Persistent Obstructive Sleep Apnea After Tonsillectomy. Learning Objectives. Mary Frances Musso, DO Pediatric Otolaryngology
|
|
- Ashlie Osborne
- 5 years ago
- Views:
Transcription
1 Persistent Obstructive Sleep Apnea After Tonsillectomy Mary Frances Musso, DO Pediatric Otolaryngology Learning Objectives Recognize indications for tonsillectomy List patients at risk for persistent OSA Identify methods used to evaluate sites of persistent obstruction Discuss treatment modalities for persistent OSA 1
2 Sleep Related Upper Airway Obstruction Primary Snoring 10% of children Sleep Disordered Breathing 25% to 40% in obese children Obstructive Sleep Apnea Syndrome 1-4% of children Untreated Effects of OSA:What We Know Cardiovascular effects Hypertension Right sided heart failure / cor pulmonale / Pulmonary HTN Ventricular remodeling Neurocognitive problems Behavioral consequences Enuresis Somatic growth retardation 2
3 Many Things We Don t Know. Guidelines 3
4 Tonsillectomy Indications for Recurrent Tonsillitis Criterion Minimum Frequency of Sore Throat Episodes Clinical features Treatment Documentation Definition At least 7 episodes in the previous year, at least 5 episodes in each of the 2 previous years, or at least 3 episodes in each of the previous 3 years Sore throat plus at least 1 of the following features qualifies as a counting episode: Temperature greater than (38.3) Cervical adenopathy (tender lymph nodes or lymph node size greater than 2 cm) Tonsillar exudate Culture positive for group A β-hemolytic streptococcus Antibiotics administered in the conventional dosage for proved or suspected streptococcal episodes Each episode of throat infection and its qualifying features substantiated by contemporaneous notation in a medical record If the episodes are not fully documented, subsequent observance by the physician of 2 episodes of throat infection with patterns of frequency and clinical features consistent with the initial history* Who Needs a Sleep Study Before Surgery? 4
5 Tonsillectomy Indications for OSA OSA Severity No OSA <1 Mild >1 to <5 PSG Criteria (AHI;; events/h) Moderate >5 to <10 Severe >10 Abnormal PSG in a child: Pulse oximetry levels less than 92% AHI >1 AHI >5 may warrant tonsillectomy Otolaryngology Head and Neck Surgery144(1S) S1 S Pediatric OSA Most common cause of upper airway obstruction remains adenoid & tonsil hypertrophy If hypertrophic tonsil & adenoid tissue are present adenotonsillectomy (T&A) first line treatment 5
6 Other Indications for Tonsillectomy Multiple antibiotic allergy/intolerance PFAPA Periodic fever, aphthous stomatitis, pharyngitis, adenitis History of peritonsillar abscess PANDAS-Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections Poorly validated clinical indications halitosis, febrile seizures, malocclusion of teeth Post-tonsillectomy Healing Day 1 Day 5 Day 7 Day 17 Isaacson G. et al. Pediatrics Vol. 130 No. 2 August 1, 2012 pp
7 Persistent OSA Published studies included- 355 subjects Treatment success of T&A 82% Excluded: craniofacial syndromes, neuromuscular disorders, morbid obesity Included: subjects up to 18 years of age Published studies included-1079 subjects Treatment success of T&A was 66% Excluded : craniofacial syndromes, chromosomal disorders & neuromuscular disorders Included : obese subjects, up to 20 years of age Risk Factors for Persistent OSA after T&A Craniofacial/ mandibular anomalies (Pierre Robin sequence, Treacher Collins) Obesity Neuromuscular disorders Genetic disorders Severe OSA prior to surgery Asthma in non-obese children 7
8 Where is the Persistent Obstruction?? PSG provides data on degree of OSA, does not identify level or levels of obstruction Anatomic sites where obstruction can occur 1. Nose and nasopharynx 2. Posterior oropharynx 3. Lateral pharyngeal walls 4. Level of hypopharynx / obstruction of BOT 5. Larynx Radiographic Studies Cine MRI Current Opinion in Otolaryngology & Head and Neck Surgery 2011, 19:
9 Drug Induced Sleep Endoscopy (DISE) + Flexible laryngoscope DLB set 9
10 DISE Findings DISE Patient: 4 y/o M with h/o CHARGE/Goldenhar Syndrome S/p T&A at 2 years of age Recent PSG Mild OSA-0 obstructive apneas, 2 central apneas, 29 obstructive hypopneas, AHI 5.76, oxygen nadir was 90% H/o allergic rhinitis currently taking Zyrtec and Flonase Has not tried CPAP Has recurrent bronchitis 10
11 1/23/18 Video Areas addressed: supraglottoplasty, adenoid remnant, turbinate reduction Future consideration: lingual tonsils and laryngeal cleft injection 11
