Tonsillectomy and Sleep Apnea in Children
Sleep apnea is an illness in which your breathing halts momentarily during sleep. A Sleep Apnea is a medical term for this failure to breathe. Sleep apnea can be due to a problem with the brain which is called central apnea but is alot more likely due to the collapse of tissues into the airway which is called obstructive apnea.
The usual cause for this obstruction in children is large tonsils and adenoids. The Adenoids are located high in the throat, behind the nose. If the adenoids are very large, they can obstruct the nasal airway. If your child has obstructive sleep apnea due to large tonsils and adenoids, removal of these tissues usually cures the problem. The surgery to remove your tonsils is a tonsillectomy and to remove your adenoids is a adenoidectomy
Alternative, non surgical treatments include using steroids or a special airway breathing device known as CPAP (Continuous Positive Airway Pressure). Steroids tend to have only a temporary effect and have many potential side effects. Children can tolerate a CPAP, but it may not work well if the tonsils and adenoids are very large. A CPAP device is usually designated for children who are too sick to undergo surgery, or who continue to have significant OSA despite surgery. Obese children may continue to have significant OSA despite having a tonsillectomy or adenoidectomy.
Tonsillectomy and Adenoidectomy
It is very important to address OSA in children as if it is left untreated, severe OSA can lead to delayed growth and eventual heart and lung failure. Less severe complications include daytime sleepiness, hyperactivity, developmental delay and poor school performance.
Tonsillectomy and adenoidectomy usually takes about 45-60 minutes and is performed under a general anesthesia. If your child has a significant degree of OSA, he or she may need to remain overnight in the hospital, and will be closely monitored during this time.
Children with moderate to severe OSA will most likely require an overnight stay because they have a somewhat greater risk of developing postoperative problems. Other children who are at particular risk of postoperative complications are those who have either seizures, cerebral palsy, Down's Syndrome, or a history of congenital heart disease. Obese children and children under the age of 3 are also at risk.
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