A 3-year-old child with Down syndrome is evaluated for obstructive sleep apnea. Polysomnography shows an AHI of 18 events/hour with significant desaturation. Adenotonsillectomy is performed. Which statement best describes the expected surgical outcome in this population?
- A Adenotonsillectomy cures OSA in over 90% of children with Down syndrome
- B Children with Down syndrome have a higher rate of residual OSA post-adenotonsillectomy compared to typically developing children ✓
- C Adenotonsillectomy is contraindicated in Down syndrome due to atlantoaxial instability
- D Tracheostomy is the first-line surgical treatment for OSA in Down syndrome
Correct answer: B. Children with Down syndrome have a higher rate of residual OSA post-adenotonsillectomy compared to typically developing children
Explanation
Children with Down syndrome have multilevel airway obstruction (midface hypoplasia, macroglossia, hypotonia, subglottic narrowing) and have significantly higher rates of residual OSA after adenotonsillectomy compared to typically developing children. Cure rates are lower, and many require CPAP or further surgery. Atlantoaxial instability does not contraindicate adenotonsillectomy.
Reference: Cummings Otolaryngology: Head and Neck Surgery, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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