BMI Z-score Improves following Adenotonsillectomy in Adolescents Aged 12-18 years

Background: Adenotonsillectomy (T&A) is the first line treatment for obstructive sleep apnea (OSA) in childhood. In prepubertal children OSA is usually associated with underweight which is improved following T&A; in adolescents OSA is commonly associated with obesity and the BMI following T&A is only sparsely studied. Thus, we sought to examine the BMI z-score change following T&A in adolescents.

Methods: Clalit Health Services is the largest health care organization in Israel with the largest patient registry. 242 adolescents aged 12-18 who underwent T&A between 2006-2015 were retrospectively investigated for BMI z-score change from up to 3 months prior to T&A and compared to BMI measures in the 3 consecutive years (up to 2019).

Results: There was a small increase, not statistically significant (P=0.26) in BMI Z-score with a median of 0.79 prior to and 0.835 following T&A. There were changes to all directions with Overweight children (n=74) tended to reduce their BMI z-score from 1.508 to 1.48 following T&A (p=NS), and in obese children (n=33) BMI z-score decreased from 2.288 to 2.000 accordingly (P=0.06, 2 tailed). On the other hand, thin individuals (n=6) increased their BMI z-score following T&A from -2.4 to -0.59 (p=0.046).

Conclusions: Adolescents following T&A show variable changes in their BMI z-score. They resemble the change seen in adults treated for OSA and not young children. The changes observed show trend to normalize the BMI z-score.