In this episode of BackTable ENT, Dr. Javan Nation, a pediatric otolaryngologist from Rady’s Children Hospital in San Diego, joins Dr. Shah to speak about the assessment and management of children with complex obstructive sleep apnea.

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SHOW NOTES

Dr. Nation and Gopi begin the episode by discussing some of the presentations and patient populations of young children who may be coming into the office with sleep apnea. Dr. Nation also discusses his approach in conducting a physical exam, including assessing their breathing and posture to identify if a pediatric patient may have sleep apnea.

Next, Drs. Nation and Gopi discuss important history taking skills that will help the larger interdisciplinary team, such as pulmonologist or craniofacial surgeon. Dr. Nation mentions that while controversial for some clinicians, he assesses teeth grinding and thumb sucking at young ages, among other physical exam findings. Dr. Nation evaluates the role of imaging, specifically CT imaging, and explains how he uses these results to communicate to families and patients. Additionally, Dr. Nation explains his approach for looking at sleep study results.

Lastly Dr. Nation summarizes how he uses sleep endoscopy in some patients to decide whether or not to recommend patients for tonsillectomy. He also explores the potential role of hypoglossal nerve stimulator in pediatric patients with sleep apnea and indications for patients getting a tracheostomy for treating obstructive sleep apnea.

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RESOURCES

SENTAC (Society for Ear, Nose, Throat Advancement in Children)

https://sentac.org/