1 Introduction Over the past decade there has been an evolution in the care for children with obstructive sleep apnea (OSA). Although adenotonsillectomy (T&A) has been regarded as typically successful in treating pediatric OSA, recent publications raise questions regarding its…
1 Introduction Laryngomalacia is the term most widely used to describe the “inward collapse of supraglottic structures during inspiration,” as originated by Jackson and Jackson in 1942. The inward collapse of the epiglottis or arytenoids results in stridor that is…
1 Introduction Tonsillectomy remains one of the most common surgical procedures performed on children. In contrast to several decades ago when infectious indications were common, the reason most children undergo tonsillectomy today is to relieve upper airway obstruction. Traditional “extracapsular”…
1 Introduction The clinical significance of adenoid hypertrophy was not truly appreciated until the mid-19th century. This was due to the adenoids' relatively inaccessible location given the technology available at that time. Once discovered, various techniques for the removal of…
1 Introduction According to a 2009 meta-analysis, 35% to 40% of children who undergo adenotonsillectomy (T&A) for obstructive sleep apnea (OSA) have persistent disease after surgery. Our discussion will briefly outline techniques currently used to identify sites of obstruction in…
1 Introduction Sleep-related breathing disorders (SRBDs) span varying degrees of airway obstruction during sleep and contribute to significant epidemiologic burden, especially in developed countries. The first report of SRBD appeared in 1976, when Guilleminault described eight children with sleep apnea…
1 Introduction Uvulopalatopharyngoplasty (UPPP) is the single most common surgical procedure performed for the correction of retropalatal obstruction causing or contributing to obstructive sleep apnea/hypopnea syndrome (OSAHS). Although its success rate has been reported at only 40% (when objective success…
1 Introduction Surgical procedures designed to shorten or otherwise modify the palate may provide relief of upper airway collapse at the palatal level in patients with sleep-disordered breathing (SDB). For patients who fail to obtain relief or suffer a relapse…
1 Introduction Sleep-disordered breathing (SDB) encompasses a spectrum of conditions, including socially unacceptable snoring (SUS) and obstructive sleep apnea syndrome (OSAS). Whereas SUS is mostly debilitating in social circumstances, OSAS and its complications pose a major health problem for society.…
1 Introduction Velopharyngeal insufficiency (VPI) is a significant speech disorder hypernasal resonance. This can result in difficulty with speech intelligibility and swallowing, which can have a major impact on a patient's quality of life. Although most VPI occurs in the…