{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T08:20:35Z","timestamp":1770970835501,"version":"3.50.1"},"reference-count":10,"publisher":"Royal College of Surgeons of England","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2009,7]]},"abstract":"<jats:p> During 2008, ENT-UK received a number of professional enquiries from colleagues about the management of children with upper airway obstruction and uncomplicated obstructive sleep apnoea (OSA). These children with sleep-related breathing disorders (SRBDs) are usually referred to paediatricians and ENT surgeons. <\/jats:p><jats:p> In some district general hospitals, (DGHs) where paediatric intensive care (PICU) facilities to ventilate children were not available, paediatrician and anaesthetist colleagues were expressing concern about children with a clinical diagnosis of OSA having routine tonsillectomy, with or without adenoidectomy. <\/jats:p><jats:p> As BAPO President, I was asked by the ENT-UK President, Professor Richard Ramsden, to investigate the issues and rapidly develop a working consensus statement to support safe but local treatment of these children. <\/jats:p><jats:p> The Royal Colleges of Anaesthetists and Paediatrics and Child Health and the Association of Paediatric Anaesthetists nominated expert members from both secondary and tertiary care to contribute and develop a consensus statement based on the limited evidence base available. <\/jats:p><jats:p> Our terms of reference were to produce a statement that was brief, with a limited number of references, to inform decision-making at the present time. <\/jats:p><jats:p> With patient safety as the first priority, the working party wished to support practice that facilitated referral to a tertiary centre of those children who could be expected, on clinical assessment alone, potentially to require PICU facilities. In contrast, the majority of children who could be safely managed in a secondary care setting should be managed closer to home in a DGH. <\/jats:p><jats:p> BAPO, ENT-UK, APA, RCS-CSF and RCoA have endorsed the consensus statement; the RCPCH has no mechanism for endorsing consensus statements, but the RCPCH Clinical Effectiveness Committee reviewed the statement, concluding it was a \u2018concise, accurate and helpful document\u2019. <\/jats:p><jats:p> The consensus statement is an interim working tool, based on level-five evidence. It is intended as the starting point to catalyze further development towards a fully structured, evidence-based guideline; to this end, feedback and comment are welcomed. This and the constructive feedback from APA and RCPCH will be incorporated into a future guideline proposal. <\/jats:p>","DOI":"10.1308\/003588409x432239","type":"journal-article","created":{"date-parts":[[2009,7,3]],"date-time":"2009-07-03T02:38:48Z","timestamp":1246588728000},"page":"371-373","source":"Crossref","is-referenced-by-count":50,"title":["Tonsillectomy and Adenoidectomy in Children with Sleep-Related Breathing Disorders: Consensus Statement of a UK Multidisciplinary Working Party"],"prefix":"10.1308","volume":"91","author":[{"given":"PJ","family":"Robb","sequence":"first","affiliation":[{"name":"British Association for Paediatric Otorhinolaryngology (BAPO) on behalf of ENT-UK"},{"name":"The Royal College of Surgeons of England, Children's Surgical Forum (RCS-CSF)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Bew","sequence":"additional","affiliation":[{"name":"Association of Paediatric Anaesthetists (APA)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Kubba","sequence":"additional","affiliation":[{"name":"British Association for Paediatric Otorhinolaryngology (BAPO) on behalf of ENT-UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Murphy","sequence":"additional","affiliation":[{"name":"Royal College of Paediatrics and Child Health (RCPCH)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Primhak","sequence":"additional","affiliation":[{"name":"Association of Paediatric Anaesthetists (APA)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A-M","family":"Rollin","sequence":"additional","affiliation":[{"name":"Vice President, Royal College of Anaesthetists (RCoA)"},{"name":"The Royal College of Surgeons of England, Children's Surgical Forum (RCS-CSF)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Tremlett","sequence":"additional","affiliation":[{"name":"Association of Paediatric Anaesthetists (APA)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"171","reference":[{"key":"b1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.68.3.360"},{"key":"b2","first-page":"866","volume":"153","author":"American Thoracic Society","year":"1995","journal-title":"Am J Respir Crit Care Med"},{"key":"b3","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1992.01880090056017"},{"key":"b4","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1542\/peds.93.5.784","volume":"93","author":"Rosen GM","year":"1994","journal-title":"Pediatrics"},{"key":"b5","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200202000-00015"},{"key":"b6","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1997.01900050067009"},{"key":"b7","doi-asserted-by":"publisher","DOI":"10.1016\/0165-5876(87)90088-7"},{"key":"b8","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.1.e19"},{"key":"b9","first-page":"ep87","volume":"90","author":"Primhak R","year":"2005","journal-title":"Arch Dis Child"},{"key":"b10","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00619.2001"}],"container-title":["The Annals of The Royal College of Surgeons of England"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/pdf\/10.1308\/003588409X432239","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T10:02:02Z","timestamp":1684144922000},"score":1,"resource":{"primary":{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/10.1308\/003588409X432239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,7]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2009,7]]}},"alternative-id":["10.1308\/003588409X432239"],"URL":"https:\/\/doi.org\/10.1308\/003588409x432239","relation":{},"ISSN":["0035-8843","1478-7083"],"issn-type":[{"value":"0035-8843","type":"print"},{"value":"1478-7083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,7]]}}}