12 DISE Patient: 12 y/o with Trisomy 21 s/p PDA ligation PSG Severe OSA- AHI 31, oxygen nadir 82%(0.2 % time under 90%) 0 obstructive apneas, 1 mixed apneas, 16 central apneas, 238 obstructive hypopneas Recurrent pneumonias: 2 pneumonias, one of which was RSV No tonsil hypertrophy on PE Areas addressed: adenoids, inferior turbinates, lingual tonsils Future consideration: tonsils, AE folds 12
13 Treatment of Persistent OSA Nonsurgical Options MEDICATIONS: Intranasal corticosteroid sprays Fluticasone, Budesonide Leukotriene inhibitors Montelukast Key Points Up to 40% of children can have persistent OSA after T&A Children that continue to be symptomatic and children who are at higher risk for persistent OSA should undergo a sleep study after T&A DISE and Cine MRI are the most common tools used to identify sites of obstruction for children with persistent OSA Surgical and nonsurgical modalities are generally needed to treat persistent OSA 13
14 Single Visit Surgery Who: Children with recurrent ear infections Where: Texas Children s Hospital West Campus When: Why: How: Offered two times a month on Fridays by Dr. Musso and Dr. Raynor One visit more efficient for patients and parents Can call WC nurses line directly to schedule an appointment option 2 14
Pediatric Obstructive Sleep apnea An update What else is there to know?
Pediatric Obstructive Sleep apnea An update What else is there to know? Garani S. Nadaraja, MD, FAAP Medical Director BCH-Oakland Clinical Assistant Professor Division of Pediatric Otolaryngology UCSF
More informationClinical Practice Guideline: Tonsillectomy in Children, Baugh et al Otolaryngology Head and Neck Surgery, 2011 J and: 144 (1 supplement) S1 30.
Pediatric ENT Guidelines Jane Cooper, FNP, CORLN References: Clinical Practice Guideline: Tympanostomy tubes in children, Rosenfeld et al., American Academy of Otolaryngology Head and Neck Surgery Foundation
More informationSleep-Disordered Breathing in Children and a Critical Review of T&A. Objectives. No disclosures
Sleep-Disordered Breathing in Children and a Critical Review of T&A No disclosures Anna Meyer, MD, FAAP Pediatric Otolaryngology Otolaryngology-Head & Neck Surgery UCSF February 2014 1 Objectives Summarize
More informationHow many tonsillectomies are necessary?
How many tonsillectomies are necessary? An eleven year retrospective study of indications and eligibility for childhood tonsillectomy in UK Dana Šumilo, Ronan Ryan, Tom Marshall Preventing Overdiagnosis,
More informationNew Guidelines for Tonsillectomy Daniel C. Chelius, Jr., MD Pediatric Otolaryngolo Pediatric Otolary gy--head Head and Neck S and Neck u S rgery
New Guidelines for Tonsillectomy Daniel C. Chelius, Jr., MD Pediatric Otolaryngology-Head and Neck Surgery November 16, 2011 EXIT Procedures Sinus surgery/skull base surgery Head and Neck Cancers Thyroid/Parathyroid
More informationTonsillectomy/Adenoidectomy
Last Review Date: January 12, 2018 Number: MG.MM.SU.58C2 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary care provider must submit to EmblemHealth
More informationSuchada Sritippayawan, MD Div. Pulmonology & Critical Care Dept. Pediatrics, Faculty of Medicine
Management of pediatric OSA Suchada Sritippayawan, MD Div. Pulmonology & Critical Care Dept. Pediatrics, Faculty of Medicine Chulalongkorn University Treatment modalities Surgery Medications NIV during
More informationAn update on childhood sleep-disordered breathing
An update on childhood sleep-disordered breathing แพทย หญ งวนพร อน นตเสร ภาคว ชาก มารเวชศาสตร คณะแพทยศาสตร มหาว ทยาล ยสงขลานคร นทร Sleep-disordered breathing Primary snoring Upper airway resistance syndrome
More informationPediatric obstructive sleep apnea Adenotonsillectomy and beyond (a surgeon s perspective)
Pediatric obstructive sleep apnea Adenotonsillectomy and beyond (a surgeon s perspective) Tony Kille, MD Associate Professor Pediatric Otolaryngology American Family Children s Hospital Madison, WI Disclosures
More informationTonsillectomy Hemorrhage. DR Tran Quoc Huy ENT department
Tonsillectomy Hemorrhage complication DR Tran Quoc Huy ENT department Topic Outline INTRODUCTION OVERVIEW OF INDICATIONS CONTRAINDICATIONS COMPLICATIONS HEMORRHAGE COMPLICATION INTRODUCTION Tonsillectomy
More informationPEDIATRIC OBSTRUCTIVE SLEEP APNEA (OSA)
PEDIATRIC OBSTRUCTIVE SLEEP APNEA (OSA) DEFINITION OSA Inspiratory airflow is either partly (hypopnea) or completely (apnea) occluded during sleep. The combination of sleep-disordered breathing with daytime
More informationAnesthesia Considerations for Dynamic Upper Airway Evaluation
Anesthesia Considerations for Dynamic Upper Airway Evaluation Mohamed Mahmoud MD Associate Professor of Anesthesia & Pediatrics Cincinnati Children s Hospital Medical Center Objectives Diagnosis of Sleep
