What is the definitive therapy for pediatric sleep-disordered breathing due to adenotonsillar hypertrophy?

• A. Nasal corticosteroids.
• B. Continuous positive airway pressure.
• C. Oral jaw advancement therapy.
• D. Adenotonsillectomy.

Answer: (D)

In children, sleep-disordered breathing caused by enlarged adenoids and tonsils is best treated definitively with surgical removal of those tissues. Adenotonsillectomy directly eliminates the primary site of airway obstruction during sleep, allowing the airway to stay open more consistently, which reduces nocturnal breathing pauses, improves oxygenation, and leads to better sleep quality, behavior, and growth in most kids.

Non-surgical options, like nasal corticosteroids, can help shrink lymphoid tissue or be used preoperatively or when surgery isn’t possible, but they don’t permanently resolve the obstruction. CPAP may be used for persistent disease or when surgery isn’t feasible, but it doesn’t address the underlying blockage. So the procedure that most reliably provides a permanent solution in this scenario is adenotonsillectomy.