A multidisciplinary clinical practice guideline, “Polysomnography for  Sleep-Disordered Breathing Prior to Tonsillectomy in Children“, was  published as a supplement to the July issue of Otolaryngology—Head  and Neck Surgery. This guideline provides otolaryngologists with  evidence-based recommendations for using polysomnography in assessing  children, aged 2 to 18 years, with sleep-disordered breathing (SDB) and  who are candidates for tonsillectomy, with or without adenoidectomy.

Polysomnography (PSG) is presently the gold standard for diagnosing  and quantifying sleep-disordered breathing in children. SDB affects  approximately 12% of children with manifestations ranging from simple  snoring to potentially serious conditions, including sleep apnea. SDB is  also the most common indication for tonsillectomy with or without  adenoidectomy in the United States. Since more than 530,000  tonsillectomies are performed annually on children younger than the age  of 15, primarily for SDB, clear and actionable guidance on optimal use  of PSG is strongly needed.

Less than 10% of children get a sleep study before tonsillectomy,”  notes Richard M. Rosenfeld, MD, MPH, guideline author and consultant.  “The polysomnography guideline will empower doctors and parents to get  the right test for the right reasons, leading to safer surgery and  better outcomes for children with tonsils that block their breathing  while asleep.”

The primary purpose of this guideline is to improve referral patterns  for polysomnography among these patients. In creating this guideline,  the American Academy of Otolaryngology—Head and Neck Surgery Foundation  selected a panel representing the fields of anesthesiology, pulmonology  medicine, otolaryngology–head and neck surgery, pediatrics, and sleep  medicine.


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