More informationPediatric Otolaryngology Disorders for Primary Care ASHOK N. REDDY, MD CONCORD OTOLARYNGOLOGY HEAD AND NECK SURGERY CONCORD, NH
Pediatric Otolaryngology Disorders for Primary Care ASHOK N. REDDY, MD CONCORD OTOLARYNGOLOGY HEAD AND NECK SURGERY CONCORD, NH DISCLOSURES None of the planners or presenters of this session have disclosed
More informationClinical Policy Title: Tonsillectomy and (or) adenoidectomy in children up to 12 years old
Clinical Policy Title: Tonsillectomy and (or) adenoidectomy in children up to 12 years old Clinical Policy Number: 11.03.04 Effective Date: October 1, 2014 Initial Review Date: April 16, 2014 Most Recent
More informationCHALLENGES IN PEDIATRIC OBSTRUCTIVE SLEEP APNEA. Amy S. Whigham, MD Assistant Professor
CHALLENGES IN PEDIATRIC OBSTRUCTIVE SLEEP APNEA Amy S. Whigham, MD Assistant Professor Disclosures I have nothing to disclose. Outline Epidemiology Diagnosis Adenotonsillectomy Failure Treatment of Refractory
More informationObstructive Sleep Disordered Breathing in children and Growth
Obstructive Sleep Disordered Breathing in children and Growth Diana Marangu Kenya Paediatric Association Respiratory Symposium Wednesday, 26 th April 2017 Outline Obstructive sleep disordered breathing
More informationM. Scott Major, M.D. Wasatch ENT and Allergy
M. Scott Major, M.D. Wasatch ENT and Allergy This presentation has no commercial content, promotes no commercial vendor and is not supported financially by any commercial vendor. I receive no financial
More informationDiagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome
Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome Director, Sleep Laboratory Center for Pediatric Sleep Disorders Boston Children s Hospital Copyright 2014 Boston Children s Hospital
More informationPediatric Sleep Disorders
Pediatric Sleep Disorders S. SHAHZEIDI, MD, FAAP, FCCP, FAASM GRAND HEALTH INSTITUTE Objectives Discuss the importance of screening for snoring Explain the signs and symptoms of parasomnias and sleep apnea
More informationTonsillectomy and Tympanostomy: Historical Perspectives and Current Guidelines
Tonsillectomy and Tympanostomy: Historical Perspectives and Current Guidelines Nathan Page, MD Division of Otolaryngology Phoenix Children s Hospital I have no disclosures I do not plan to discuss unapproved
More informationACUTE ADENOIDITIS -An infection & enlargement of the adenoid A disease causing nasal obstruction CHRONIC ADENOIDITIS when adenoid hypertrophied it
ACUTE ADENOIDITIS -An infection & enlargement of the adenoid A disease causing nasal obstruction CHRONIC ADENOIDITIS when adenoid hypertrophied it obstruct posterior nose or Eustachian tube extension of
More informationDilemmas in Approaching the Tonsils
Dilemmas in Approaching the Tonsils David Darrow Tonsillectomy remains among the most commonly performed major surgeries in the world. When performed for the proper indications, this procedure unquestionably
More informationAnesthetic Risks of Obstructive Sleep Apnea in Children
Anesthetic Risks of Obstructive Sleep Apnea in Children Dawn M. Sweeney, M.D. Associate Professor of Anesthesiology and Pediatrics University of Rochester Medical Center Risk Factors for OSA in Children
More information4 ENT. 4.1 Bone anchored hearing aids. 4.2 Cochlear implants. (
4 ENT 4.1 Bone anchored hearing aids This commissioning responsibility has transferred to NHS England (http://www.england.nhs.uk/). Queries around treatment availability and eligibility, as well as referrals
More informationSubspecialty Rotation: Otolaryngology
Subspecialty Rotation: Otolaryngology Faculty: Evelyn Kluka, M.D. GOAL: Hearing Loss. Understand the morbidity of hearing loss, intervention strategies, and the pediatrician's and other specialists' roles
More informationPediatric Airway Disorders Speaker Disclosure Outline
Pediatric Airway Disorders G. Paul Digoy, M.D. Director of Pediatric Otolaryngology OU Health Sciences Center Paul-Digoy@ouhsc.edu Office: 405 271-5504 Speaker Disclosure Speakers, moderators, or panelists
More informationSURGERY FOR SNORING AND MILD OBSTRUCTIVE SLEEP APNOEA
SURGERY FOR SNORING AND MILD OBSTRUCTIVE SLEEP APNOEA INTRODUCTION Snoring with or without excessive daytime somnolence, restless sleep and periods of apnoea are all manifestations of sleep disordered
More informationClinical Policy Title: Tonsillectomy and (or) adenoidectomy in children up to 12 years old
Clinical Policy Title: Tonsillectomy and (or) adenoidectomy in children up to 12 years old Clinical Policy Number: 11.03.04 Effective Date: October 1, 2014 Initial Review Date: April 16, 2014 Most Recent
More informationObstructive sleep apnea Is it time for personalized medicine?
