OTO: Influence of Tonsillar Size on OSA Improvement in Children Undergoing Adenotonsillectomy

This podcast highlights original research published in the August 2015 issue of Otolaryngology - Head and Neck Surgery, the official journal of the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) Foundation. Editor in chief John Krouse is joined by senior author Stacey Ishman and associate editor David Darrow in discussing the association of tonsillar size in children, the severity of obstructive sleep apnea (OSA), and the response to surgical treatment for OSA in these children.   Obstructive sleep apnea (OSA) is a problem of increasing concern for children and their parents.  Many otolaryngologists may believe that OSA is worse in children with very large tonsils than it is in children with smaller tonsils.  The present paper, however, suggests that the severity of OSA is independent of tonsillar size, and that children with both small and large tonsils appear to have similar reductions in objective indicators of OSA after adenotonsillectomy.  An important message from this study is that even children with small tonsils on physical examination may have clinically significant OSA, and that surgical treatment might be of benefit even in this patient population.  In addition, the participants discuss the role of polysomnography as a diagnostic modality in these children, as well as other diagnostic considerations that may be important.  Drs. Ishman and Darrow discuss the implications of these observations for the medical and surgical management of children with obstructive sleep apnea. Click here to read the full article.