Role of Adenotonsillectomy and Tonsillectomy in Children with Down Syndrome Who Develop Obstructive Sleep Apnea by Obesity as a Risk Factor

Table 2

Diagnosis and differential diagnosis of obstructive sleep apnea in children.

S. no.	Symptoms	Physical examinations	Differential diagnosis
1	Snoring	Obesity	Nasoseptal obstruction
2	Pulmonary hypertension	Adenotonsillar hypertrophy	Adenotonsillar hypertrophy
3	Nighttime awakening	Growth disturbances	Macroglossia
4	Unusual daytime behavior	Lingual tonsils	Lingual tonsils
5	Poor academic performance	Craniofacial abnormalities	Hypotonic pharynx
6	Cessation of breathing	Failure to thrive	Maxillary hypoplasia
7	Cyanosis	Laryngeal pathology	Laryngeal abnormality
8	Cor pulmonale	—	Enlarged soft palate/uvula
9	Excessive daytime somnolence	—	Micrognathia
10	Gasping of air	—	—
11	Enuresis	—	—
12	Irritability	—	—