Obstructive sleep apnea Is it time for personalized medicine? CATHERINE KIER, MD Professor of Clinical Pediatrics Division Chief, Pediatric Pulmonary, and Cystic Fibrosis Center Director, Pediatric Sleep
More informationUsing Questionnaire Tools to Predict Pediatric OSA outcomes. Vidya T. Raman, MD Nationwide Children s Hospital October 201
Using Questionnaire Tools to Predict Pediatric OSA outcomes Vidya T. Raman, MD Nationwide Children s Hospital October 201 NCH Conflict of Interest SASM $10,000 Grant NCH intramural/interdepartmental $38,000
More informationClinical Policy Title: Tonsillectomy and (or) adenoidectomy in children less than 5 years old
Clinical Policy Title: Tonsillectomy and (or) adenoidectomy in children less than 5 years old Clinical Policy Number: 11.03.04 Effective Date: October 1, 2014 Initial Review Date: April 16, 2014 Most Recent
More informationPediatric OSA. Pediatric OSA: Treatment Options Beyond AT. Copyright (c) 2012 Boston Children's Hospital 1
Pediatric OSA Treatments Options Beyond AT Report of Financial Relationships (past 12 months) with commercial entities producing, marketing, re selling, or distributing health care goods or services consumed
More informationThe Ear, Nose and Throat in MPS
The Ear, Nose and Throat in MPS Annerose Keilmann Voice Care Center Bad Rappenau, Germany Preciptorship program on MPS Wiesbaden, November 2 nd 2015 Alterations of the outer and middle ear in MPS I narrowing
More informationAn Update on the Management of Pediatric Obstructive Sleep Apnea Benjamin J. Rubinstein, MD 1 Cristina M. Baldassari, MD, FAAP, FACS 1,2,*
Curr Treat Options Peds (2015) 1:211 223 DOI 10.1007/s40746-015-0022-8 Otolaryngology (EM Arjmand and D Sidell, Section Editors) An Update on the Management of Pediatric Obstructive Sleep Apnea Benjamin
More informationThe University of Arizona Pediatric Residency Program. Primary Goals for Rotation. Otolaryngology
The University of Arizona Pediatric Residency Program Primary Goals for Rotation Otolaryngology 1. GOAL: Hearing Loss. Understand the morbidity of hearing loss, intervention strategies, and the pediatrician's
More informationUpper Airway Obstruction
Upper Airway Obstruction Adriaan Pentz Division of Otorhinolaryngology University of Stellenbosch and Tygerberg Hospital Stridor/Stertor Auditory manifestations of disordered respiratory function ie noisy
More informationUpdate on sleep disorders in children
Update on sleep disorders in children CATHERINE KIER, MD Professor of Clinical Pediatrics Division Chief, Pediatric Pulmonary, and Cystic Fibrosis Center Director, Pediatric Sleep Disorders Center SUNY
More informationAlexandria Workshop on
Alexandria Workshop on 1 Snoring & OSA Surgery Course Director: Yassin Bahgat MD Claudio Vicini MD Course Board: Filippo Montevecchi MD Pietro Canzi MD Snoring & Obstructive ti Sleep Apnea The basic information
More informationRecognize the broad impact of hearing impairment on child and family, including social, psychological, educational and financial consequences.
