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Randomized Control Trials of Surgery for Pediatric OSA

K

Karolinska University Hospital

Status

Completed

Conditions

Pediatric Disorder
Otorhinolaryngologic Diseases
Sleep Apnea, Obstructive

Treatments

Procedure: APP
Procedure: ATE

Study type

Interventional

Funder types

Other

Identifiers

NCT02315911
NCT02315911

Details and patient eligibility

About

Randomized study on pediatric OSA with 2 groups: mild-moderate OSA and severe OSA. Mild-moderate are randomized to either expectancy or ATE. Severe are randomized to either ATE or APP. Pediatric age span of 2 until 4,9 years.

Full description

Children who are referred to ENT clinic because of sleep-disordered breathing and fulfil the inclusion criteria undergo polysomnography (PSG) and fill in questionnaires. Depending on the outcome of the PSG, whether a) the child have mild to moderate OSA (AHI between 2-9.9) the family is asked to be in the study. If yes, the doctor take a sealed envelope and open it, either the child are randomized to adenotonsillectomy (ATE) or 6 months expectancy. Whether PSG shows b) severe OSA and the family accept participation the child is operated within a month. There is a straification beetween 2 groups, if AHI is 1) between 10 and 29.9 or 2) above 30. A sealed envelope is open in the operating room by the surgeon. The child is randomized to either ATE or ATE and suturing of the tonsillar pillars. The study is blinded for the family, who will not know which method the child has undergone. After 6 months all children will undergo follow-up with PSG and questionnaires. If the expectancy group will deteriorate during waiting time, or the child still has moderate to severe OSA, they will undergo ATE. Further follow-ups at three and ten years. Altogether 160 children should be evaluated with two PSG, 80 in each group.

Enrollment

143 patients

Sex

All

Ages

2 to 5 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • OAHI >= 2
  • Tonsillary hypertrophy, Brodsky size 2-4
  • Adequate swedish knowledge

Exclusion criteria

  • Cardiovascular disorders
  • Pulmonary disorders
  • Neuromuscular disorders
  • Cranoifacial malformations
  • Genetic disorders
  • Earlier performed adenoid-tonsillary-surgery
  • Bleeding disorders

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Quadruple Blind

143 participants in 4 patient groups

expectancy for mild-moderate OSA
No Intervention group
Description:
6 months expectancy
ATE for mild-moderate OSA
Experimental group
Description:
adeno-tonsillectomy
Treatment:
Procedure: ATE
ATE for severe OSA
Experimental group
Description:
adeno-tonsillectomy
Treatment:
Procedure: ATE
APP for severe OSA
Experimental group
Description:
adeno-pharyngoplasty
Treatment:
Procedure: APP

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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