My 7 year old son was just diagn. with severe sleep apnea. His test shows he had 59 episodes an hour, lasting up to 30 sec. His sleep doc says it is one of the worst cases in a child he has seen, and that his T&A's are huge. We have appt. with ENT 9/26,I'm sure they are going to remove them, not sure what to expect after that.


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Thanks Rebecca

Hi rebecca:
"After that" starts immediately after surgery.  We talked with Beo a bit ago, so just to review the high points:

Quote:

(In) severe OSA, the potential for serious complications is increased, so you have to have confidence in anesthesia, nurses, respiratory care and the post-anesthesia care unit, cause you're watching closely in that immediate post-op period.  Actually, in any T&A, that's the area where you have to have sharp, vigilant people.

Gimme that, and everything else becomes academic.

Quote:

While most people usually think bleeding and obstructed airway secondary to swelling top the list of complications of T&A in children, as much if not more of a concern is this thing called Post-Obstructive Pulmonary Edema, which results in terrific oxygenation and breathing problems in immediate post-op period (hence the need for a vigilant PACU).

Post-Obstructive Pulmonary Edema, Type II (or POPE II or PPE II) is a big concern post-tonsillectomy for severe OSA in children.  While it's not likely, if your physician says the OSA is that bad, I'd be making sure that everybody has their attention focused on where it should be post-op.  While this is a real big deal, a good PACU team, acting quickly and expertly, will address this effectively.  In other words, hope for the best, but plan for the worst.

And you will absolutely need a follow-up PSG.
sleepydave