Otolaryngology Note: The goals and objectives described in detail below are not meant to be completed in a single one month block rotation but are meant to be cumulative, culminating in a thorough and
More informationThe Throat. Image source:
The Throat Anatomy Image source: http://anatomyforlayla.blogspot.co.za/2007/04/blog-post.html The Throat consists of three parts: 1. The Nasopharynx is the upper part of the throat and it is situated behind
More informationSleep Diordered Breathing (Part 1)
Sleep Diordered Breathing (Part 1) History (for more topics & presentations, visit ) Obstructive sleep apnea - first described by Charles Dickens in 1836 in Papers of the Pickwick Club, Dickens depicted
More informationSleep Disordered Breathing
Sleep Disordered Breathing SDB SDB Is an Umbrella Term for Many Disorders characterized by a lack of drive to breathe Results n repetitive pauses in breathing with no effort Occurs for a minimum of 10
More informationPedsCases Podcast Scripts
PedsCases Podcast Scripts This is a text version of a podcast from Pedscases.com on Obstructive Sleep Apnea These podcasts are designed to give medical students an overview of key topics in pediatrics.
More informationDiagnosis and Treatment of Respiratory Illness in Children and Adults
Page 1 of 9 Main Algorithm Annotations 1. Patient Reports Some Combination of Symptoms Patients may present for an appointment, call into a provider to schedule an appointment or nurse line presenting
More informationPEDIATRIC SLEEP GUIDELINES Version 1.0; Effective
MedSolutions, Inc. Clinical Decision Support Tool Diagnostic Strategies This tool addresses common symptoms and symptom complexes. Requests for patients with atypical symptoms or clinical presentations
More informationCopyright (c) 2012 Boston Children's Hospital 1
SURGICAL MANAGEMENT OF PEDIATRIC OBSTRUCTIVE SLEEP RELATED BREATHING DISORDERS Gi Soo Lee, M.D. Ed.M. Department of Otolaryngology and Communication Enhancement Boston Children s Hospital REPORT OF FINANCIAL
More informationPolysomnography (PSG) (Sleep Studies), Sleep Center
Policy Number: 1036 Policy History Approve Date: 07/09/2015 Effective Date: 07/09/2015 Preauthorization All Plans Benefit plans vary in coverage and some plans may not provide coverage for certain service(s)
More informationQuestions: What tests are available to diagnose sleep disordered breathing? How do you calculate overall AHI vs obstructive AHI?
Pediatric Obstructive Sleep Apnea Case Study : Margaret-Ann Carno PhD, CPNP, D,ABSM for the Sleep Education for Pulmonary Fellows and Practitioners, SRN ATS Committee April 2014. Facilitator s guide Part
More informationObstructive Sleep Apnea- Hypopnea Syndrome and Snoring: Surgical Options
Obstructive Sleep Apnea- Hypopnea Syndrome and Snoring: Surgical Options Joshua L. Kessler, MD, FACS Boston ENT Associates Clinical Instructor, Otology and Laryngology Harvard Medical School Why Consider
More informationSLEEP APNOEA DR TAN KAH LEONG ALVIN CO-DIRECTOR SLEEP LABORATORY SITE CHIEF SDDC (SLEEP) DEPARTMENT OF OTORHINOLARYNGOLOGY, HEAD & NECK SURGERY
SLEEP APNOEA DR TAN KAH LEONG ALVIN CO-DIRECTOR SLEEP LABORATORY SITE CHIEF SDDC (SLEEP) DEPARTMENT OF OTORHINOLARYNGOLOGY, HEAD & NECK SURGERY
More informationA comparative study of adult and pediatric polysomnography
International Journal of Otorhinolaryngology and Head and Neck Surgery Athiyaman K et al. Int J Otorhinolaryngol Head Neck Surg. 2018 May;4(3):630-635 http://www.ijorl.com pissn 2454-5929 eissn 2454-5937
More informationHome Video to Assess the Snoring Child
Home Video to Assess the Snoring Child Federico Murillo-González Consider the following case: a 5 year-old child who snores and constantly wakesup every night, breathes through the mouth during the day,
More informationOSA in children. About this information. What is obstructive sleep apnoea (OSA)?
