Sleep-related Breathing Disorder: A Rare Complication Following Coblation Adenotonsillectomy

1. Director, Department of ENT, Hopkins ENT and No Snore Clinic, Tambaram, Chennai, Tamil Nadu, India. 2. Assistant Professor, Department of Pathology, Bhaarath Medical College and Hospital, Chennai, Tamil Nadu, India. 3. Professor, Department of Pathology, Bhaarath Medical College and Hospital, Chennai, Tamil Nadu, India. 4. Professor and Head, Department of Pathology, Bhaarath Medical College and Hospital, Chennai, Tamil Nadu, India.

Abstract

Sleep-Disordered Breathing (SDB) encompasses a wide range of respiratory conditions, from primary snoring to Obstructive Sleep Apnoea (OSA). OSA is widely recognised as a potential cause of significant morbidity in children. We describe the case of a five-year-old girl who underwent coblation adenotonsillectomy to treat a Sleep-Related Breathing Disorder (SRBD). However, three months after surgery she experienced severe apnoeic episodes. Further investigation uncovered a polypoid-like growth in the upper posterior nasopharynx, which was effectively treated with a second surgery. This case highlights the importance of postoperative monitoring and thorough evaluation in patients who undergo adenotonsillectomy for SRBD. Despite initial surgery, the persistence or recurrence of severe symptoms, such as apnoeic episodes, may indicate underlying issues, such as polypoid lesions, that require further intervention. Successful management in this case was achieved through revision surgery, emphasising the need for vigilance and comprehensive follow-up in paediatric patient with SRBD.

Apnoea, Adenoid tissue, Granulation tissue, Sleep related breathing disorder