Practice Focus

Is Polysomnagraphy Required Prior to T+A for Diagnosis of OSA versus Mild Sleep Disordered Breathing in Children?

Polysomnography (PSG) has been recommended by the American Academy of Pediatrics as the gold standard for the diagnosis of obstructive sleep apnea (OSA) versus mild sleep disordered breathing (SDB) prior to tonsillectomy and adenoidectomy (T+A) in children. Mild SDB includes primary snoring and upper airway resistance syndrome. Controversy exists regarding the accuracy of history and physical exam (H+P) alone in children for the diagnosis of OSA versus mild SDB prior to T+A. Thus, PSG has been recommended to confirm the diagnosis

Are Routine Dissolvable Nasal Dressings Necessary Following ESS?

Nasal dressings have frequently been advocated to improve wound healing and prevent ongoing bleeding after endoscopic sinus surgery (ESS). Initial experience focused on removable nasal packing materials; however, their adverse effect profile, such as pain/discomfort and mucosal trauma, has driven the development of absorbable biomaterials. Despite these developments, there is still little agreement on the optimal choice of nasal dressing or whether nasal dressings are required at all