In an interview with ENTtoday, Dr. Ishman emphasized that while the AAO-HNS guideline offers the most comprehensive guidance for otolaryngologists, the AAP guideline offers diagnostic options other than sleep studies and recognizes that sleep studies are not feasible in all situations.
Scott Brietzke, MD, MPH, an otolaryngologist at Walter Reed National Military Medical Center in Bethesda, Md., agreed that the AAO-HNS guideline is the most relevant for otolaryngologists and encouraged otolaryngologists to be aware of the other guidelines, while underscoring the need for clinical judgment in determining when and in whom to order a sleep study. “You can’t realistically perform a sleep study with every child who comes through your office door with a sleep complaint,” he said. “You have to balance the benefit of the study and a particular child’s situation.” Informed otolaryngologists, he added, generally use sleep studies judiciously, basing each decision on the patient’s individual situation rather than following a guideline blindly.
A Look at the Guidelines
The recommendations from the AAO-HNS guidelines on the use of polysomnography for SDB prior to TA in children are listed in “AAO-HNS Recommendations for When to Order a Sleep Study Prior to Adenotonsillectomy,” below.