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Pediatric OSA: Evidence-Based Review of Treatment Results

  • SLEEP MEDICINE: Sleep Apnea (K Pang, Section Editor)
  • Published:
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Abstract

Purpose of Review

Review current evidence-based treatment outcomes and future management directions for children with obstructive sleep apnea (OSA).

Recent Findings

Effective medical therapies include weight loss, leukotriene modifiers, nasal corticosteroids, oral appliances, and positive airway pressure. The first randomized controlled trials for adenotonsillectomy in childhood OSA show improved polysomnography results but no postoperative change in neurocognitive outcomes when compared to watchful waiting. Factors have been identified (e.g., craniofacial disorders and obesity) which can lead to decreased adenotonsillectomy success. The tongue base and supraglottis are common additional sites of obstruction, and supraglottoplasty and lingual tonsillectomy are commonly performed procedures for persistent OSA. Additional surgical targets include the nasal cavity, palate/pharynx, tongue base, and larynx.

Summary

The management of pediatric OSA is multidisciplinary and includes a variety of medical and surgical therapies. Although adenotonsillectomy remains first-line treatment, favorable outcomes exist for nonsurgical modalities. In children with persistent OSA after adenotonsillectomy, several procedures exist to address additional obstruction, but further investigation to delineate their appropriate indications is warranted.

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Authors and Affiliations

  1. Divisions of Pediatric Otolaryngology – Head & Neck Surgery and Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center, 400 Oak Street, Cincinnati, OH, 45219, USA

    Carol Li, Yann-Fuu Kou & Stacey L. Ishman

  2. Department of Otolaryngology – Head & Neck Surgery, University of Cincinnati School of Medicine, Cincinnati, OH, USA

    Carol Li & Yann-Fuu Kou

  3. Department of Otolaryngology – Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Stacey L. Ishman

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Li, C., Kou, YF. & Ishman, S.L. Pediatric OSA: Evidence-Based Review of Treatment Results. Curr Otorhinolaryngol Rep 9, 246–253 (2021). https://doi.org/10.1007/s40136-021-00348-4

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