Identification and evaluation of obstructive sleep apnea prior to adenotonsillectomy in children: is there a problem?

In this issue of Weatherly et al. [ ] have described in their article, Identification and Evaluation of Obstructive Sleep Apnea Prior to Adenotonsillectomy in Children: A survey of Practice Patterns, how otolaryngologists approach sleep disordered breathing (SDB) in children. Based on this study, SDB has overtaken recurrent throat infections as the major surgical indication for adenotonsillectomy (AT) in children. They also note that less than 10% of children suspected of having SDB had any objective testing performed prior to surgery and that less than 5% had laboratory based polysomnography. This is in direct conflict with the recommendations of both the American Academy of Pediatrics [ ] and the American Thoracic Society [ ], both of whom recommend objective confirmation of SDB prior to consideration of any intervention for SDB. A brief review of SDB in children, its clinical consequences and Sleep Medicine 1