Practice Patterns for the Management of Pediatric oSDB: What Is the Current National Landscape?

Area of Science:

• Pediatric Otolaryngology
• Sleep Medicine
• Surgical Practice Patterns

Background:

• Pediatric obstructive sleep-disordered breathing (oSDB) management requires updated clinical consensus.
• Current practice patterns among pediatric otolaryngologists are not well-defined.

Purpose of the Study:

• To characterize national practice patterns in the evaluation and management of pediatric oSDB, including obstructive sleep apnea (OSA).
• To identify variations in tonsillectomy techniques, DISE use, and multidisciplinary care.

Main Methods:

• A cross-sectional online survey was distributed to 450 ASPO members.
• The survey assessed tonsillectomy techniques, DISE utilization, and multidisciplinary care approaches for pediatric oSDB and OSA.

Main Results:

• Significant variability exists in tonsillectomy techniques (70% use intracapsular dissection) and DISE (81% perform DISE).
• Junior surgeons and academic practitioners were more likely to utilize intracapsular tonsillectomy and DISE.
• Multidisciplinary care was more prevalent in academic settings (64%) compared to nonacademic settings (26%).

Conclusions:

• Wide variability in pediatric oSDB management necessitates standardization.
• Key areas for standardization include intracapsular tonsillectomy, pediatric DISE protocols, and multidisciplinary care models.