Obstructive sleep apnea in Down syndrome children: a surgical approach.

Obstructive sleep apnea is considered in five Down syndrome children. All had altered anatomy consistent with this syndrome involving the oropharynx, cranium, and midface. Based on earlier work, it was established that, except for specific isolated instances, routine tonsillectomy and adenoidectomy would not reverse obstructive respiratory patterns in this patient population. A modified pharyngopalatal surgical approach has been successful in alleviating upper airway sleep obstruction in Down syndrome.