With the development of sleep medicine, children’s obstructive sleep apnea hypoventilation syndrome (OSAHS) is gradually being emphasized. The main cause of OSAHS in children is adenoid hypertrophy and tonsil hypertrophy, so surgical removal of adenoids and tonsils is the main method of treating OSAHS in children, and the surgical efficiency reaches 90%. Most of the children have good surgical results, and only some of them continue to snore, breathe with their mouths open, and hold their breaths after the surgical treatment. Below I will discuss with the parents of children with OSAHS. What is OSAHS in children? OSAHS refers to snoring, open-mouth breathing and breath-holding in children under 14 years old. The medical diagnostic criteria are: sleep apnea refers to the cessation of oral and nasal airflow during sleep for a period of time greater than or equal to 2 respiratory cycles, and hypoventilation refers to the decrease of airflow by more than 50%, lasting for a period of time greater than or equal to 2 respiratory cycles, accompanied by a decrease of oxygen saturation by 0.03. Sleep apnea hypoventilation index (AHI) greater than or equal to 5 times/hour can be diagnosed as OSAHS in children. The respiratory cycle is the time it takes for a person to breathe in and out. For example, if your child takes 30 breaths a minute, his/her respiratory cycle is 2 seconds, and if he/she stops breathing for more than 4 seconds during sleep, it is considered an apnea, and if it occurs more than 5 times a night, the diagnosis of childhood OSAHS is basically confirmed. Decrease in oxygen saturation can only be recorded by medical equipment. In April 2003, our hospital introduced polysomnography (PSG), which can provide a scientific basis for pediatric patients. II. What are the causes and dangers of OSAHS in children? The causes of OSAHS in children mainly include 1. enlarged adenoids (pharyngeal tonsils or proliferative bodies), generally adenoid hypertrophy in children is mostly physiological, peaked at 4~5 years old, and gradually atrophied after puberty, but a few adults still have remnants of the hereditary factors, but also related to inflammation.2. enlarged tonsils.3. congenital and acquired nasopharyngeal stenosis and atresia. Children OSAHS can cause obesity, open jaw, thick lips, maxillary protrusion, teeth misalignment, oozing (kata) otitis media, rhinosinusitis; severe cases can cause adenoid face (commonly known as “concave face”), daytime drowsiness, fatigue, mental retardation in children, reduced academic performance; can also cause nocturnal enuresis, diabetes, hypertension and so on. It can also cause nocturnal enuresis, diabetes mellitus, high blood pressure and so on. Therefore, this disease should cause the parents of children to pay great attention to. Third, how to clearly diagnose children OSAHS? We based on the parents complained that the child sleeps at night snoring, open-mouth breathing, etc., the size of the tonsils of a mouth can be seen clearly, ENT doctors can easily determine the tonsils of the second or third degree. The adenoids are deeper in the hidden not easy to find, we can with the help of other instruments and equipment to check the discovery. 1. fiber nasopharyngolaryngoscope, the nasal cavity slightly sprayed with some anesthetic, from the nasal cavity into a hose only 4mm can see the adenoids clearly, if the adenoids of the size of the back of the nose more than half of the aperture is the indications of the operation. 2. x-ray pharyngeal lateral plain film examination. If your child is afraid of the above examination, we can look at the size of the adenoids by taking the lateral pharyngeal position. The ratio of the adenoids to the anterior and posterior widths of the nasopharyngeal cavity in the lateral nasopharyngeal position (A/N): less than 0.60 is normal in children, and 0.60~0.70 is pathologically hypertrophic. The minimum airway gap between the soft palate and the adenoids in the lateral nasopharyngeal position is ≤3mm, and more than 5mm is normal. Then the A/N ratio is more than 0.06 or the minimum airway gap between soft palate and adenoids ≤3mm is also an indication for adenoidectomy.3. Other: the application of rigid nasal endoscopy and hand palpation can also determine the size of the adenoids, this method is not easy to accept due to the children in most of the hospitals are currently using the first two methods. Surgical treatment of OSAHS in children Once your child is diagnosed with OSAHS in children, he or she should go to a large regular hospital for treatment. Maybe you are worried that your child is too young, in general we can perform tonsil and adenoidectomy for children over 24 months (2 years old). Perhaps you are also concerned that your child will be immunocompromised after removal of the tonsils. In addition to the adenoids (pharyngeal tonsils) and tonsils (palatine tonsils) in our pharynx, there are lingual tonsils and the inner and outer pharyngeal lymphatic rings that are involved in the body’s immunity. If your child is hospitalized, and after a routine pre-operative physical examination, nothing abnormal is found, we will arrange for surgery after 1~2 days of hospitalization. We will ask the most experienced anesthesiologist to administer general anesthesia to your child, and after about 10 minutes of successful general anesthesia, we will be able to operate on your child. About 30~40 minutes (10 minutes for adenoids, 20~30 minutes for tonsils) the surgery will be finished, after another 5~10 minutes your child will be able to wake up completely and go back to the hospital room to rest, play a dozen drops, after 1 day of cold fluid, the second day after the operation, begin to gargle before and after three meals a day, and then after 3~5 days of anti-inflammatory treatment, your child will be able to recover and leave the hospital. The biggest complication of this kind of surgery is bleeding, so your child should be well looked after within two weeks of the surgery to avoid strenuous exercise and eat softer food. After 3 months, your child will be able to play with other healthy children.