Pediatric OSA: Evidence-Based Review of Treatment Results

Carol Li, Yann Fuu Kou, Stacey L. Ishman

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: Review current evidence-based treatment outcomes and future management directions for children with obstructive sleep apnea (OSA). Recent Findings: Effective medical therapies include weight loss, leukotriene modifiers, nasal corticosteroids, oral appliances, and positive airway pressure. The first randomized controlled trials for adenotonsillectomy in childhood OSA show improved polysomnography results but no postoperative change in neurocognitive outcomes when compared to watchful waiting. Factors have been identified (e.g., craniofacial disorders and obesity) which can lead to decreased adenotonsillectomy success. The tongue base and supraglottis are common additional sites of obstruction, and supraglottoplasty and lingual tonsillectomy are commonly performed procedures for persistent OSA. Additional surgical targets include the nasal cavity, palate/pharynx, tongue base, and larynx. Summary: The management of pediatric OSA is multidisciplinary and includes a variety of medical and surgical therapies. Although adenotonsillectomy remains first-line treatment, favorable outcomes exist for nonsurgical modalities. In children with persistent OSA after adenotonsillectomy, several procedures exist to address additional obstruction, but further investigation to delineate their appropriate indications is warranted.

Original languageEnglish (US)
Pages (from-to)246-253
Number of pages8
JournalCurrent Otorhinolaryngology Reports
Issue number3
StatePublished - Sep 2021
Externally publishedYes


  • Adenotonsillectomy
  • Medical treatment
  • Pediatric obstructive sleep apnea
  • Sleep-disordered breathing
  • Surgical treatment
  • Treatment outcomes

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Immunology and Allergy
  • Otorhinolaryngology


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