Isolated Adenoidectomy for Pediatric Sleep‐Disordered Breathing: A Systematic Review and Meta‐analysis
Hussein Smaily, Sara Benchekroun, Evana Francis, Patrick Cherfane, Michele Cherfane, Hisham Cheikh‐Hassan, Caroline SiroisAbstract
Objective
To evaluate the efficacy of isolated adenoidectomy in managing pediatric sleep‐disordered breathing (SDB) and upper airway obstruction (UAO).
Data Sources
MEDLINE, EMBASE, and CENTRAL were systematically searched from inception through March 2025.
Review Methods
Following Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines, we included studies reporting outcomes of isolated adenoidectomy in children with SDB and UAO. Two reviewers independently screened studies, extracted data, and assessed risk of bias. A meta‐proportion analysis was conducted to evaluate symptomatic improvement and the need for further surgical intervention.
Results
Twenty‐two observational studies including 4460 children were analyzed. The weighted mean age was 5.2 years. Isolated adenoidectomy led to a mean apnea‐hypopnea index reduction of 11.3 events/h across four studies. The pooled proportion of symptomatic improvement was 75% (95% CI 60‐88), while the pooled rate of further surgical intervention was 17% (95% CI 11‐24). Subgroup analyses suggested greater symptomatic improvement and lower reoperation rates in children older than 3 years.
Conclusion
Isolated adenoidectomy improves both objective sleep parameters and subjective outcomes. In appropriately selected children, it may represent a conservative alternative to adenotonsillectomy. These findings, however, require confirmation through well‐designed randomized controlled trials.