Surgical Treatment in Jubilee Hospital Trivandrum, Kerala, India.
Snoring and Obstructive sleep apnea syndrome (OSAS) is a common problem in children, and is increasing being recognized as a cause of daytime sleepiness and behavioral problems. Most common cause of Snoring and mouth breathing in children is because of enlarged adenoid and Tonsils. Nasal allergy and frequent cold also contribute to mouth breathing.
Although snoring is a common symptom in children with obstructive sleep apnea, it is important to remember that between 10-20 percent of normal children snore (primary snoring) on a regular or intermittent basis.
In addition to continuous loud snoring, other symptoms of obstructive sleep apnea in children include:
and Failure to thrive (weight loss or poor weight gain)
and Mouth breathing and “adenoid face”
and Enlarged tonsils and adenoids-recurrent infections
and Problems sleeping and restless sleep
and Excessive daytime sleepiness
and Daytime behavior problems, including problems paying attention, aggressive behavior and hyperactivity and low IQ.
and Not doing well at school due to poor concentration.
How to make Diagnosis
The diagnosis of OSA in children is usually based on the characteristic symptoms and evidence of adeno-tonsillar hypertrophy (big tonsils and adenoids) and mouth breathing.
A good history from the parents is more than enough.
Children suspected of having OSA should usually be evaluated by an ENT Surgeon for further evaluation. X-ray/CT Scan of the upper airway often helps to find the areas of obstruction. A nasal Endoscopy can be performed in older children. Pediatric Sleep study (Polysomnogram) may be possible in older children.
How to Treat
Although younger children with OSA are not overweight, if a child is overweight, that might contribute to his symptoms. Weight loss is therefore important for overweight children with obstructive sleep apnea. Every attempt should be made to lose weight.
Other underlying medical conditions, especially nasal allergies, should also be treated. Nasal steroid sprays and antihistamines might help to improve the nasal obstruction and OSA symptoms in children with allergies.
Tonsillectomy and Adenoidectomy
The main treatment for kids with OSA is surgery, with removal of the child’s enlarged tonsils and adenoids (tonsillectomy and adenoidectomy or Ts&Ads).
This procedure is done under general anesthesia. Many cases can be done as day case without admitting the child in hospital. But I recommend overnight observation and can be discharged the next day morning. The Procedure is done by conventional dissection, laser or Coblator.
Prognosis
Excellent, one hundred percent cure from OSA in most cases which are caused by tonsillar and adenoid hypertrophy, but not congenital and other anomalies of face causing airway obstruction.
For Appointment– call 0471-2334561/62/63/64, 6452020,407822 Fax-0471-2330925
Email: drpaulose@yahoo.com
Clinic hours: Mon-Wed-Friday (8AM -1 PM)
Operation Days: Tue-Thu-and Saturdays (8AM-4PM)
To reach Jubilee Hospital: jubileehospitaltrivandrum
