The purpose of this study is to compare the effectiveness of a novel personalized surgical approach to the standard AT in children with small tonsils (ST). This will be accomplished by randomizing children with ST and OSA to one of these two treatments and comparing outcomes after 6 months. It is the investigators' central hypothesis that a personalized drug-induced sleep endoscopy (DISE)-directed surgical approach that uses existing procedures to address the specific fixed and dynamic anatomic features causing obstruction (ie, anatomic endotypes) in each child with ST will perform better than the currently recommended standard first line approach of AT. This novel approach may improve OSA outcomes and reduce the burden of unnecessary AT or secondary surgery for persistent OSA after an ineffective AT. To test this hypothesis, the investigators propose to study children aged 2-17 years with small tonsils and OSA.
Age range
2 Years – 17 Years
Sex
ALL
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A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
Change from Baseline Polysomnography Measures: Obstructive Apnea-Hypopnea Index (oAHI) at 6 months
Timeframe: 6 month follow up sleep study (after surgery)
Change from Baseline Polysomnography Measures: Total Apnea-Hypopnea Index (AHI) at 6 months
Timeframe: 6 month follow up sleep study (after surgery)
Change from Baseline Polysomnography Measures: REM Apnea-Hypopnea Index (REM AHI) at 6 months
Timeframe: 6 month follow up sleep study (after surgery)
Change from Baseline Polysomnography Measures: minimum Oxygen saturation (SpO2) at 6 months
Timeframe: 6 month follow up sleep study (after surgery)
Change from Baseline Polysomnography Measures: Oxyhemoglobin desaturation ≥ 3% Index (desat index) at 6 months
Timeframe: 6 month follow up sleep study (after surgery)
Change from Baseline Polysomnography Measures: Percent Total Sleep Time with ETCO2 > 50 mmHg at 6 months
Timeframe: 6 month follow up sleep study (after surgery)
Change from Baseline Polysomnography Measures: Max End Tidal CO2 (ETCO2) at 6 months
Timeframe: 6 month follow up sleep study (after surgery)