Effects of adeno-tonsillectomy on polysomnography patterns in Down syndrome children with obstructive sleep apnea: a comparative study with children without Down syndrome.

Objective: To determine if adeno-tonsillectomy (T&A) in children with Down syndrome (DS) improves breathing, measured by apnea hypopnea index (AHI), rapid eye movement AHI (REM-AHI) and the lowest oxygen desaturation (SaO2), and sleep disruption, measured by arousal index (ArI) and time spent in stages 1-4 and rapid eye movement (REM) sleep and compare these results with a group of non-DS children with obstructive sleep apnea (OSA).

Study Design: Retrospective chart review at pediatric sleep center.

Patients: Eleven DS and nine non-DS children underwent pre- and post-T&A polysomnography between 1997 and 2005.

Management of suprastomal tracheal fibroma: introduction of a new technique and comparison with other techniques.

Objective: Suprastomal tracheal granuloma/fibroma (SSTGF) is a common cause of failure to decannulate following pediatric tracheostomy. Because larger lesions obstruct the trachea, it is necessary to remove them prior to decannulation. Various methods have been described for the management of these obstructing tracheal lesions, including the KTP laser, Nd-YAG laser, sphenoid punch, optical forceps, microsuspension laryngoscopy with an articulated arm (MSLAA), and external excision.