Tonsillectomy for Primary Snoring: Findings of the Pediatric Adenotonsillectomy Trial for Snoring (PATS)

Monday, September 30, 2024

1:30 PM – 2:20 PM EDT

Location: MBCC, Lincoln Road EF

CME/MOC Credit: 1

Disclosure(s):

Cristina M. Baldassari, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Erin M. Kirkham, MD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ignacio E. Tapia, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Stacey L. Ishman, MD, MPH, FACS, FAAP, HCQM:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: Adenotonsillectomy (AT) is the mainstay treatment for children with obstructive sleep apnea. However, controversy exists as to whether tonsillectomy is indicated in children with primary snoring/mild obstructive sleep disordered breathing (oSDB). Prior studies have suggested diminished cognition and poor quality of life in snoring children with mild oSDB, yet research demonstrating improved treatment outcomes in such children after AT is lacking. The multi-institutional, NIH-funded Pediatric Adenotonsillectomy and Snoring Trial (PATS) was designed to assess the efficacy of AT in the treatment of children with mild oSDB. Over 400 children between 3 and 13 years of age from 7 participating children’s hospitals were randomized to watchful waiting or early AT. Executive function, quality of life, behavior, blood pressure, and polysomnogram parameters were assessed at baseline and after 12 months. Children were eligible for inclusion if they were otherwise healthy and had an apnea hypopnea index (AHI) less than 3. This mini-seminar will feature discussion and commentary on the findings from the landmark PATS study. We will plan to feature case-based discussions to highlight how the data from the PATS study can be utilized to establish treatment paradigms for children with mild oSDB. Participants, which include otolaryngologists and a pulmonologist who were primary investigators for the trial, will also debate controversies such as whether classification for pediatric mild oSDB needs to evolve to include metrics beyond AHI and whether AT is indicated for children with an AHI less than 1. We anticipate that this will be an engaging panel that will ensure that attendees are familiar with the most up-to-date management options for mild oSDB.

Learning Objectives:

To understand recent findings from the multi-institutional, NIH-funded Pediatric Adenotonsillectomy and Snoring Trial (PATS).
To highlight controversies in the evaluation and management of primary snoring.
To suggest treatment algorithms for children wih mild oSDB.

Moderator(s)

CB

Cristina M. Baldassari, MD

Professor
Eastern Virginia Medical School
Virignia Beach, VA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Panelist(s)

EK

Erin M. Kirkham, MD, MPH

Assistant Professor - Otolaryngology Head & Neck Surgery
University of Michigan
ANN ARBOR, MI, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Ignacio E. Tapia, MD

Professor of Pediatrics. Chief, Division of Pediatric Pulmonology
University of Miami
Miami, FL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Stacey L. Ishman, MD, MPH, FACS, FAAP, HCQM

Adjunct Clinical Professor - Otolaryngology Head & Neck Surgery - University of Cincinnati
Instructor, University of Wisconsin - Madison
Cincinnati, OH, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.