Obstructive sleep apnea syndrome is a chronic condition of airway obstruction, common in children, with known clinical consequences. The etiology of OSAS in children stems from a combination of obstructing structural factors and neuromotor factors. In children, tonsilar hypertrophy accounts for this condition in most cases, however, in about 20% of the cases, other causes are involved. For the treatment of apnea in children, adenotonsillectomy is the most commonly performed procedure, though we should indicate the treatment according to its underlying cause. The aim of this paper is to highlight other possible apnea etiologies, contributing to appropriate diagnosis and treatment. We present two cases of patients with apnea of unusual origin: one of respiratory dystonia and another of supraglottic stenosis as the causative factor of obstructive sleep apnea. In conclusion, we emphasize the need for the ENT to perform detailed research on the etiology of apnea, for individualized treatment.
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