Assessment of the Influence of OSA and Associated Risk Factors on Postoperative Complications in Pediatric Adenotonsillectomy

Introduction: Obstructive Sleep Apnea (OSA) is a significant pediatric health concern, often attributed to hypertrophy of lymphatic tissue, particularly the tonsils and adenoids. Adenotonsillectomy remains the primary treatment modality, though the procedure is not without risk. This study aimed to assess the influence of OSA and associated risk factors on postoperative complications in children undergoing adenotonsillectomy. Methods: This retrospective observational study was conducted in the Department of Otolaryngology–Head and Neck Surgery, Anwer Khan Modern Medical College Hospital, Dhaka, Bangladesh, from December 2022 to December 2024. In this study, we included 143 pediatric patients with obstructive sleep apnea (OSA) who underwent adenotonsillectomy within the study period at the otolaryngology department of our institution. Result: The majority of patients were aged 5–8 years (39.16%), with a slight male predominance (56.64%). Comorbidities were present in 53 patients (37.06%), with rhinitis being the most common (29.37%). Most procedures were completed within 20–40 minutes (72.73%). Per-operative hemorrhage was noted in 22.38% of patients. The most common postoperative complication was sore throat (78.32%), followed by sneezing (29.37%), pain (26.57%), and cough (20.28%). Despite these symptoms, full recovery was observed in all patients (100%). Risk factors significantly associated with complications included a young age of <3 years (21.68%), low body weight <13 kg (18.88%), low BMI <14.5 kg/m² (17.48%), comorbidities (37.06%), and longer surgical duration >40 minutes (20.28%). Conclusion: This study showed that Adenotonsillectomy remains a safe and effective treatment for pediatric OSA, although perioperative and postoperative complications are not uncommon. Identifying risk factors such as comorbidities, young age, and low BMI can help optimize perioperative planning and postoperative care to improve outcomes.