Airway and Sleep Group Podcast

Pediatric Laser Treatments for Sleep Apnea and Hypertrophic Tonsils

Dr. Liliana Calkins

If your child is suffering from inflamed or enlarged tonsils, or obstructed breathing, your first thought may be that he or she needs a tonsillectomy. Thanks to alternative treatment modalities like laser technology, however, your child may not have to undergo invasive surgery. Take a look at the latest pediatric laser treatments for sleep apnea and hypertrophic tonsils.


What are Hypertrophic Tonsils?

Simply explained, hypertrophic is the medical terminology for enlarged tonsils or tonsillar swelling.


Symptoms of Hypertrophic Tonsils

Symptoms of tonsillar hypertrophy can include:

  • Difficulty feeding in the pediatric population
  • Mouth breathing or noisy breathing
  • Restlessness during sleep or sleep apnea
  • Excessive daytime sleepiness even after 7 hours of sleep/hypersomnolence
  • Loud snoring
  • Behavior changes
  • Poor school performance


Sleep Apnea and Hypertrophic Tonsils

“Most cases of obstructive sleep apnea in children are associated with hypertrophic tonsils,” cites an article in American Family Physician. “Hypertrophic tonsils can be caused by recurrent pharyngitis and local inflammation, especially in children and young adults.” Although tonsillar enlargement may be asymptomatic, enlarged tonsils can fall back and block the oropharynx, or the part of the throat at the back of the mouth.  Unchecked, “tonsillar hypertrophy may also lead to respiratory and cardiac complications.”


Pediatric obstructive sleep apnea (POSA) is a common chronic condition that causes repetitive episodes of partial or complete collapse of the upper airway during sleep, resulting in a reduction or cessation of airflow. Because the person finds it difficult to breathe, they typically awake throughout the night. POSA is a significant medical problem linked with permanent cognitive functional loss, decreased emotional regulation, and growth stunting if not treated in children.


Minimally-Invasive Laser-Assisted Treatment for Pediatric Obstructive Sleep Apnea


The latest generation of surgical lasers offers faster, safer and less-invasive treatments for hypertrophic tonsils and obstructive sleep apnea. The use of their scientifically-proven ACW Nd:YAG and Er:YAG laser wavelengths provides extremely precise laser incision, and controlled thermal coagulation and bleeding effects to ensure a more successful and comfortable surgical treatment designed to shrink hypertrophic tonsils and immediately open the airway.


Benefits of the laser-assisted treatment include:

  • Minimally-invasive procedures
  • No sedation may be required
  • Little or no bleeding
  • Less patient downtime
  • Faster healing
  • High-precision treatments with simultaneous disinfection


At Airway & Sleep group, we utilize Fontana’s family of high-performance LightWalker® and SkyPulse® surgical laser-assisted uvulopalatoplasty systems for treatment of sleep apnea. The Fotona LightWalker® laser, previously used for inflammatory conditions and wound closure, is targeted specifically at the soft palate for mucosal contraction and keratinization. This approach has been reported to safely and effectively reduce symptoms and increase both airway volume by tightening and elevating the oropharyngeal tissues.


While treatment for adults with obstructive sleep apnea (OSA) is generally treated with air pressure machines, like the CPAP, the first line of treatment for pediatric patients has commonly been the surgical removal of hypertrophic tonsils and adenoids. But either a partial or full tonsillectomy has both short- and long-term risks. Short-te