About this information This information explains all about sleep-related breathing problems in children, focusing on the condition obstructive sleep apnoea (OSA). It tells you what the risk factors are
More informationThe Role of Obesity and Inflammation in Pediatric Sleep-Disordered Breathing
The Role of Obesity and Inflammation in Pediatric Sleep-Disordered Breathing CATHERINE KIER, MD Professor of Clinical Pediatrics Division Chief, Pediatric Pulmonary, and Cystic Fibrosis Center Director,
More informationProblem Based Learning Discussion: Perioperative management of the child with obstructive sleep apnea
Problem Based Learning Discussion: Perioperative management of the child with obstructive sleep apnea Moderators: Allison Fernandez MBA MD and Deborah Schwengel MD Institution: Johns Hopkins School of
More informationSnoring and Obstructive Sleep Apnea: Patient s Guide to Minimally Invasive Treatments Chapter 2
Snoring and Obstructive Sleep Apnea: Patient s Guide to Minimally Invasive Treatments Chapter 2 CAUSES OF SNORING AND SLEEP APNEA We inhale air through our nose and mouth. From the nostrils, air flows
More informationRoles of Surgery in OSA MASM Annual Fall Conference 2017 October 14, 2017 Kathleen Yaremchuk, MD, MSA Chair, Department of Otolaryngology/Head and
Roles of Surgery in OSA MASM Annual Fall Conference 2017 October 14, 2017 Kathleen Yaremchuk, MD, MSA Chair, Department of Otolaryngology/Head and Neck Surgery Senior Staff Sleep Medicine Henry Ford Hospital
More information11/19/2012 ก! " Varies 5-86% in men 2-57% in women. Thailand 26.4% (Neruntarut et al, Sleep Breath (2011) 15: )
Snoring ก Respiratory sound generated in the upper airway during sleep that typically occurs during inspiration but may occur during expiration ICSD-2, 2005..... ก ก! Prevalence of snoring Varies 5-86%
More informationThe Role of Obesity and Inflammation in Pediatric Sleep-Disordered Breathing
The Role of Obesity and Inflammation in Pediatric Sleep-Disordered Breathing CATHERINE KIER, MD Professor of Clinical Pediatrics Division Chief, Pediatric Pulmonary, and Cystic Fibrosis Center Director,
More informationClinical Practice Guideline: Tonsillectomy in Children (Update)
Supplement Clinical Practice Guideline: Tonsillectomy in Children (Update) Ron B. Mitchell, MD 1, Sanford M. Archer, MD 2, Stacey L. Ishman, MD, MPH 3, Richard M. Rosenfeld, MD, MPH, MBA 4, Sarah Coles,
More information4/11/2013. Objective
Sleep nasopharyngoscopy py in children: rationale and facts Hamdy El-Hakim FRCS(Ed) FRCS(ORL) Associate Professor Pediatric Otolaryngology Division of Otolaryngology Head & Neck Surgery The Stollery Children
More informationNASAL CONTINUOUS POSITIVE AIRWAY PRESSURE FOR OBSTRUCTIVE SLEEP APNEA IN CHILDREN. Dr. Nguyễn Quỳnh Anh Department of Respiration 1
1 NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE FOR OBSTRUCTIVE SLEEP APNEA IN CHILDREN Dr. Nguyễn Quỳnh Anh Department of Respiration 1 CONTENTS 2 1. Preface 2. Definition 3. Etiology 4. Symptoms 5. Complications
More informationACUTE AND CHRONIC TONSILLOPHARYNGITIS AND OBSTRUCTIVE ADENOIDAL HYPERTROPHY
ACUTE AND CHRONIC TONSILLOPHARYNGITIS AND OBSTRUCTIVE ADENOIDAL HYPERTROPHY SCOPE OF THE PRACTICE GUIDELINE This clinical practice guideline is for use by the Philippine Society of Otolaryngology-Head
More informationInformation for patients, families and carers. General Tonsillectomy Information An e-book
General Tonsillectomy Information An e-book Key Points The tonsils are a collection of cells in the back of the throat that fight infection. When there is inflammation of the tonsils, this is called tonsillitis.
More informationDepartment of Pediatric Otolarygnology. ENT Specialty Programs
Department of Pediatric Otolarygnology ENT Specialty Programs Staffed by fellowship-trained otolaryngologists, assisted by pediatric nurse practitioners, ENT (Otolaryngology) at Nationwide Children s Hospital
More informationUpper Respiratory Tract Infections / 42
Upper Respiratory Tract Infections 1 Upper Respiratory Tract Infections Acute tonsillitispharyngitis Acute otitis media Acute sinusitis Common cold Acute laryngitis Otitis externa Mastoiditis Acute apiglottis
More information5, 2002 RESIDENT PHYSICIAN: W.
TITLE: Adult and Pediatric Obstructive Sleep Apnea SOURCE: Grand Rounds Presentation, UTMB, Dept. of Otolaryngology DATE: June 5, 2002 RESIDENT PHYSICIAN: W. Kevin Katzenmeyer, MD FACULTY PHYSICIAN: Ronald
More informationChildren s Hospital of Pittsburgh Continuity Clinic Curriculum Week of November 7, Stacey Cook, MD, PhD
Children s Hospital of Pittsburgh Continuity Clinic Curriculum Week of November 7, 2016 Stacey Cook, MD, PhD Topic: Sleep disorders: Obstructive Sleep Apnea Syndrome (OSAS) Learning Objectives: After completing
More informationChronic Tonsillitis 1
Chronic Tonsillitis 1 Aetiology Complication of acute tonsillitis Subclinical infections of tonsils Children and young adults Chronic infection in sinuses or teeth 2 Types Chronic follicular tonsillitis
More informationPOLICY All patients will be assessed for risk factors associated with OSA prior to any surgical procedures.
