Children can benefit from surgery for sleep apnea

Mar 1 2005

Times have changed. Within the last ten years, the primary reason that children have had surgery to remove their tonsils and adenoids is not because of infection. Instead, up to 90 percent of the adenotonsillectomy surgeries are to correct obstructive sleep apnea (OSA).

There is a growing awareness that sleep apnea in children may cause a wide range of problems including developmental delay, failure to thrive, cardio-respiratory complications and behavioral disorders, says Erica Bennett, M.D., a Pediatric Otolaryngology (“Ear, Nose and Throat”) surgeon who recently joined the Division of Otolaryngology within the UNM School of Medicine Department of Surgery. And, while very young children need to be monitored in the hospital closely for complications, Bennett said a growing number of parents see the benefits of surgery for children – some even younger than three years of age - if means their children have the possible opportunity to forego years of medication

A sleep study can show when children are suffering from inadequate oxygen levels and OSA, a condition where a person quits breathing momentarily while asleep then awakens briefly throughout the night.

“Parents recognize the value of surgery when they see that their child has low levels of oxygen during sleep. And, it makes sense that not getting enough rest can be an underlying cause of a failure to thrive,” said Bennett. Studies, including one at UNM, have shown that very young children can improve markedly after adenotonsillectomy for severe OSA. One UNM study showed that children under three years of age did show significant improvement in the respiratory distress index (RDI), defined as the average number of apneas and hypopneas per hour of sleep, as measured by a laboratory sleep study. The UNM study confirmed previous reports that children less than three years represent a high-risk group for complications after adenotonsillectomy for OSA and recommended a longer hospital stay so that very young children could be monitored overnight in the hospital.

Bennett recently joined the Division of Otolaryngology and is board certified in Otolaryngology-Head and Neck Surgery. She received her M.D. Degree from the University of Southern California Medical School. After an internship in General Surgery; she completed a residency in Otolaryngology-Head and Neck Surgery and two fellowships in Pediatric Otolaryngology, one emphasizing craniofacial disorders. While she practices the entire spectrum of pediatric otolaryngology, her special interests include velopharyngeal insufficiency, cleft lip and palate, craniofacial disorders, and airway reconstruction.

Children who need surgery for ear, nose and throat problems need a multidisciplinary approach to their care, said Bennett. “We work closely with an audiologist and speech pathologist as well as a full spectrum of pediatric subspecialists at UNM on complex and routine problems.”

Bennett sees patients at the UNM ENT Clinic located at the Northeast Heights Family Pracitce Clinic at 7801 Academy NE. While the very young may need an overnight stay in the hospital, often, older children can be scheduled for outpatient surgery at the UNM Outpatient Surgery and Imaging Services Building, located at 1213 University Blvd. NE.

“Whenever we can, we try to make it easy on the family and often that means seeing them away from the traditional hospital setting,” said Bennett. “Parents and their children are often stressed enough without having to deal with issues like parking and overnight stays in the hospital.”