There's not enough information to definitively say what the correct course is, and we can't look at any further evaluation that has been done. Your child has severe sleep apnea based on the reported AHI, has an oxygen requirement, and by definition had failure to thrive while being <5th percentile for weight. One thing not commented on in this post at all is how feeding has been going, if there is tiring during feeding, desaturations during feeding, and how noisy the baby is when agitated and how noisy when sleeping. These can also all point to whether laryngomalacia is a potential cause.These all indicate at the very least that an evaluation of the airway is necessary, and it is reasonable if there are significant issues to correct those issues and minimize the need for further procedures.
ENT surgeons - would you do pediatric supraglottoplasty and/or remove adenoids?My baby is almost 5 months old, scheduled next week for endoscopy & bronchoscopy - the ent surgeon wants blanket consent going in for supraglottoplasty and removal of adenoids if indicated.On sleep study around 2.5 months ago, baby had a significant number of hypopneas (approx 27 times per hour) and 5 apneas (total) without a decline in O2 sats for either. Oxygen and carbon dioxide levels remained stable/good throughout duration of study. (Baby was not on supplemental oxygen during the study.)Baby has no noisy breathing, no feeding concerns (weight has gone from < 1 percentile at birth to currently 7th percentile) and is hitting all developmental milestones.Baby was IUGR, born at 5.5 lbs at 38 weeks. Released from hospital on day 3. Baby had trouble holding o2 sats at 2 weeks old, and was put on oxygen. Has remained on .5 liter since. A pulmonologist and the ENT doing the procedures both said the baby could come off of oxygen based on the sleep study, however the pulmonologist who initiated oxygen treatment in the hospital wants to continue until after the procedure.Since the study, baby is sometimes off of oxygen during the day and o2 levels hold stable. I also see significantly less startle during sleep. In my opinion, his condition is improving, and if I understand correctly a high number of babies outgrow apnea and laryngomalacia (what theyre looking for, not currently diagnosed).Looking for outside thoughts on this before deciding how to proceed.