gms | German Medical Science

Background: We were able to show that a simultaneous tonsillectomy during a Multi-Level-Surgery (MLS) in adults with OSA had an positive Effect on the surgical outcome [1]. In this study we did check the influence of tonsil size on the degree of OSA.

Patients and methods: 37 adults with OSA have been included in a prospective analysis between 04/2015 and 10/2015.Preoperativ standard Polysomnography and Epworth-Sleepiness-Scale (ESS) have been done. While MLS tonsil volumes where quantified by the archimedic princip (water displacement).

Results: There were three groups defined by Volume (V) of both tonsils: A (N=13) V until 5 ml; B (N=16) V: 5–10 ml and C (N=9) V: 10–15 ml. Concerning the Body-Mass-Index there was a significant difference between the groups (A: 28.1 kg/m²; B: 29.8 kg/m²; C: 29.5 kg/m²).

Group A did show a mean AHI of 19.3 ± 9.4, group B of 21.5 ± 14.4 and group C of 25 ± 10.6. These differences were not significant.

Conclusion: Tonsillectomy is known as an effective treatment of OSA. So the assumption is obvious that the degree of OSA rises by increasing tonsil volume. Such a research for adults does not exist by the knowledge of the authors.

This hypothesis could be confirmed in this study without influence of the BMI. These are not significant differences, perhaps because of the low number of cases.

If large tonsils and high AHI are good predictors for a good surgical outcome in MLS, postoperative investigations have to show.