Lingual Tonsillectomy for Pediatric Obstructive Sleep Apnea: Indications and Surgical Technique

Abstract

The objective of this chapter is to describe lingual tonsillectomy (LT) as a treatment strategy for children with persistent obstructive sleep apnea after adenotonsillectomy. Drug-induced sleep endoscopy is a useful tool that enables physicians to identify sites of obstruction resulting from dynamic airway collapse and direct surgical interventions accordingly. Lingual tonsil hypertrophy is graded according to the degree of effacement of the vallecula and the posterior displacement of the epiglottis. The surgical technique for microscopic- and endoscopic-assisted coblation LT is described along with postoperative care and complications. LT is an important and efficacious technique for the treatment of pediatric obstructive sleep apnea in patients with base of tongue obstruction.