Revised Date: Page: 1 of 7 SCOPE All Pre-Admission Testing (PAT) and Same Day Surgery (SDS) nurses at HRMC. PURPOSE The purpose of this policy is to provide guidelines for identifying surgical patients
More informationDOWNLOAD OR READ : TREATMENT FOR SNORING PROBLEMS PDF EBOOK EPUB MOBI
DOWNLOAD OR READ : TREATMENT FOR SNORING PROBLEMS PDF EBOOK EPUB MOBI Page 1 Page 2 treatment for snoring problems treatment for snoring problems pdf treatment for snoring problems problem, presenting
More informationCurrent Issues in Pharyngitis: Carlos A. Arango, M.D., F.A.A.P. Assistant Professor Department of Pediatrics University of Florida
Current Issues in Pharyngitis: Carlos A. Arango, M.D., F.A.A.P. Assistant Professor Department of Pediatrics University of Florida Pharyngitis Inflammation of any structures of the pharynx Common cause
More informationCommissioning Policy Individual Funding Request
Commissioning Policy Individual Funding Request Tonsillectomy - Referral for Assessment Criteria Based Access and Prior Approval Policy Date Adopted: 04 November 2016 Version: 1617.1.01 Individual Funding
More informationPediatric Sleep-Disordered Breathing
Pediatric Sleep-Disordered Breathing OSA in infants and young children is generally characterized by partial, persistent obstruction of the upper airway Continuum Benign primary snoring Upper-airway resistance
More informationChildhood Obstructive Sleep Apnea
Childhood Obstructive Sleep Apnea 1 PROF. RAJESHWAR DAYAL MD, FAMS,FIAP,DNB, DCH (LONDON) NATIONAL CONVENOR,IAP SLEEP PROGRAM NATIONAL VICE PRESIDENT IAP 2011 HEAD DEPARTMENT OF PAEDIATRICS S. N. MEDICAL
More informationUPPER RESPIRATORY TRACT INFECTIONS. IAP UG Teaching slides
UPPER RESPIRATORY TRACT INFECTIONS 1 INTRODUCTION Most common problem in children below 5 years. In this age group they get about 6 8 episodes per year. It includes infections of nasal cavity, throat,
More informationSleep Apnea: Vascular and Metabolic Complications
Sleep Apnea: Vascular and Metabolic Complications Vahid Mohsenin, M.D. Professor of Medicine Yale University School of Medicine Director, Yale Center for Sleep Medicine Definitions Apnea: Cessation of
More informationSleep Studies: Attended Polysomnography and Portable Polysomnography Tests, Multiple Sleep Latency Testing and Maintenance of Wakefulness Testing
Portable Polysomnography Tests, Multiple Sleep Latency Testing and Maintenance of Wakefulness Testing MP9132 Covered Service: Yes when meets criteria below Prior Authorization Required: Yes as indicated
More informationThe Effect of Beclomethasone Nasal Spray on the Size of Adenoid and its Related Obstructive Symptoms in Children with Adenoid Hypertrophy.
In the name of God Shiraz E-Medical Journal Vol. 10, No. 1, January 2009 http://semj.sums.ac.ir/vol10/jan2009/86051.htm The Effect of Beclomethasone Nasal Spray on the Size of Adenoid and its Related Obstructive
More informationDoctorStevenPark.com!
