EFICÁCIA DA ADENOTONSILECTOMIA NA MELHORA DA APNEIA OBSTRUTIVA DO SONO EM CRIANÇAS

ABSTRACT Introduction: Obstructive sleep apnea (OSA), defined by repeated obstruction of the upper airway during sleep, affects approximately 5% of the pediatric population. When left untreated, this condition can significantly impact behavior, physical and cognitive development, and overall well-being. The most common initial approach to treating pediatric OSA is the surgical removal of the tonsils and adenoids, since their enlargement often leads to airway obstruction or partial collapse, resulting in snoring and episodes of apnea and hypopnea. Objective: To evaluate the effectiveness of adenotonsillectomy (AT) in improving OSA symptoms in children, identifying key clinical outcomes, surgical indication criteria, and its impact on patients’ quality of life (QoL). Methodology: A narrative review was conducted with searches in the PubMed and BVS databases using standardized descriptors related to adenotonsillectomy and pediatric sleep apnea. Studies published between 2015 and 2025, in Portuguese, English, or Spanish, with full-text availability, were included. The PRISMA 2020 protocol was applied for data analysis and organization. Results and Discussion: Nine studies were included. Adenotonsillectomy showed significant improvement in QoL and clinical symptoms in children with OSA, particularly in moderate to severe cases, although complete resolution was not observed in all patients. Outcomes varied according to surgical technique and disease severity, supporting an individualized approach. Studies also reported benefits in mild cases and positive effects on other types of apnea, with notable advantages from technologies like endoscopy and plasma-assisted surgery. Conclusion: The literature confirms that AT is an effective intervention in most pediatric OSA cases, leading to symptom relief, improved QoL, and, in many cases, normalization of respiratory indices. However, case variability, the possibility of persistent OSA, and the need for personalized surgical methods highlight the importance of a patient-centered, evidence-based approach with continuous postoperative follow-up. Keywords: Adenoidectomy, Tonsillectomy, Adenotonsillectomy, Sleep Apnea, Obstructive Sleep Apnea, Sleep Disorders, Child, Pediatrics.