Study designs of evaluations included in the review
Other than the evaluation of outcomes before and after surgery, no a priori study design was reported. All of the studies included in the review were case series.
Specific interventions included in the review
Studies that included surgical treatment (removal of adenoids and both tonsils) were eligible for inclusion.
Participants included in the review
Studies of children (younger than 18 years old) with OSAHS, but without significant co-morbidity including craniofacial syndrome, morbid obesity and neuromuscular disorders, were eligible for inclusion. Where reported, the mean age ranged from 4.5 to 7.5 years, the pre-intervention Apnea Hypopnea Index (AHI) scores ranged from 6.375 to 31.5, and the polysomnogram (PSG) criteria for OSAHS ranged from 1 to 5.
Outcomes assessed in the review
Studies that evaluated participants with nocturnal PSG before and after surgery and assessed, at a minimum, the measurement of apnoea and hypopnoea using plethysmography and pulse oximetry with calculation of an AHI, were eligible. The overall success (percentage) of normalising PSG measurements was also included in the review; criteria for success ranged from 1 to 5 events per hour. Studies must have presented sufficient data to allow calculation of the parameters of interest (change in AHI and number of patients successfully treated).
How were decisions on the relevance of primary studies made?
Article titles and abstracts were reviewed for eligibility against the inclusion criteria. The authors did not state how the primary papers were selected for the review, or how many reviewers performed the selection.