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One clinical decision that continues to present a challenge to many otolaryngologists is when to order a sleep study for a child in whom obstructive sleep apnea (OSA) or sleep-disordered breathing (SDB) is suspected and for whom an adenotonsillectomy (TA) is indicated.
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September 2016Clinical guidelines published in 2011 by the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) have provided some guidance on this decision, as have guidelines published in 2012 by the American Academy of Pediatrics (AAP) and, to a lesser extent, those published in 2011 by the American Academy of Sleep Medicine (AASM).
Although all three guidelines contain similar suggestions, they differ significantly in their final recommendations, said Stacey L. Ishman, MD, MPH, surgical director of the Upper Airway Center at Cincinnati Children’s Hospital Medical Center in Ohio, in a recently published article (JAMA Otolaryngol Head Neck Surg. 2016;142:179-118).