Tonsillectomy as a treatment of obstructive sleep apnea in adults with tonsillar hypertrophy

Objectives: High surgical success rates for adenotonsillectomy in children with sleep-related breathing disorders have been described in various studi es. The purposes of the present study were to observe how often a substanti al tonsillar hypertrophy is associated with obstructive sleep apnea (OSA) i n adults and to evaluate the efficiency of a bilateral tonsillectomy. Study Design: Data from a prospective study with 11 adults who underwent tonsill ectomy as single treatment for sleep-related breathing disorders were evalu ated based on the severity level of their preoperative apnea-hypopnea index (AHI). Material and Methods: Within 3 years, 11 patients with a substantia l tonsillar hypertrophy underwent attended polysomnography in the sleep lab oratory. Tonsillectomy was performed, and postoperative complications and p olysomnographic findings were reviewed. Follow-up time was 3 to 6 months. R esults: Nine of 11 patients (81.8%) were diagnosed with OSA. Five of these patients exhibited severe OSA, four patients had mild OSA, and two patients were simple snorers with an AHI below 10. The surgical response rates (def ined as decrease in the postoperative AHI greater than or equal to 50% and a postoperative AHI of less than 20) were 80.0% in severe apneics and 100% in mild apneics. No serious complications occurred. Conclusions: Substantia l tonsillar hypertrophy can rarely cause OSA in adults. In the carefully se lected patient a tonsillectomy should be considered an effective and safe s urgical option for the treatment of this disorder.