! DoctorStevenPark.com!!! Subscribe in itunes @ doctorstevenpark.com/itunes Show notes @ doctorstevenpark.com/001! Sleep & Breathing: The 2 Keys to Optimal Health What I ll Cover Why only humans have sleep
More informationJMSCR Volume 03 Issue 01 Page January 2015
www.jmscr.igmpublication.org Impact Factor 3.79 ISSN (e)-2347-176x Efficacy of Intranasal Steroid Spray in the Treatment of Post Adenoidectomy Recurrence Authors Dr. B.V. Chandre Gowda 1, Dr. Smitha.S.G
More informationUpdated Friedman Staging System for Obstructive Sleep Apnea
Updated Friedman Staging System for Obstructive Sleep Apnea Michael Friedman a, b Anna M. Salapatas b Lauren B. Bonzelaar c a Section of Sleep Surgery, Rush University Medical Center, and b Section of
More informationNasal Mass Presenting as Obstructive Sleep Apnea Syndrome
ORIGINAL ARTICLE pissn 2093-9175 / eissn 2233-8853 http://dx.doi.org/10.17241/smr.2015.6.2.54 Nasal Mass Presenting as Obstructive Sleep Apnea Syndrome Seung Hoon Lee, MD, PhD, In Sik Song, MD, Jae Woo
More informationNational Sleep Disorders Research Plan
Research Plan Home Foreword Preface Introduction Executive Summary Contents Contact Us National Sleep Disorders Research Plan Return to Table of Contents SECTION 5 - SLEEP DISORDERS SLEEP-DISORDERED BREATHING
More informationDown Syndrome: Otolaryngologic Manifestations Past, Present, and Future Sally R. Shott, M.D. Professor Cincinnati Children s Hospital Medical Center University of Cincinnati Department of Otolaryngology
More informationComplications of Sleep-Disordered Breathing
Complications of Sleep-Disordered Breathing Similarities between Pediatrics and Adults CATHERINE KIER, MD Professor of Clinical Pediatrics Division Chief, Pediatric Pulmonary, and Cystic Fibrosis Center
More informationSleep endoscopy with artificial induction of sleep and somnography in 385 snorers
Sleep endoscopy with artificial induction of sleep and somnography in 385 snorers N.S. HESSEL, D.M. LAMAN, V.C.P.J. VAN AMMERS, N. DE VRIES, H. VAN DUIJN SINT LUCAS ANDREAS ZIEKENHUIS, LOCATIE SINT LUCAS,
More informationPORTABLE OR HOME SLEEP STUDIES FOR ADULT PATIENTS:
Sleep Studies: Attended Polysomnography and Portable Polysomnography Tests, Multiple Sleep Latency Testing and Maintenance of Wakefulness Testing MP9132 Covered Service: Prior Authorization Required: Additional
More informationORIGINAL ARTICLE. Impact of Tonsillectomy and Adenoidectomy on Child Behavior
ORIGINAL ARTICLE Impact of Tonsillectomy and Adenoidectomy on Child Behavior Nira A. Goldstein, MD; J. Christopher Post, MD; Richard M. Rosenfeld, MD, MPH; Thomas F. Campbell, PhD Objective: To measure
More informationEvaluation, Management and Long-Term Care of OSA in Adults
Evaluation, Management and Long-Term Care of OSA in Adults AUGUST 2015 Providing diagnostic tools and therapies that are evidence-based is a key part of a successful sleep practice. This resource outlines
More informationUpdate on Sleep Apnea Diagnosis and Treatment
Update on Sleep Apnea Diagnosis and Treatment Damien Stevens MD Pulmonary/Critical Care/Sleep Medicine Medical Director KU Medical Center Sleep Laboratory Objectives Discuss physiology of sleep and obstructive
More informationPEDIATRIC OBSTRUCTIVE SLEEP
ORIGINAL ARTICLE Drug-Induced Sleep Endoscopy in Persistent Pediatric Sleep-Disordered Breathing After Adenotonsillectomy Megan L. Durr, MD; Anna K. Meyer, MD; Eric J. Kezirian, MD, MPH; Kristina W. Rosbe,
More informationPediatric Otolaryngology University of Kentucky April 2009
Common ENT Problems: How to evaluate and when to refer Maria C. Veling M.D. Pediatric Otolaryngology University of Kentucky April 2009 1 Objectives Identify symptoms and findings of clinically significant
More informationObstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management
TASK FORCE REPORT ERS STATEMENT Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management Athanasios G. Kaditis 1, Maria Luz Alonso Alvarez 2, An Boudewyns 3, Emmanouel
More informationReview Article Sleep Endoscopy in the Evaluation of Pediatric Obstructive Sleep Apnea
Hindawi Publishing Corporation International Journal of Pediatrics Volume 2012, Article ID 576719, 6 pages doi:10.1155/2012/576719 Review Article Sleep Endoscopy in the Evaluation of Pediatric Obstructive
More informationDerriford Hospital. Peninsula Medical School
Asthma and Allergic Rhinitis iti What is the Connection? Hisham Khalil Consultant ENT Surgeon Clinical Senior Lecturer, PMS Clinical Sub-Dean GP Evening 25 June 2008 Plymouth Derriford Hospital Peninsula
More informationI have no disclosures
Disclosures Streptococcal Pharyngitis: Update and Current Guidelines Richard A. Jacobs, MD, PhD Emeritus Professor of Medicine Division of Infectious Diseases I have no disclosures CID 2012:55;e 86-102
More information