Obstructive sleep apnea hypoventilation syndrome in children is a sleep disordered breathing disease, the cause of which is mostly upper airway obstruction, and tonsillar adenoid hypertrophy is an important cause of airway obstruction . As an immune organ in the body, the tonsillar adenoids are prone to hyperplasia and hypertrophy of adjacent organs during childhood due to growth and development and inflammatory stimulation, which can cause heart, lung, brain and other organ pathologies in severe cases and directly affect the physical and intellectual development of children. Obstructive sleep apnea hypoventilation syndrome in children is a potentially harmful disease that affects the growth and development of children due to long-term chronic hypoxia, and has received great attention from medical professionals and families of children in recent years. In children, enlarged tonsils and adenoids are the most common cause of upper airway restrictive obstruction. The tonsils and adenoids are largest in size between 3 and 6 years of age and are the age group with the highest prevalence, with more boys than girls reported in the literature in a ratio close to 3:l. The diagnosis in children relies on a comprehensive evaluation of history, physical examination, lateral nasopharyngeal film or CT scan of the nasal cavity and fiberoptic nasopharyngoscopy to determine the plane of narrowing of the upper airway obstruction. Pathological adenoid hypertrophy is determined from different angles based on imaging and endoscopy.PSG monitoring is mainly used to understand the severity of the disease in children with 0SAHS. PSG monitoring is used to guide surgery and outcome observation, especially in children under 2 years of age with high-risk factors, to help determine the indication for surgery. Previously, it was believed that children must reach 4 years of age or older to undergo surgery. Domestic and international studies have shown that even in infants a few months old, as soon as the diagnosis is established, surgery must be performed to relieve the symptoms of upper airway obstruction. If a low age infant is determined to have respiratory distress due to tonsillar and adenoid hypertrophy, in addition to advocating an aggressive approach to surgical treatment, it should be considered that the tonsils and adenoids have the function of producing lymphocytes in early infancy. They have a cell-regulated immune response to specific antigens. Therefore, in infants and children with grade III tonsillar hypertrophy, it is best to preserve one side even if the immune function is normal, and the tonsils are generally preserved and the adenoids are simply removed, preserving the immune role of the remaining members of the pharyngeal endolymphatic ring. In children with mild adenoid hyperplasia who undergo tonsil surgery, it is also advocated to remove the adenoids together to prevent compensatory adenoid hyperplasia after tonsil surgery. The adenoidectomy can be performed under direct vision with endoscopy, which is safe and thorough to facilitate hemostasis and is not easy to recur after surgery. Therefore, it is believed that anyone with tonsillar adenoid hypertrophy and dyspnea should be operated as early as possible to relieve the upper airway obstruction, and the surgical result is exact and satisfactory. In recent years, palatopharyngoplasty has been applied to children, and the efficacy needs to be further observed.