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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Risk factors for persistent OSA and/or respiratory complications following adenotonsillectomy

Risk factors for persistent OSA and/or respiratory complications following adenotonsillectomy
Condition/disease Comments
Age <3 years The risk for perioperative respiratory complications is increased compared with older children. The clinical examination may not accurately predict the presence of OSA.
Obesity (BMI ≥95th percentile) The risk for OSA generally increases with severity of obesity.
Down syndrome

Evaluate for hypothyroidism prior to surgery. In addition, there is an increased risk for atlantoaxial instability for children with Down syndrome.

These patients are likely to require adjuvant surgical procedures or therapy to manage residual sleep apnea after adenotonsillectomy, due to multiple sites of obstruction.
Craniofacial anomalies

Severity and sites of airway obstruction vary depending on the anomaly.

These patients are likely to require adjuvant procedures or therapy to manage sleep apnea, due to multiple sites of obstruction.
Neuromuscular disorders These children also may have significant hypoventilation, in addition to obstructive symptoms.
Mucopolysaccharidosis Pulmonary and cardiac dysfunction may also be present.
Sickle cell disease These children have increased adenoid and tonsil size compared with normal volunteers. They are also at increased risk for complications in the immediate perioperative period, including acute chest syndrome.
This table summarizes patient characteristics associated with persistent OSA and/or respiratory complications following adenotonsillectomy in children. A preoperative polysomnogram is warranted in these children to inform perioperative management (eg, additional precautions and monitoring) and to provide baseline data in case the OSA persists or recurs after surgery.
OSA: obstructive sleep apnea; BMI: body mass index.
Based on recommendations from:
  1. Roland PS, Rosenfeld RM, Brooks LJ, et al. Clinical practice guideline: Polysomnography for sleep-disordered breathing prior to tonsillectomy in children. Otolaryngol Head Neck Surg 2011; 145:S1.
  2. Mitchell RB, Archer SM, Ishman SL, et al. Clinical Practice Guideline: Tonsillectomy in Children. Otolaryngol Head Neck Surg 2019; 160:S1.
Graphic 103835 Version 8.0

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