Our Summary

This research paper is about a group of experts who came together to develop a consensus statement on the topic of persistent obstructive sleep apnea (OSA) in children. OSA is a condition where a child’s breathing stops and starts during sleep, and it’s considered persistent when it continues even after surgery to remove the tonsils or adenoids.

The experts, chosen by relevant organizations, used a method from the American Academy of Otolaryngology-Head and Neck Surgery to develop their findings for children aged 2-18 years. They used a systematic approach to search the existing literature and used a technique called the Delphi method to refine their opinions and create statements that they could all agree on.

After three rounds of surveys, they agreed on 34 statements, but could not reach consensus on 18 others. The agreed-upon statements covered a range of topics, including general information, patient assessment, managing patients who are overweight, medical management, sleep endoscopy (a procedure where a small camera is used to examine the throat during sleep), surgical management, and care after surgery.

In conclusion, the paper suggests that these consensus statements can be used to improve the care of children with persistent OSA, create treatment plans, and identify areas that need more research.

FAQs

  1. What is persistent obstructive sleep apnea (OSA) in children?
  2. What method did the experts use to develop their consensus statement on persistent OSA in children?
  3. What topics did the agreed-upon consensus statements cover?

Doctor’s Tip

One helpful tip a doctor might give a patient about adenoidectomy is to follow post-operative care instructions carefully. This may include avoiding strenuous activity, eating soft foods, and taking prescribed pain medication as directed. It is also important to attend follow-up appointments to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for adenoidectomy include children with persistent obstructive sleep apnea (OSA) who have not responded to other treatments such as continuous positive airway pressure (CPAP) therapy or tonsillectomy. Adenoidectomy may also be recommended for children with recurrent throat infections or chronic nasal obstruction due to enlarged adenoids. Additionally, children with complications such as ear infections, sinusitis, or dental abnormalities related to enlarged adenoids may also be candidates for adenoidectomy. It is important for healthcare providers to assess each patient individually and consider their specific symptoms and medical history before recommending adenoidectomy.

Timeline

Before adenoidectomy:

  • A child may experience symptoms of persistent obstructive sleep apnea (OSA) such as snoring, gasping for breath during sleep, daytime sleepiness, and difficulty concentrating.
  • The child may undergo a sleep study to diagnose OSA and determine the severity of the condition.
  • Treatment options such as continuous positive airway pressure (CPAP) therapy or adenoidectomy may be considered.
  • The child may undergo pre-operative assessments and preparations for the surgery.

After adenoidectomy:

  • The child undergoes adenoidectomy surgery to remove the adenoids, which are lymphoid tissue located at the back of the nasal cavity.
  • The child may experience some pain, discomfort, and swelling in the throat following the surgery.
  • The child is monitored for any complications or side effects of the surgery.
  • The child may experience improvements in symptoms of OSA such as better sleep quality, reduced snoring, and improved daytime function.
  • The child may require follow-up appointments with healthcare providers to monitor their progress and ensure proper healing.
  • The child may need to make lifestyle changes to maintain good sleep hygiene and overall health.

What to Ask Your Doctor

Some questions a patient should ask their doctor about adenoidectomy based on the information in this research paper could include:

  1. What is the success rate of adenoidectomy in treating obstructive sleep apnea in children, particularly in cases of persistent OSA?

  2. How will you assess my child’s condition before recommending adenoidectomy? What tests or evaluations will be conducted?

  3. Are there any specific factors, such as being overweight, that may affect the outcome of adenoidectomy for persistent OSA in children?

  4. What are the potential risks and complications associated with adenoidectomy in children with persistent OSA?

  5. Will medical management be necessary before or after adenoidectomy for my child’s persistent OSA?

  6. Will sleep endoscopy be used as part of the evaluation process for my child’s persistent OSA before considering adenoidectomy?

  7. What is the recommended post-operative care for children after undergoing adenoidectomy for persistent OSA?

  8. Are there any alternative treatments or therapies that should be considered before proceeding with adenoidectomy for persistent OSA in children?

  9. How will you determine if adenoidectomy was successful in treating my child’s persistent OSA after the surgery has been performed?

  10. Are there any ongoing research or advancements in the treatment of persistent OSA in children that may impact the recommendations for adenoidectomy in the future?

Reference

Authors: Ishman SL, Maturo S, Schwartz S, McKenna M, Baldassari CM, Bergeron M, Chernobilsky B, Ehsan Z, Gagnon L, Liu YC, Smith DF, Stanley J, Zalzal H, Dhepyasuwan N. Journal: Otolaryngol Head Neck Surg. 2023 Feb;168(2):115-130. doi: 10.1002/ohn.159. PMID: 36757810