Surgical management of obstructive sleep apnea in children with Down syndrome.

Obstructive sleep apnea (OSA) is relatively common in children with Down Syndrome due to anatomical and immunological variations which place them at particular risk. Secondary cardio-respiratory complications of upper airway obstruction may be found at the time of initial diagnosis; these require medical therapy before surgical correction of the OSA is attempted. The selection of appropriate surgical therapy is influenced by the anatomical structure of the individual child. Tonsillectomy and adenoidectomy alone infrequently provide lasting relief of obstruction for these children. We have found that uvulopalatopharyngoplasty (UPPP), with or without simultaneous anterior reduction of the tongue, alleviates this form of airway obstruction. This paper describes the procedures and reports our experience of six patients with Down syndrome.