Controversies in the Evaluation and Treatment of Pediatric Sleep Apnea
2016 AAO-HNSF Annual Meeting &OTO EXPOSM
Keyword(s)
Sleep disordered breathing, management of children with sleep disordered breathing
Sleep disordered breathing (SDB) is a common pediatric problem seen by otolaryngologists, and adenotonsillectomy is one of the most common surgical procedures performed in children. Numerous controversies exist regarding the management of pediatric SDB. Published guidelines from national otolaryngology, sleep medicine, and pediatric societies differ significantly in their recommendations. There has also been a large amount of recent published research on new diagnostic and treatment options. Thus, it can be challenging for otolaryngologists to determine the most appropriate management strategies for children presenting with SDB. Our primary aim is to identify and discuss controversies in the evaluation and treatment of children with SDB. These include: 1) whether or not home polysomnogram can be used to diagnose pediatric obstructive sleep apnea (OSA); 2) the most appropriate treatment for snoring and mild OSA; 3) whether tonsillectomy or tonsillotomy has superior treatment outcomes for pediatric SDB; 4) the role of drug induced sleep endoscopy as a diagnostic procedure; and 5) positive airway pressure verses further surgical therapy for persistent OSA following adenotonsillectomy. The proposed Mini-Seminar will include a panel discussion of these questions in a point-counter-point format. Panelists will provide evidence-based “pro and con” arguments for each controversy. To provide the best care to pediatric patients presenting with SDB, otolaryngologists must be familiar with the most up-to-date management options and be able to incorporate the current literature into their practice.
Description
Sleep disordered breathing (SDB) is a common pediatric problem seen by otolaryngologists, and adenotonsillectomy is one of the most common surgical procedures performed in children. Numerous controversies exist regarding the management of pediatric SDB. Published guidelines from national otolaryngology, sleep medicine, and pediatric societies differ significantly in their recommendations. There has also been a large amount of recent published research on new diagnostic and treatment options. Thus, it can be challenging for otolaryngologists to determine the most appropriate management strategies for children presenting with SDB. Our primary aim is to identify and discuss controversies in the evaluation and treatment of children with SDB. These include: 1) whether or not home polysomnogram can be used to diagnose pediatric obstructive sleep apnea (OSA); 2) the most appropriate treatment for snoring and mild OSA; 3) whether tonsillectomy or tonsillotomy has superior treatment outcomes for pediatric SDB; 4) the role of drug induced sleep endoscopy as a diagnostic procedure; and 5) positive airway pressure verses further surgical therapy for persistent OSA following adenotonsillectomy. The proposed Mini-Seminar will include a panel discussion of these questions in a point-counter-point format. Panelists will provide evidence-based “pro and con” arguments for each controversy. To provide the best care to pediatric patients presenting with SDB, otolaryngologists must be familiar with the most up-to-date management options and be able to incorporate the current literature into their practice. Learning Objectives:1: Understand common controversies in the management of pediatric sleep disordered breathing. 2: Become familiar with new evidence-based literature that addresses these controversies. 3: Incorporate innovative diagnostic and treatment advances in the management of children with pediatric sleep disordered breathing. Faculty:Cristina Baldassari, MD(no relationships to disclose); Ron B. Mitchell, MD(No relationships to disclose); Stacey L. Ishman, MD, MPH(Acclarent ( or other payments for services (employment) (Products/Services: None): Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received); Scott E. Brietzke, MD, MPH(No relationships to disclose); Norman R. Friedman, MD(No relationships to disclose)
