Adenotonsillar hypertrophy and obstructive sleep apnea
Suggested Pre-Referral Evaluation and Management Guidelines
Assess daytime and nocturnal breathing for stertor, snoring, witnessd apneas, gasping, chest retractions, mouth breathing, or associated symptoms such as feeding difficulties, daytime sleepiness, behavioral issues or academic concerns.
Consider prolonged course of oral antibiotics for tonsillar hypertrophy following infection associated with onset of symptoms.
Signs of severe obstruction such as failure to thrive, pulmonary hypertension, LVH, or severe OSA on PSG (AHI over 5 or desaturations below 85%) may require more urgent evaluation.
Suggested Additional Test/Management Prior to Specialty Visit
Obtain polysomnogram for children under 3 years of age obese children, those with craniofacial syndromes such as Down syndrome, those with bleeding, pulmonary, or cardiac disorders or for those who have already had adenotonsillectomy.
Consider polysomnogram for other children when history is not consistent with physical examination. Results should be provided to the otolaryngology clinic.
PSG Results should be provided to the otolaryngology clinic prior to the appointment if performed at non-university of Michigan facilities.
Patient Education/Information (includes preps)
Next available. Contact clinic nurse for patients with signs of severe obstruction as listed above
How to Get Results to Consultant
UMHS Patients: See Michart.
External Patients: Hand carry results including hard copies or diskette of any imaging studies to visit.