Down's syndrome with lingual tonsil hypertrophy producing sleep apnoea

Area of Science:

• Pediatric Otolaryngology
• Genetics and Sleep Medicine

Background:

• Down syndrome is associated with craniofacial abnormalities that can predispose individuals to sleep-disordered breathing.
• Lingual tonsillitis is a rare cause of upper airway obstruction and sleep apnea in children.

Observation:

• A pediatric patient with Down syndrome presented with severe sleep apnea attributed to lingual tonsillitis.
• The patient adopted an unusual sleeping posture to alleviate airway obstruction.

Findings:

• A single-stage lingual tonsillectomy effectively resolved the sleep apnea without the need for a tracheostomy.
• Post-operatively, the patient spontaneously returned to a normal sleeping posture.

Implications:

• Lingual tonsillectomy is a viable and effective treatment for sleep apnea caused by lingual tonsillitis in pediatric patients, including those with Down syndrome.
• This approach avoids the morbidity associated with tracheostomy in select cases.
• Restoration of normal sleep posture can be an indicator of successful airway management.