After tonsillectomy for sleep apnea, a 13-year-old girl in Oakland, California has been declared brain dead. Evidence shows the procedure may be useful, but the risks mean it should be considered as a treatment of last resort.
Tonsillectomies Used to Be Common
Tonsillectomy used to be a normal thing for kids growing up in the 50s, 60s, and 70s, when they were told to be brave for the surgery and look forward to the ice cream they got to eat afterward. The purpose was to combat chronic throat infections. However, in the 1980s, it was shown that this routine procedure didn’t give much in the way of results, so it fell out of favor.
Now tonsillectomies are growing in popularity again, this time as a sleep apnea treatment. There are perhaps 530,000 procedures performed every year on children under 15. According to the American Academy of Otolaryngology, the procedure boomed back between 1996 and 2006, when procedures increased about 75%.
Risks and Benefits of Tonsillectomies
Tonsillectomies have been shown to be effective at treating sleep apnea. For mild sleep apnea, children with an apnea-hypopnea index (AHI) of <10, it’s 100% effective. But it’s less effective the more severe the sleep apnea. It’s only about 73% effective for patients with a higher AHI, and only 64% effective for patients with severe sleep apnea.
We’re not exactly sure how dangerous surgery is for these children. The most recent safety estimates come from the 1970s when fatal complications occurred in 1 in 16,000-35,000 children. But that was for a generally healthy surgical population. Today’s children receiving the procedure mostly have sleep apnea, which increases surgical risk.
Other Treatment Options
But, like adults, there are many ways to treat childhood sleep apnea, so surgery doesn’t have to be approached right away. Lifestyle modifications, such as reducing allergens, changing sleep position, and weight loss are a good start for sleep apnea treatment. In addition, CPAP can be effective for children, although compliance rates are even lower than for adults.
Adult Sleep Apnea Surgery
Like children, adults are sometimes encouraged to get surgery for sleep apnea. This leads to additional risk and should be postponed until other treatment options have been tried, including oral appliance therapy.
If you are an adult looking to learn more about sleep apnea treatment options, please call (303) 691-0267 at the TMJ Therapy & Sleep Center of Colorado in Denver today for more information.