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Postgraduate Education Corner: Pulmonary, Critical Care, and Sleep Pearls |

A 5-Year-Old Girl With Persistent OSA After Tonsillectomy and AdenoidectomyResidual Apnea after Tonsillectomy

Lourdes DelRosso, MD; Anil A. Gungor, MD; Senthilkumar Sankararaman, MD; Jody H. Tate, MD; Romy Hoque, MD
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From the Department of Neurology, Division of Sleep Medicine (Drs DelRosso, Tate, and Hoque), the Department of Otolaryngology (Dr Gungor), and the Department of Pediatrics (Dr Sankararaman), Louisiana State University School of Medicine, Shreveport, LA.

Correspondence to: Lourdes DelRosso, MD, Department of Neurology, Division of Sleep Medicine, Louisiana State University School of Medicine, 1501 Kings Hwy, Shreveport, LA 71103; e-mail: lourdesdelrosso@me.com


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(3):1073-1075. doi:10.1378/chest.13-0113
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A 5-year-old girl with a medical history of asthma, allergic rhinitis, recurrent tonsillitis, and recurrent otitis media presented for evaluation of witnessed snoring, witnessed apneas, and OSA on diagnostic polysomnogram (PSG) despite two tonsillectomy and adenoidectomy (T&A) procedures. At 2 years of age she underwent a T&A procedure for witnessed snoring and witnessed apneas with tonsillar enlargement. When she was 4 years of age, persistent snoring and apneas with adenoid regrowth prompted a repeat T&A procedure. A diagnostic PSG 6 months after repeat adenoidectomy revealed an apnea-hypopnea index (AHI) of 3.5, a rapid eye movement AHI of 26, and a minimum oxygen saturation of 81% associated with sleep-disordered breathing. The diagnostic criteria for pediatric sleep apnea include an AHI ≥1.

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