Persistent sleep apnea after adenotonsillectomy in pediatric patients with head and neck burns

Background: To determine if face, head, or neck burns increases risk of persistent sleep disordered breathing (SDB) or obstructive sleep apnea (OSA) after adenotonsillectomy. Methods: The TriNetX database was used to gather data for patients who had face, head, or neck burn including mouth and pharynx and history of sleep study with adenotonsillectomy. A comparison of persistent SDB or OSA was done between cohort 1, a group with sleep study and adenotonsillectomy after burn injury, and cohort 2, a group with treatment before a burn. Risk of persistence was evaluated as relative risk (RR) with 95 % confidence interval (CI). Results: Eighty-three pediatric patients were included. Fifty-one patients were in cohort 1, and 32 in cohort 2. Forty-three patients in cohort 1 had persistent SDB or OSA as compared to 11 in cohort 2, which was statistically significant (RR: 2.45; 95 % CI: 1.50–4.02; p-value <0.0001). After propensity score matching, both groups had 23 patients, and 19 had persistent SDB or OSA in cohort 2, while cohort 1 had 10 patients. The difference in persistence was significant (RR 1.9; 95 % CI: 1.15–3.14; p-value equals 0.006). Conclusions: Pediatric patients with a face, head, or neck burn had a higher rate of persistent SDB or OSA after adenotonsillectomy compared to patients who had surgery prior to thermal injury.