Whether tonsillectomy is necessary for pediatric osa with small tonsils? Drug induced sleep endoscopy can tell

Introduction: Adenotonsillectomy is considered the first-line treatment for children with obstructive sleep apnea (OSA). However, children with small tonsils may not experience the same benefit from adenotonsillectomy as the children whose tonsils are hypertrophy. In China, tonsillectomy is not commonly performed for the children whose tonsils are below grade 2 tonsils (according to Brodsky grading scale). However, whether small tonsils contribute lateral pharyngeal wall obstruction is unsure by routine examinations.

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