Adenotonsillar Hypertrophy

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AG Schilder - One of the best experts on this subject based on the ideXlab platform.

  • effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or Adenotonsillar Hypertrophy open randomised controlled trial
    Clinical Otolaryngology, 2005
    Co-Authors: Birgit K Van Staaji, Maroeska M. Rovers, Emma H. Van Den Akker, Gerrit Jan Hordijk, Arno W Hoes, AG Schilder
    Abstract:

    OBJECTIVE: To assess the effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or Adenotonsillar Hypertrophy. DESIGN: Open, randomised controlled trial. SETTING: 21 general hospitals and three academic centres in the Netherlands. PARTICIPANTS: 300 children aged 2-8 years requiring adenotonsillectomy. INTERVENTION: Adenotonsillectomy compared with watchful waiting. MAIN OUTCOME MEASURES: Episodes of fever, throat infections, upper respiratory tract infections, and health related quality of life. RESULTS: During the median follow up period of 22 months, children in the adenotonsillectomy group had 2.97 episodes of fever per person year compared with 3.18 in the watchful waiting group (difference -0.21%, 95% confidence interval -0.54 to 0.12), 0.56 throat infections per year compared with 0.77 (-0.21, -0.36 to -0.06), and 5.47 upper respiratory tract infections per person year compared with 6.00 (-0.53, -0.97 to -0.08). No clinically relevant differences were found for health related quality of life. Adenotonsillectomy was more effective in children with a history of three to six throat infections than in those with none or two. 12 children had surgery related complications. CONCLUSION: Adenotonsillectomy in children with mild symptoms of throat infections or Adenotonsillar Hypertrophy has no major clinical benefits over watchful waiting.

  • Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or Adenotonsillar Hypertrophy: open, randomised controlled trial.
    Clin Otolaryngol, 2005
    Co-Authors: AG Schilder
    Abstract:

    To assess the effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or Adenotonsillar Hypertrophy.

  • effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or Adenotonsillar Hypertrophy open randomised controlled trial
    BMJ, 2004
    Co-Authors: Birgit K. Van Staaij, Maroeska M. Rovers, Emma H. Van Den Akker, Gerrit Jan Hordijk, Arno W Hoes, AG Schilder
    Abstract:

    Objective To assess the effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or Adenotonsillar Hypertrophy. Design Open, randomised controlled trial. Setting 21 general hospitals and three academic centres in the Netherlands. Participants 300 children aged 2-8 years requiring adenotonsillectomy. Intervention Adenotonsillectomy compared with watchful waiting. Main outcome measures Episodes of fever, throat infections, upper respiratory tract infections, and health related quality of life. Results During the median follow up period of 22 months, children in the adenotonsillectomy group had 2.97 episodes of fever per person year compared with 3.18 in the watchful waiting group (difference -0.21, 95% confidence interval -0.54 to 0.12), 0.56 throat infections per person year compared with 0.77 (-0.21, -0.36 to -0.06), and 5.47 upper respiratory tract infections per person year compared with 6.00 (-0.53, -0.97 to -0.08). No clinically relevant differences were found for health related quality of life. Adenotonsillectomy was more effective in children with a history of three to six throat infections than in those with none to two. 12 children had complications related to surgery. Conclusion Adenotonsillectomy has no major clinical benefits over watchful waiting in children with mild symptoms of throat infections or Adenotonsillar Hypertrophy.

Jay N Dolitsky - One of the best experts on this subject based on the ideXlab platform.

  • Treatment of symptomatic chronic Adenotonsillar Hypertrophy with amoxicillin/clavulanate potassium: short- and long-term results.
    Pediatrics, 1998
    Co-Authors: Anthony P Sclafani, Jeffrey Ginsburg, M K Shah, Jay N Dolitsky
    Abstract:

