Primary indications for adenotonsillectomy in the pediatric population include recurrent infections and obstructive sleep-disordered breathing (oSDB). Obstructive SDB is a spectrum of disorders ranging from primary snoring to obstructive sleep apnea (OSA).

OSA affects anywhere from 1.2-5.7% of the pediatric population; increased incidence correlates with the epidemic of obesity in children and its impact on a child's quality of life is often underestimated. Up to 40% of children with oSDB have associated behavioral problems (anxiety, depression, hyperactivity, secondary enuresis, aggression), which can result in poor school performance.

Obstructive SDB can also lead to growth failure and should be considered on the differential for failure to thrive. The impact of OSA on quality of life can be similar to that of other chronic illnesses, such as rheumatologic diseases.

Prompt ENT referral was recommended for detailed evaluation and possible adenoidectomy, adenotonsillectomy, and tonsillectomy.

This case was submitted with supervision and input from:

Soni C. Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center