Pediatric Sleep Apnea Surgery
Surgical removal of the tonsils and adenoids is the most common first step in treating obstructive sleep apnea (OSA) in children.
Tonsillectomy and adenoidectomy is one of the most common and safe operations performed on children today. Major complications are rare. Your child’s ENT doctor will explain the operation and answer any questions you may have before the procedure.
The procedure usually takes less than a half hour and is performed under general anesthesia. Typically, your child will be able to go home a few hours after the surgery. If your child’s sleep apnea is severe, doctors may recommend observation in the hospital overnight after the surgery.
Your child will recover from the procedure in a week or two. During the recovery period, your child’s doctor will recommend a soft diet, plenty of fluids and rest.
Your child should be able to return to school and normal activities within 7 to 10 days – when he/she is able to eat and drink normally, sleep through the night and manage without pain medication.
Why and when is surgery necessary?
If enlarged tonsils and/or adenoids are contributing to obstructive sleep apnea (OSA), your child's doctor may recommend a tonsillectomy and adenoidectomy (surgical removal of the tonsils and adenoids). Even when they are not significantly enlarged, removal of the tonsils and adenoids is often helpful and is usually the first step in treating OSA.
In most cases, your child will first undergo a sleep study to confirm the diagnosis and evaluate the severity of his or her OSA.
Are there risks associated with adenotonsillectomy?
The most common side effect of this surgical procedure is a sore throat with short-term eating and drinking difficulty. Other possible complications include infection and excessive bleeding, but these are rare.
How effective are these procedures in treating obstructive sleep apnea?
Tonsillectomy and adenoidectomy are very effective in treating OSA, and this is the only treatment needed for most children. Children who are obese or who have certain medical problems or syndromes are more likely to have residual OSA after surgery. Your sleep doctor can help evaluate your child after surgery and determine if any further treatment is needed.
What if surgery is not successful at treating/curing my child’s OSA?
The answer to this question depends on several factors, including your child’s age, symptoms, other medical problems, and the severity of the residual OSA. Some children may be prescribed Continuous Positive Airway Pressure, or CPAP, which is a machine that delivers pressurized air through a mask to help keep the throat and airway open. Other children may be able to be managed with simple medication such as a pill or nasal spray. Your doctor or sleep specialist can discuss with you what the best options are for your child. Rarely, surgery on a child’s palate or tongue may be considered.