    To evaluate the short- and long-term effects of treatment of symptomatic chronic Adenotonsillar Hypertrophy (CATH) with a 30-day course of amoxicillin/clavulanate potassium (AMOX/CLAV). Children 2 to 16 years of age with obstructive symptoms attributable to CATH, who did not have a history of recurrent adenotonsillitis. A prospective, randomized, double-blinded, placebo-controlled trial. Ambulatory clinic of a tertiary care hospital. Patients were randomly treated with 30-day courses of either placebo (PLAC) or AMOX/CLAV (40 mg/kg in 3 divided doses daily). Patients' signs and symptoms were assessed by physical examination and by both physician and parental forced-choice questionnaires 1, 3, and 24 months after treatment. The decision to proceed to surgery or to continue expectant management was made for all patients by the same physician, based on reported symptoms and physical findings. Treatment with a 30-day course of AMOX/CLAV significantly reduced the need for surgery in the short term compared with PLAC (37.5% vs 62.7%) at 1-month follow-up). The reduced need for surgery in the AMOX/CLAV-treated group persisted at 3 months (AMOX/CLAV 54.5% vs PLAC 85.7%) and 24 months (AMOX/CLAV 83.3% vs PLAC 98.0%). A 30-day course of AMOX/CLAV significantly reduces the need for surgery in children with obstructive Adenotonsillar Hypertrophy at 1-month follow-up. This relative reduction persists at 3 and 24 months posttreatment, although the absolute percentages of patients requiring surgery increased in both groups as time after treatment increased. The reduction in symptoms in AMOX/CLAV-treated patients is modest but significant even in long-term follow-up. The precise role of this treatment for CATH is yet to be determined; however, our results suggest that a 30-day course of AMOX/CLAV can be used in situations when a temporary relief in symptoms is desirable or surgery would incur unacceptable risk.

  • treatment of symptomatic chronic Adenotonsillar Hypertrophy with amoxicillin clavulanate potassium short and long term results
    Pediatrics, 1998
    Co-Authors: Anthony P Sclafani, Jeffrey Ginsburg, M Shah, Jay N Dolitsky
    Abstract:

    Objective. To evaluate the short- and long-term effects of treatment of symptomatic chronic Adenotonsillar Hypertrophy (CATH) with a 30-day course of amoxicillin/clavulanate potassium (AMOX/CLAV). Patients. Children 2 to 16 years of age with obstructive symptoms attributable to CATH, who did not have a history of recurrent adenotonsillitis. Design. A prospective, randomized, double-blinded, placebo-controlled trial. Setting. Ambulatory clinic of a tertiary care hospital. Intervention. Patients were randomly treated with 30-day courses of either placebo (PLAC) or AMOX/CLAV (40 mg/kg in 3 divided doses daily). Outcome Measures. Patients9 signs and symptoms were assessed by physical examination and by both physician and parental forced-choice questionnaires 1, 3, and 24 months after treatment. The decision to proceed to surgery or to continue expectant management was made for all patients by the same physician, based on reported symptoms and physical findings. Results. Treatment with a 30-day course of AMOX/CLAV significantly reduced the need for surgery in the short term compared with PLAC (37.5% vs 62.7%) at 1-month follow-up). The reduced need for surgery in the AMOX/CLAV-treated group persisted at 3 months (AMOX/CLAV 54.5% vs PLAC 85.7%) and 24 months (AMOX/CLAV 83.3% vs PLAC 98.0%). Conclusions. A 30-day course of AMOX/CLAV significantly reduces the need for surgery in children with obstructive Adenotonsillar Hypertrophy at 1-month follow-up. This relative reduction persists at 3 and 24 months posttreatment, although the absolute percentages of patients requiring surgery increased in both groups as time after treatment increased. The reduction in symptoms in AMOX/CLAV-treated patients is modest but significant even in long-term follow-up. The precise role of this treatment for CATH is yet to be determined; however, our results suggest that a 30-day course of AMOX/CLAV can be used in situations when a temporary relief in symptoms is desirable or surgery would incur unacceptable risk.

  • Treatment of Symptomatic Chronic Adenotonsillar Hypertrophy With Amoxicillin/Clavulanate Potassium: Short- and Long-term Results
    Pediatrics, 1998
    Co-Authors: Anthony P Sclafani, M Shah, Jeffrey B. Ginsburg, Jay N Dolitsky
    Abstract:

