An obese child has severe OSA and large tonsils. What is the most accurate counselling before adenotonsillectomy?
Obesity increases perioperative respiratory risk and persistence of OSA. Adenotonsillectomy can still help when adenotonsillar hypertrophy contributes, but it is not a guaranteed cure.
A. Tonsillectomy guarantees normal sleep studies: Residual disease is common in obesity.
B. Weight management makes airway assessment unnecessary: Both anatomical obstruction and systemic risk require attention.
C. Day-case surgery is always safe: Severe OSA and obesity may require planned monitored admission.
D. Surgery may improve obstruction but residual OSA is common and postoperative monitoring plus weight management are needed: Obesity increases perioperative respiratory risk and persistence of OSA. Adenotonsillectomy can still help when adenotonsillar hypertrophy contributes, but it is not a guaranteed cure.
E. CPAP can never be required after surgery: Persistent OSA may need positive-pressure therapy.
If the child had a craniofacial syndrome or neuromuscular weakness, residual risk and perioperative planning would be even more complex.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for current guidance, local policy and specialist judgement.
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