Management of Children Referred to ENT with Suspected Obstructive Sleep Apnea Following Overnight Oximetry. | ||||
Egyptian Journal of Ear, Nose, Throat and Allied Sciences | ||||
Article 2, Volume 21, Issue 2, August 2020, Page 44-50 PDF (764.41 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/ejentas.2020.13603.1120 | ||||
View on SCiNiTO | ||||
Authors | ||||
Ahmed Yehia Hussein 1; Bradley Story2; Goubran Eskander3; Amr Abdelhamid 4; Atef El-kholy5 | ||||
1Otorhinolaryngology department, Faculty of Medicine, Ain Shams University | ||||
2Manchester University of Medicine | ||||
33St Helens and Knowsley NHS Trust | ||||
4Department of Otorhinolaryngology, Ain Shams University/Manchester University NHS Foundation Trust | ||||
5Manchester University NHS Foundation Trust | ||||
Abstract | ||||
Background: Obstructive sleep apnea (OSA) has been associated with increased risk of respiratory complications after adenotonsillectomy in children. Not all such children require overnight admission, and same-day surgery is appropriate for some patients. Selection of those that are suitable for same day discharge relies on accurate identification of OSA severity. Guidelines about ‘Day Care Adenotonsillectomy in presence of Sleep Apnea’’ provided by Nottingham Children’s Hospital, the UK, published in 2014, and applies to those children who had a sleep study performed pre-operatively. A typical cost-effective practical sleep study entails at-home overnight pulse oximetry. Aim: The aim of audit study was to see if suspected OSA is appropriately managed at Trafford General Hospital (TGH), the UK, according to the standards provided by Nottingham Children’s Hospital, in addition to taking one standard from the Royal College of Pediatrics and Child Health report, on Standards for Services for Children with Disorders of Sleep Physiology, published in 2009. Study Design: This is a retrospective local audit study focused on children who were referred to ENT at TGH for suspected OSA or who were suspected of OSA during ENT follow-up for another non-OSA reason. Conclusion: There is good practice in excluding insufficiently analyzed oximetry. Non-compliance was mostly due to mild OSA being ruled in on an inconclusive study. The listing and referral for adenotonsillectomy is appropriate despite conflicting local practice to refer all children with suspected OSA to a specialized centre. | ||||
Keywords | ||||
Adenotonsillectomy; obstructive sleep apnea; overnight admission; sleep study | ||||
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