Adenotonsillectomy improves asthma control

Removing tonsils and adenoids to treat obstructive sleep apnea (OSA) in children also reduces symptoms of asthma, a new study reports.

To investigate whether adenotonsillectomy, which effectively treats OSA, would also improve asthma outcomes in children who have both inflammatory airway conditions, researchers used data from the 2003-2010 MarketScan database of privately insured patients to compare 13,506 children with asthma who had undergone surgery for OSA with 27,012 children with asthma who hadn’t had surgery.

Children who had adenotonsillectomy showed a sharp decrease in acute asthma exacerbations in contrast with children who didn’t have surgery: 1566 incidents postoperatively compared with 2243 before the operation. Acute status asthmaticus, asthma-related emergency department visits, and prescriptions for asthma medications (bronchodilators, inhaled corticosteroids, leukotriene receptor antagonists, and systemic corticosteroids) also declined significantly in the children who underwent adenotonsillectomy.

If prospectively designed clinical trials confirm their findings, the researchers conclude, treating adenotonsillar tissue morbidity could prove an important means of controlling asthma and reducing the need for medication.

They acknowledge that the MarketScan database has some limitations, namely lack of information on race and obesity, and lack of data on uninsured children and children covered by Medicaid.

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