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Paediatric obstructive sleep apnoea: is our operative management evidence-based?

Published online by Cambridge University Press:  21 February 2018

L Pabla ,
J Duffin ,
L Flood  and
K Blackmore
L Pabla*
Affiliation:
ENT Department, James Cook University Hospital, Middlesbrough, UK
J Duffin
Affiliation:
ENT Department, James Cook University Hospital, Middlesbrough, UK
L Flood
Affiliation:
ENT Department, James Cook University Hospital, Middlesbrough, UK
K Blackmore
Affiliation:
ENT Department, James Cook University Hospital, Middlesbrough, UK
*
Address for correspondence: Miss Lakhbinder Pabla, ENT Department, James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK E-mail: Lakh.pabla.bal@gmail.com
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Abstract

Background:

Despite the plethora of publications on the subject of paediatric obstructive sleep apnoea, there seems to be wide variability in the literature and in practice, regarding recourse to surgery, the operation chosen, the benefits gained and post-operative management. This may reflect a lack of high-level evidence.

Methods:

A systematic review of four significant controversies in paediatric ENT was conducted from the available literature: tonsillectomy versus tonsillotomy, focusing on the evidence base for each; anaesthetic considerations in paediatric obstructive sleep apnoea surgery; the objective evidence for the benefits of surgical treatment for obstructive sleep apnoea; and the medical treatment options for residual obstructive sleep apnoea after surgical treatment.

Results and conclusion:

There are many gaps in the evidence base for the surgical correction of obstructive sleep apnoea. There is emerging evidence favouring subtotal tonsillectomy. There is continuing uncertainty around the prediction of the level of post-operative care that any individual child might require. The long-term benefit of surgical correction is a particularly fertile ground for further research.

Keywords

ChildTonsillectomySleep Apnea, ObstructiveTreatment

Information

Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 4 , April 2018 , pp. 293 - 298
Copyright
Copyright © JLO (1984) Limited 2018 

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