    Objective. To evaluate the short- and long-term effects of treatment of symptomatic chronic Adenotonsillar Hypertrophy (CATH) with a 30-day course of amoxicillin/clavulanate potassium (AMOX/CLAV). Patients. Children 2 to 16 years of age with obstructive symptoms attributable to CATH, who did not have a history of recurrent adenotonsillitis. Design. A prospective, randomized, double-blinded, placebo-controlled trial. Setting. Ambulatory clinic of a tertiary care hospital. Intervention. Patients were randomly treated with 30-day courses of either placebo (PLAC) or AMOX/CLAV (40 mg/kg in 3 divided doses daily). Outcome Measures. Patients9 signs and symptoms were assessed by physical examination and by both physician and parental forced-choice questionnaires 1, 3, and 24 months after treatment. The decision to proceed to surgery or to continue expectant management was made for all patients by the same physician, based on reported symptoms and physical findings. Results. Treatment with a 30-day course of AMOX/CLAV significantly reduced the need for surgery in the short term compared with PLAC (37.5% vs 62.7%) at 1-month follow-up). The reduced need for surgery in the AMOX/CLAV-treated group persisted at 3 months (AMOX/CLAV 54.5% vs PLAC 85.7%) and 24 months (AMOX/CLAV 83.3% vs PLAC 98.0%). Conclusions. A 30-day course of AMOX/CLAV significantly reduces the need for surgery in children with obstructive Adenotonsillar Hypertrophy at 1-month follow-up. This relative reduction persists at 3 and 24 months posttreatment, although the absolute percentages of patients requiring surgery increased in both groups as time after treatment increased. The reduction in symptoms in AMOX/CLAV-treated patients is modest but significant even in long-term follow-up. The precise role of this treatment for CATH is yet to be determined; however, our results suggest that a 30-day course of AMOX/CLAV can be used in situations when a temporary relief in symptoms is desirable or surgery would incur unacceptable risk.

Ali M Strocker - One of the best experts on this subject based on the ideXlab platform.

  • Adenotonsillar Hypertrophy and epstein barr virus in pediatric organ transplant recipients
    Laryngoscope, 2001
    Co-Authors: Nina L Shapiro, Ali M Strocker
    Abstract:

    Objectives/Hypothesis: Epstein-Barr virus‐related (EBV-related) lymphoid hyperplasia of the tonsils and adenoids is a precursor to post-transplantation lymphoproliferative disorder (PTLD). The incidence of posttransplantation Adenotonsillar Hypertrophy, a potential early sign of PTLD or EBV-related lymphoid hyperplasia, is not known. We sought to identify potential risk factors for Adenotonsillar Hypertrophy manifested as EBV-related hyperplasia and early PTLD in the pediatric solid organ transplant population. Study Design: Cross-sectional analysis. Methods: We developed a 65-point questionnaire concerning obstructive sleep disorder and upper respiratory tract infections and an 8-point focused physical examination, to identify prevalence of and risk factors for Adenotonsillar Hypertrophy in the pediatric transplant population. We evaluated 120 pediatric solid organ transplant recipients by parental questionnaire and focused Adenotonsillar physical examination. Results: Of the 120 patients, 62 had undergone liver transplantation and 58 had undergone kidney transplantation. Overall, the mean questionnaire score was 8.36 (range, 0‐40) and the mean physical examination score was 3.86 (range, 1‐8). Patients whose EBV serological test result was negative at the time of transplant had higher scores for both the questionnaire (mean score, 10.24) and the physical examination (mean score, 4.56) than those whose EBV serological test result was positive at the time of transplantation (scores of 7.38 and 3.30 for questionnaire and physical examination, respectively). The difference in examination scores was statistically significant (P <.003). Conclusions: Epstein-Barr virus seronegativity at the time of organ transplantation is a known risk factor for PTLD, with associated risk of developing EBV-related lymphoid hyperplasia. Our results indicate a higher incidence of symptoms and signs consistent with Adenotonsillar Hypertrophy in the EBV seronegative population. Adenotonsillar Hypertrophy may be a precursor to EBV-related lymphoid hyperplasia and PTLD and must be identified in this patient population.

