[en] Introduction and objective: The adenotonsillar hypertrophy is the fundamental cause of childhood obstructive sleep apnea syndrome (OSAS), a frequent pathology that can cause a series of important complications. In certain circumstances, it can be diagnosed without the need of complex tests and treated effectively, with adenotonsillectomy being the choice; since, with the current resources, assuming all the recommendations of the main guidelines are impractical, the number of children that would require referral for diagnostic polysomnography (PSG) and adenotonsillectomy would exceed our capacity. Limiting the guidelines to available means would significantly ignore the health repercussions of childhood OSA, making it difficult to recognize children at risk, as well as being able to offer adequate treatment. Our objective is to establish the recommendations based on the best available scientific evidence to increase, in an efficient way, the diagnosis of pediatric OSAS and to establish the adequate surgical recomendation as well as the safety in the perioperative procedure. Sections: Review of the bibliography of national and international guidelines on the management of childhood OSAS and assessment of own experience derived from clinical practice and prospective follow-up studies of operated patients. Summary of the evidence on childhood OSAS. Resolution of disagreements between scientific evidence and current clinical practice with proposals to minimize them. Recommendations for the diagnostic procedure and the surgical procedure. Perioperative management scheme and post-surgical follow-up. Conclusions: The application of the suggested changes regarding the management of children with suspected OSAS will allow: 1) greater prominence in the process of Primary and Secondary Care provided by general pediatricians to consider adenotonsillectomy; 2) the widespread use of specific questionnaires for the detection of OSAS, nocturnal oximetry and video recording during sleep as assessment tools; and 3) greater availability of complex sleep studies (PSG) to meet international standards for certain conditions.

[es] Introducci?n y objetivo: La hipertrofia adenoamigdalar es la causa fundamental del SAOS infantil, patolog?a frecuente que puede causar complicaciones importantes. En determinadas circunstancias, puede ser diagnosticado sin necesidad de pruebas complejas y tratado eficazmente, siendo de elecci?n la adenoamigdalectom?a, ya que, con los recursos actuales, asumir todas las recomendaciones de las principales gu?as resulta impracticable, pues el n?mero de ni?os que requerir?an derivaci?n para polisomnograf?a (PSG) diagn?stica y adenoamigdalectom?a superar?an nuestra capacidad. Nuestro objetivo es establecer las recomendaciones basadas en la mejor evidencia cient?fica disponible para incrementar, de manera eficiente, el diagn?stico del SAOS pedi?trico, adecuar la indicaci?n quir?rgica as? como la seguridad en el procedimiento perioperatorio./nSecciones: Revisi?n de bibliograf?a de gu?as nacionales e internacionales de manejo de SAOS infantil y valoraci?n de experiencia propia derivada de pr?ctica cl?nica y estudios prospectivos de seguimiento de pacientes intervenidos. S?ntesis de la evidencia sobre el SAOS infantil. Recomendaciones para el procedimiento diagn?stico y el procedimiento quir?rgico. Resoluci?n de discordancias entre la evidencia cient?fica y la pr?ctica cl?nica actual con propuestas para minimizarlas.