A 5-year-old child presents with recurrent snoring, witnessed apnea, and enuresis. Overnight polysomnography shows an apnoea-hypopnoea index (AHI) of 12 events/hour. The first-line treatment is:
- A Continuous positive airway pressure (CPAP)
- B Weight reduction alone
- C Adenotonsillectomy ✓
- D Intranasal corticosteroid spray
Correct answer: C. Adenotonsillectomy
Explanation
In otherwise healthy children with obstructive sleep apnea predominantly due to adenotonsillar hypertrophy, adenotonsillectomy is the first-line treatment and resolves OSA in 70–90% of cases. CPAP is used when surgery fails, is contraindicated, or the child has significant comorbidities. Intranasal steroids may help mild OSA but not an AHI of 12. Weight reduction alone is insufficient for this severity.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.