Literature Updates from November 2014

Quantifying Respiratory Complications Post-Adenotonsillectomy in Patients With Normal or Inconclusive Overnight Oximetry

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.

Diagnosis of Obstructive Sleep Apnea in Children: A Systematic Review

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.

The Diagnostic Yield of Pediatric Polysomnography Based on the Professional Background of Referring Physicians

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.

Variation in Post-Adenotonsillectomy Admission Practices in 24 Pediatric Hospitals

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.

Mortality and Major Morbidity After Tonsillectomy: Etiologic Factors and Strategies for Prevention

“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.