An overnight home oximetry that is “normal/inconclusive” (MOS of 1) can be used as a screening tool to identify patients with sleep-disordered breathing who can be safely sent to peripheral hospitals or outpatient surgical centers for T&A.
A 6-item questionnaire is a sensitive and easy-to-use screening tool for pediatric OSA in a pediatric sleep clinic setting.
There is limited evidence concerning diagnostic alternatives to PSG for identifying OSA in children. However, polygraphy, urinary biomarkers, and rhinomanometry may be valid tests if their apparently high DTA is confirmed by subsequent studies.
PSGs ordered by PCPs were more likely to be normal than PSGs by sleep physicians. Sleep clinic assessment before PSGs may assist in appropriate service utilization, improve delivery of care, and reduce health care costs by using these tests appropriately.
Many questions remain unanswered and future research as well as PSG standardization will further clarify the role of PSG in the evaluation and treatment of disrupted breathing patterns in children.
This review focuses on the epidemiology, pathogenesis, and diagnosis of OSA, and the state-of-the-art and future directions in the perioperative management of children with OSA.
Post T&A admission rates vary tremendously across comparable tertiary-care pediatric hospitals. There is a crucial need for a better understanding of the risk of complications on the first postoperative night, and the appropriate indications for monitored admission on that night.
For an appropriately selected child, adenotonsillectomy can be safely performed as a daycase procedure in a tertiary centre.
“The 5-year death rate was 70 per 10 000 for patients and 11 per 10 000 for controls. Children with OSA have significant morbidities several years before and after their diagnosis.
“This study, the largest collection of original reports of post-tonsillectomy mortality to date, found that events unrelated to bleeding accounted for a preponderance of deaths and anoxic brain injury.