  • Adenotonsillar Hypertrophy and Epstein-Barr virus in pediatric organ transplant recipients
    Laryngoscope, 2001
    Co-Authors: Nina L Shapiro, Ali M Strocker
    Abstract:

    Objectives/Hypothesis: Epstein-Barr virus‐related (EBV-related) lymphoid hyperplasia of the tonsils and adenoids is a precursor to post-transplantation lymphoproliferative disorder (PTLD). The incidence of posttransplantation Adenotonsillar Hypertrophy, a potential early sign of PTLD or EBV-related lymphoid hyperplasia, is not known. We sought to identify potential risk factors for Adenotonsillar Hypertrophy manifested as EBV-related hyperplasia and early PTLD in the pediatric solid organ transplant population. Study Design: Cross-sectional analysis. Methods: We developed a 65-point questionnaire concerning obstructive sleep disorder and upper respiratory tract infections and an 8-point focused physical examination, to identify prevalence of and risk factors for Adenotonsillar Hypertrophy in the pediatric transplant population. We evaluated 120 pediatric solid organ transplant recipients by parental questionnaire and focused Adenotonsillar physical examination. Results: Of the 120 patients, 62 had undergone liver transplantation and 58 had undergone kidney transplantation. Overall, the mean questionnaire score was 8.36 (range, 0‐40) and the mean physical examination score was 3.86 (range, 1‐8). Patients whose EBV serological test result was negative at the time of transplant had higher scores for both the questionnaire (mean score, 10.24) and the physical examination (mean score, 4.56) than those whose EBV serological test result was positive at the time of transplantation (scores of 7.38 and 3.30 for questionnaire and physical examination, respectively). The difference in examination scores was statistically significant (P

Anthony P Sclafani - One of the best experts on this subject based on the ideXlab platform.

  • Treatment of symptomatic chronic Adenotonsillar Hypertrophy with amoxicillin/clavulanate potassium: short- and long-term results.
    Pediatrics, 1998
    Co-Authors: Anthony P Sclafani, Jeffrey Ginsburg, M K Shah, Jay N Dolitsky
    Abstract:

    To evaluate the short- and long-term effects of treatment of symptomatic chronic Adenotonsillar Hypertrophy (CATH) with a 30-day course of amoxicillin/clavulanate potassium (AMOX/CLAV). Children 2 to 16 years of age with obstructive symptoms attributable to CATH, who did not have a history of recurrent adenotonsillitis. A prospective, randomized, double-blinded, placebo-controlled trial. Ambulatory clinic of a tertiary care hospital. Patients were randomly treated with 30-day courses of either placebo (PLAC) or AMOX/CLAV (40 mg/kg in 3 divided doses daily). Patients' signs and symptoms were assessed by physical examination and by both physician and parental forced-choice questionnaires 1, 3, and 24 months after treatment. The decision to proceed to surgery or to continue expectant management was made for all patients by the same physician, based on reported symptoms and physical findings. Treatment with a 30-day course of AMOX/CLAV significantly reduced the need for surgery in the short term compared with PLAC (37.5% vs 62.7%) at 1-month follow-up). The reduced need for surgery in the AMOX/CLAV-treated group persisted at 3 months (AMOX/CLAV 54.5% vs PLAC 85.7%) and 24 months (AMOX/CLAV 83.3% vs PLAC 98.0%). A 30-day course of AMOX/CLAV significantly reduces the need for surgery in children with obstructive Adenotonsillar Hypertrophy at 1-month follow-up. This relative reduction persists at 3 and 24 months posttreatment, although the absolute percentages of patients requiring surgery increased in both groups as time after treatment increased. The reduction in symptoms in AMOX/CLAV-treated patients is modest but significant even in long-term follow-up. The precise role of this treatment for CATH is yet to be determined; however, our results suggest that a 30-day course of AMOX/CLAV can be used in situations when a temporary relief in symptoms is desirable or surgery would incur unacceptable risk.

  • treatment of symptomatic chronic Adenotonsillar Hypertrophy with amoxicillin clavulanate potassium short and long term results
    Pediatrics, 1998
    Co-Authors: Anthony P Sclafani, Jeffrey Ginsburg, M Shah, Jay N Dolitsky
    Abstract:

