The treatment of persistent obstructive sleep apnea (OSA) after an adenotonsillectomy is a challenge, especially for children with Down syndrome. As otolaryngologists with sleep subcertification, we are keenly aware of the current limitations for both medical and secondary surgical treatment options for this cohort. We applaud the insight of Yu and colleagues for their landmark investigation in this issue of JAMA Otolaryngology–Head & Neck Surgery on upper airway stimulation (UAS) for adolescents with Down syndrome and OSA, which expan ds the role of UAS from adults to children.
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