Skip Polysomnography Before Adenotonsillectomy for Snoring? —Reply

In Reply We thank Kaditis et al for bringing attention to the insights and clinical complexities illuminated by the results of the Pediatric Adenotonsillectomy Trial for Snoring (PATS), as published in JAMA and JAMA Otolaryngology –Head& Neck Surgery. As elucidated by the authors, PATS introduced the term mild sleep-disordered breathing (SDB) to encompass children with both primary snoring (AHI,<1) and mild obstructive sleep apnea (OSA) (apnea-hypopnea index [AHI], 1-3), distinct from the conventional definition of mild OSA typically denoted by an AHI of 1 to 5. It is noteworthy that all participants in PATS underwent assessment by an otolaryngologist and were deemed candidates for adenotonsillectomy (AT) based on symptoms and clinical evaluation prior to polysomnography, with most presenting with primary snoring rather than mild OSA. The PATS findings challenge clinicians to reevaluate the conventional definition for mild OSA. Both PATS and the Childhood Adenotonsillectomy Trial (CHAT) highlight the importance of moving away from relying on the AHI as the primary measure to determine a child ’s candidacy for AT.
Source: JAMA Otolaryngology - Head and Neck Surgery - Category: ENT & OMF Source Type: research