    Objective. To evaluate the short- and long-term effects of treatment of symptomatic chronic Adenotonsillar Hypertrophy (CATH) with a 30-day course of amoxicillin/clavulanate potassium (AMOX/CLAV). Patients. Children 2 to 16 years of age with obstructive symptoms attributable to CATH, who did not have a history of recurrent adenotonsillitis. Design. A prospective, randomized, double-blinded, placebo-controlled trial. Setting. Ambulatory clinic of a tertiary care hospital. Intervention. Patients were randomly treated with 30-day courses of either placebo (PLAC) or AMOX/CLAV (40 mg/kg in 3 divided doses daily). Outcome Measures. Patients9 signs and symptoms were assessed by physical examination and by both physician and parental forced-choice questionnaires 1, 3, and 24 months after treatment. The decision to proceed to surgery or to continue expectant management was made for all patients by the same physician, based on reported symptoms and physical findings. Results. Treatment with a 30-day course of AMOX/CLAV significantly reduced the need for surgery in the short term compared with PLAC (37.5% vs 62.7%) at 1-month follow-up). The reduced need for surgery in the AMOX/CLAV-treated group persisted at 3 months (AMOX/CLAV 54.5% vs PLAC 85.7%) and 24 months (AMOX/CLAV 83.3% vs PLAC 98.0%). Conclusions. A 30-day course of AMOX/CLAV significantly reduces the need for surgery in children with obstructive Adenotonsillar Hypertrophy at 1-month follow-up. This relative reduction persists at 3 and 24 months posttreatment, although the absolute percentages of patients requiring surgery increased in both groups as time after treatment increased. The reduction in symptoms in AMOX/CLAV-treated patients is modest but significant even in long-term follow-up. The precise role of this treatment for CATH is yet to be determined; however, our results suggest that a 30-day course of AMOX/CLAV can be used in situations when a temporary relief in symptoms is desirable or surgery would incur unacceptable risk.

  • Treatment of Symptomatic Chronic Adenotonsillar Hypertrophy With Amoxicillin/Clavulanate Potassium: Short- and Long-term Results
    Pediatrics, 1998
    Co-Authors: Anthony P Sclafani, M Shah, Jeffrey B. Ginsburg, Jay N Dolitsky
    Abstract:

    Objective. To evaluate the short- and long-term effects of treatment of symptomatic chronic Adenotonsillar Hypertrophy (CATH) with a 30-day course of amoxicillin/clavulanate potassium (AMOX/CLAV). Patients. Children 2 to 16 years of age with obstructive symptoms attributable to CATH, who did not have a history of recurrent adenotonsillitis. Design. A prospective, randomized, double-blinded, placebo-controlled trial. Setting. Ambulatory clinic of a tertiary care hospital. Intervention. Patients were randomly treated with 30-day courses of either placebo (PLAC) or AMOX/CLAV (40 mg/kg in 3 divided doses daily). Outcome Measures. Patients9 signs and symptoms were assessed by physical examination and by both physician and parental forced-choice questionnaires 1, 3, and 24 months after treatment. The decision to proceed to surgery or to continue expectant management was made for all patients by the same physician, based on reported symptoms and physical findings. Results. Treatment with a 30-day course of AMOX/CLAV significantly reduced the need for surgery in the short term compared with PLAC (37.5% vs 62.7%) at 1-month follow-up). The reduced need for surgery in the AMOX/CLAV-treated group persisted at 3 months (AMOX/CLAV 54.5% vs PLAC 85.7%) and 24 months (AMOX/CLAV 83.3% vs PLAC 98.0%). Conclusions. A 30-day course of AMOX/CLAV significantly reduces the need for surgery in children with obstructive Adenotonsillar Hypertrophy at 1-month follow-up. This relative reduction persists at 3 and 24 months posttreatment, although the absolute percentages of patients requiring surgery increased in both groups as time after treatment increased. The reduction in symptoms in AMOX/CLAV-treated patients is modest but significant even in long-term follow-up. The precise role of this treatment for CATH is yet to be determined; however, our results suggest that a 30-day course of AMOX/CLAV can be used in situations when a temporary relief in symptoms is desirable or surgery would incur unacceptable risk.

Kristina Sundquist - One of the best experts on this subject based on the ideXlab platform.

  • sibling risk of pediatric obstructive sleep apnea syndrome and Adenotonsillar Hypertrophy
    Sleep, 2009
    Co-Authors: Danielle Friberg, Jan Sundquist, Xinjun Li, Kari Hemminki, Kristina Sundquist
    Abstract:

