Current Concepts in the Surgical Management of Pediatric OSA

Abstract

Given that adenotonsillar hypertrophy is a common cause of upper airway obstruction in children with obstructive sleep apnea (OSA), adenotonsillectomy (T&A) has long been the first-line management approach. Despite the positive outcomes associated with this procedure, persistent disease occurs postoperatively in 34 % of children. A number of studies have therefore used drug-induced sleep endoscopy and other methods to identify sites of upper airway obstruction that may be amenable to surgical correction. Research is increasingly focused on the effectiveness of surgical procedures other than T&A, such as suturing of the tonsillar pillars, expansion pharyngoplasty, lingual tonsillectomy, supraglottoplasty, rapid maxillary expansion, and tongue suspension. This article presents an overview of these topics, focusing on current concepts in the surgical management of OSA.