French Society of Otorhinolaryngology and Head and Neck Surgery (SFORL) guidelines concerning the role of otorhinolaryngologists in the management of paediatric obstructive sleep apnoea syndrome: Follow-up protocol for treated children

Chinese guideline for the diagnosis and treatment of childhood obstructive sleep apnea (2020)

“…Current evidence indicates that accompanying diseases (e.g., asthma and allergic rhinitis) and family history of OSA do not increase the risk of postoperative persistent OSA. However, on the basis of existing guidelines and expert recommendations, 2 , 42 , 43 , 44 clinicians should perform careful postoperative evaluation and airway management in children with OSA aged <3 years, as well as those with accompanying diseases, severe OSA, hypoxemia, and/or relevant family history. In addition, clinicians should perform comprehensive assessments of the upper airway in children with OSA, especially those whose disease severity (based on PSG assessment) is not consistent with adenoid and/or tonsil hypertrophy (i.e., children with adenoid and/or tonsil hypertrophy who do not exhibit frequent sleep apnea events, or those with frequent sleep apnea events who do not exhibit clinically significant adenoid and/or tonsil hypertrophy).…”

“…The efficacy of combined use of these drugs is an important research avenue concerning drug treatments for children with OSA and adenoid hypertrophy, consistent with the guidelines of the French Society of ear nose and throat and Head & Neck Surgery. 42 On the basis of the above findings and instructions of these drugs, these drugs are recommended for use in children aged >2 years. The current clinical studies are limited to short-term follow-up and lack normative long-term prospective analysis.…”

“…During orthodontic treatment, it is particularly necessary for children with OSA to complete regular orthodontic follow-up; sleep monitoring should be carried out systematically for 3–6 months after discontinuation of treatment. 42 For children with OSA who exhibit mouth breathing, oral muscle function training can be used as adjuvant therapy. Clinical question 11: What is the efficacy of weight loss in obese children with OSA?…”

Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

“…There is now little doubt that hypertrophy of upper airway lymphadenoid tissues constitutes the most common factor underlying the presence of obstructive sleep apnea (OSA) in children, a condition that was formally identified as a singular disease only in 1976 by Guilleminault and colleagues [1]. As corollary of such repeatedly confirmed fact, adenotonsillectomy (T&A) has become the initial treatment recommended by the American Academy of Pediatrics (AAP) consensus guidelines for pediatric OSA in 2002 and subsequently in 2012 [2,3], and other guidelines around the world echo such recommendations [4][5][6][7][8][9][10]. In more recent years, and particularly since 2006 when we initially described the relatively high prevalence of residual OSA after T&A [11,12], confirmation and realization that, although the severity of OSA will routinely improve after surgery, it can persist in a significant proportion of patients has definitely settled in [13][14][15][16].…”

Debates in pediatric obstructive sleep apnea treatment

“…Indeed, in this respect, the SFORL guideline states that results of medium and long-term clinical follow-up of treatment with intranasal corticosteroids or montelukast must be reported in the light of the current lack of published reports on the long-term efficacy and safety of these treatments. 19 …”