Apnea in Sickle Cell Anemia

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To evaluate the effects of Tonsillectomy and Adenoidectomy (T&A) on Obstructive Sleep Apnea (OSA) secondary to Upper Airway Obstruction (UAO) in children with Sickle Cell Disease (SCD).

Methods

Twenty eight children with SCD and history of snoring, with or without adeno tonsillar hypertrophy, were evaluated for UAO and OSA.

Results

Eight children were confirmed to have OSA by multichannel polysomnography and underwent T&A. Follow up examination showed symptomatic clinical and objective improvement in sleep study parameters in OSA.

Conclusions

T&A appears to be a safe, effective option to treat selected patients with OSA due to UAO in SCD children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Wittig RM, Roth T, Keenum AJ, Sarnaik S. Snoring, daytime sleepiness and Sickle cell anemia. Am J Dis Child 1988; 142:589.

    CAS  PubMed  Google Scholar 

  2. Sidman JD, Fry TL. Exacerbation of sickle cell disease by obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 1988; 114: 916–917.

    CAS  PubMed  Google Scholar 

  3. Halvorson DJ, McKie V, McKie K, Ashmore PE, Porbusky ES. Sickle cell disease and tonsillectomy. Preoperative management and post operative complications. Arch Otolaryngol Head Neck Surg 1997; 123: 689–692.

    CAS  PubMed  Google Scholar 

  4. Samuels MP, Stebbens VA, Davies SC, Picton - Jones E, Southall D. Sleep related upper airway obstruction and hypoxemia in sickle cell disease. Arch Dis Child 1992; 67: 925–929

    Article  CAS  PubMed  Google Scholar 

  5. Viner S, Szali JP, Hoffstein V. Are history and physical examinations a good screening test for obstructive sleep apnea? Ann Int Medicine 1991; 115: 356–359.

    CAS  Google Scholar 

  6. Salle C, Ramo R, Dalko C et al. Prevalence of Obstructive Sleep Apnea in children and adolescents with sickle cell anemia. J Bras Pneumol 2009; 35: 1075–1083.

    Google Scholar 

  7. Rosenfield RM, Green RP. Tonsillectomy and Adenoidectomy: changing trends. Ann Otol Rhinol Laryngol 1990; 99: 187–190.

    Google Scholar 

  8. Maddern BR, Reed HT, Ohene-Frempong K, Beckerman RC. Obstructive Sleep Apnea syndrome in sickle cell disease. Ann Otol Rhinol Laryngol 1989; 98: 174–178.

    CAS  PubMed  Google Scholar 

  9. Schechter MS and the American Academy of Pediatrics, Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. Technical report: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatr 2002; 109: 704–712.

    Article  Google Scholar 

  10. Robertson PL, Aldrich M, Hanash SM, Goldstein GW. Stroke associated with obstructive sleep apnea in a child with sickle cell anemia. Annals of Neurology 1988; 23: 614–616.

    Article  CAS  PubMed  Google Scholar 

  11. Kaleyias J, Mostofi N, Grant M et al. Severity of Obstructive Sleep Apnea in Children With Sickle Cell Disease. J Pediatric hematology Oncology 2008; 30: 659–665.

    Article  Google Scholar 

  12. Hill CM, Hogan AM, Onugha N et al. Increased cerebral blood flow velocity in children with mild sleepdisordered breathing: a possible association with abnormal neuropsychological function. Pediatr 2006; 118: e1100–e1108.

    Article  Google Scholar 

  13. Bader-Meunier B, François M, Verlhac S et al. Increased cerebral blood flow velocity in children with sickle cell disease: adenotonsillectomy or transfusion regimens? Pediatr 2007; 120; 235–236: 236–237.

    Article  Google Scholar 

  14. Coker NJ, Milner PF. Elective surgery in patients with sickle cell anemia. Arch Otolaryngol 1982; 108: 574–576.

    CAS  PubMed  Google Scholar 

  15. Vichinsky EP, Haberkern CM, Neumayr L et al. A comparison of conservative and aggressive transfusion regimen in perioperative management of sickle cell anemia. N Engl J Med 1995; 333: 206–213.

    Article  CAS  PubMed  Google Scholar 

  16. Duke RL, Scot JP, Panepinto JA, Flanary VA. Perioperative management of sickle cell diseasechildren undergoing adenotonsillectomy. Otolaryngol Head Neck Surg 2006; 134: 370–373.

    Article  PubMed  Google Scholar 

  17. Wali YA, al Okbi H, al Abri R. A comparison of two transfusion regimens in the perioperative management of children with sickle cell disease undergoing adenotonsillectomy. Pediatr Hematol Oncol 2003; 20: 7–13.

    PubMed  Google Scholar 

  18. Waldron P, Pegelow C, Neumayr L et al. Tonsilletomy, adenoidectomy and myringotomy in sickle cell disease: perioperative morbidity. Preoperative Transfusion in Sickle Cell Disease Study Group. J Pediatr Hematol Oncol 1999; 21: 129–135.

    Article  CAS  PubMed  Google Scholar 

  19. Marshall MJ, Bucks RS, Hogan AM, Hambleton IR, Height SE, Dick MC, Kirkham FJ, Rees DC. Auto adjusting positive airway pressure in children with sickle cell anemia: results of a phase 1 randomized trial. Hematologica 2009; 94: 1006–1010.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Raj Warrier.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Warrier, R., Chauhan, A. & Athale, U. Tonsillectomy and Adenoidectomy For Obstructive Sleep Apnea in Sickle Cell Anemia. Indian J Pediatr 77, 669–672 (2010). https://doi.org/10.1007/s12098-010-0093-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-010-0093-2

Key words

Navigation