0882 Polysomnographic Outcomes in Children with Achondroplasia Before and After Adenotonsillectomy

Abstract Introduction Obstructive sleep apnea hypopnea syndrome (OSAHS) is common in children with achondroplasia due to anatomic differences including midface hypoplasia. Although adenotonsillectomy is first-line therapy for OSAHS in children, less is known about outcomes of this surgical procedure in children with achondroplasia. Methods This IRB-approved, retrospective review examines polysomnogram (PSG) data from children with achondroplasia before and after adenotonsillectomy. Children were included in the analysis if they completed pre-and post-surgical PSG in the same AASM-accredited pediatric sleep laboratory between 2010 and 2025. Clinical and PSG data were obtained via chart review. Descriptive statistics were performed; two-tailed t-tests were calculated to compare respiratory indices before and after adenotonsillectomy. Results 22 patients (mean age 24.5 months, 50% male, 77% white) met inclusion criteria. Pre-surgical PSG with mean AHI 28.0(42.4) events/hour, OAI 6.1(8.0) events/hour, CAI 2.9(6.6) events/hour, SpO2 nadir 76(17)%, 2.0(3.0)% of TST with SpO2< 90%, and 36% with hypoventilation. 73% of patients had AHI >10 events/hour. Post-surgical PSG with mean AHI 17.5(18.2) events/hour (p=0.07), OAI 4.8(11.8) events/hour (p=0.66), CAI 1.8.(3.4) events/hour (p=0.01), SpO2 nadir 85(8.5)% (p=0.01), 0.7(1.5) of TST with SpO2< 90% (p=0.08), and 32% with hypoventilation. 55% of patients with residual AHI >10 events/hour. There were no significant changes in sleep architecture between groups. Conclusion Adenotonsillectomy improves respiratory indices in children with achondroplasia; however, residual OSAHS and hypoventilation were common after surgery. Close clinical monitoring and repeat PSG after surgery are recommended for ongoing management. Support (if any) None