ABSTRACT
Adenotonsillar hypertrophy is the leading cause of childhood obstructive sleep apnea syndrome (OSAS) and adenotonsillectomy is the mainstay of treatment. Tonsillectomy was initially a popular method for treating a variety of respiratory and/or systemic diseases. In the early twentieth century, the primary indication for adenotonsillectomy was recurrent tonsillar infection. Although adenotonsillar hypertrophy is the leading cause of childhood OSAS, OSAS is also associated with a number of other pediatric medical conditions that affect neural control of the upper airway, reduce airway caliber, or increase its collapsibility. The diagnosis of childhood OSAS is suggested by the history and physical examination, and can be confirmed by polysomnography. Children with OSAS are at increased risk for respiratory compromise in the period surrounding the adenotonsillectomy. Preoperative risk assessment, anesthetic and surgical care tailored to reduce such risks, and postoperative monitoring are necessary for these children.