    SLEEP DISORDERED BREATHING (SDB) IS A CONDITION CHARACTERIZED BY INTERMITTENT PARTIAL OR COMPLETE UPPER AIRWAY OBSTRUCTION THAT disrupts normal ventilation during sleep and normal sleep patterns.1 There is no consensus on the definition of pediatric SDB, but clinically there is a spectrum of symptoms, in which the milder forms only have primary snoring and mouth-breathing, while the more severe forms have symptoms similar to the more defined entity obstructive sleep apnea syndrome (OSAS), i.e., intermittent breathing pauses (apneas), habitual snoring, snorts or gasps, disturbed sleep,1 and daytime neurobehavioral problems with impaired school performance.2 Complications of OSAS include failure to thrive and, in severe cases, cor pulmonale and even death.1 To diagnose OSAS, sleep studies are required; the gold standard is full-night polysomnography (PSG) with electroencephalography (EEG).1 However, PSG is expensive, time-consuming, and not widely available; thus the term SDB is most often clinically used. The correlation between clinical history of snoring and apnea and the polysomnographic findings have been investigated. One study showed that apneic episodes every night detected by parents were the most important single risk factor for OSAS.3 Further, previous adenoidectomy was a risk factor, suggesting that the epipharyngeal space does not play a central role in pediatric OSAS.3 Another study showed that tonsillar Hypertrophy was correlated to more severe apnea among pre-school-age children, but not among school-age children.4 The most important risk factor to SDB and OSAS is Adenotonsillar Hypertrophy.5 There are diverging results concerning if the severity of OSAS is proportional to the size of the tonsils and adenoids,6 or not.7 Other risk factors are obesity, craniofacial anomalies, and/or neuromuscular disorders etc.8,9 Surgical removal of Adenotonsillar Hypertrophy is the first treatment option in children.8,10–12 Removal of adenoids from the nasopharynx alone may not be sufficient to treat OSAS and is mostly performed to treat primary snoring and mouth breathing.3 A recent epidemiologic review suggests that the prevalence of parent-reported symptoms of SDB on questionnaire is 4% to 11%; OSA diagnosed by varying criteria on diagnostic studies, 1% to 4%.13 The prevalence of SDB is higher among boys than girls, and among African Americans compared to other races.13 In addition, obesity and overweight showed to have different importance among older versus younger children, in whom enlarged tonsils are believed to play a major role in SDB risk.13 The prevalence of Adenotonsillar Hypertrophy in children is unknown. Genetic studies of adults and children indicate that also heredity can be an important risk factor for OSA or SDB.14–18 Genome scan of white adults in USA has been performed.14 Evidence for linkage to the apnea-hypopnea index (severity of OSA) was found in 2 chromosome regions. The Cleveland Family Study in the United States suggested that the angiotensin-converting enzyme (ACE) deletion allele may protect against hypertension in the setting of obstructive sleep apnea.15 Further shown in OSA children is that RNA derived from peripheral leukocytes confirms the presence of involved genes related to the inflammatory response.16 Apolipoprotein E (ApoE) epsilon4 allele was associated with not only increased odds of having SDB, but also with an increased risk for neurocognitive dysfunction,17 and polymorphisms involving more than one locus in the ApoE gene and its regulatory region were associated with OSA in Caucasian children.18 In Sweden, there is a special hospital diagnostic code for OSAS. However, it is seldom used for children as they only occasionally undergo sleep studies, i.e., polysomnography at hospitals, with measurements of breathing, pulse oximetry, and/or transcutaneous carbon dioxide, can be performed. SDB has no special diagnostic code and therefore, children with such symptoms and suspected OSAS get the code Adenotonsillar Hypertrophy instead. If a child previously has undergone adenoidectomy but still has symptoms, the code of Hypertrophy of tonsils is used. The construction of a large population-based patient register has led to the rapid development of genetic-epidemiological studies in Sweden.19,20 In addition, a recently published large-scale population-based study from our group has found that, after accounting for socioeconomic status, age, geographic region, and period of diagnosis, adults with at least one sibling who had a hospital diagnostic code of OSAS had a 3-fold increased risk of getting diagnosed with the same code during 8 years.21 In the present study we included hospital data on all children in Sweden during the study period between 1997 and 2004, i.e., a total of 2.7 million individuals. The individual study population was siblings born in 1978 and onward. The use of hospital register data eliminated recall bias. Recall bias is a potential problem when conducting case-control studies of familial risk because patients in the case group are prone to report a positive family history of the disease or other health problem being studied. The main aim of this study was to define the familial risk of hospitalization for primary diagnostic codes of (1) OSAS and/or (2) suspected OSAS, with clinical signs of SDB and Adenotonsillar Hypertrophy, in Swedish children less than 19 years of age. A further aim was to determine whether there were any differences by age and gender.