Adenotonsillar hypertrophy and obstructive sleep apnea
Suggested Pre-Referral Evaluation and Management Guidelines
Assess daytime and nocturnal breathing for stertor, snoring, cessation of all breathing efforts, gasping, struggling, chest retractions, mouth breathing, feeding difficulties, daytime sleepiness.
Consider prolonged course of oral antibiotics for tonsillar hypertrophy following infection.
Signs of severe obstruction such as failure to thrive, complete obstruction of the oropharyngeal airway, 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 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 when history is not consistent with physical examination. Results should be provided to the otolaryngology clinic.
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 Careweb.
External Patients: Hand carry results including hard copies or diskette of any imaging studies to visit.