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Published on: December 6, 2016
A solitary tonsil can cause severe obstructive sleep apnea
Michael C Sklar1, Indra Narang, Bo-Yee Ngan
1Department of Otolaryngology - Head and Neck Surgery, The Hospital for Sick Children, Toronto, Canada.
Summary
Enlarged tonsils and adenoids commonly cause pediatric obstructive sleep apnea. In a unique case, removing a single remaining tonsil successfully treated severe sleep apnea in a child.
Area of Science:
- Otolaryngology
- Pediatric Sleep Medicine
- Sleep Surgery
Background:
- Obstructive sleep apnea (OSA) in children is frequently caused by tonsil and adenoid hypertrophy.
- Bilateral tonsillectomy with adenoidectomy is the standard surgical intervention for pediatric OSA.
Observation:
- A child presented with persistent severe OSA and attention deficit hyperactivity disorder (ADHD) after unilateral tonsillectomy and adenoidectomy.
- The patient's remaining tonsil was identified as the sole cause of airway obstruction.
Findings:
- This case is the first documented instance of a solitary tonsil causing severe pediatric obstructive sleep apnea.
- Polysomnography confirmed severe OSA, which resolved completely after the removal of the single remaining tonsil.
Implications:
- Highlights the importance of considering even a single enlarged tonsil as a cause of pediatric OSA.
- Suggests that unilateral tonsillectomy may not always be sufficient for treating pediatric OSA.
- Emphasizes the need for thorough pre-operative assessment and post-operative follow-up in pediatric sleep apnea cases.
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