Note: last updated before 2017

The current guidelines for management of pediatric obstructive sleep apnea recommend adenotonsillectomy first; this has a >80% success rate (AAOHNS position statement, Tonsillectomy and OSAs, adopted 2010 revised 2014). Sleep endoscopy prior to surgical intervention for sleep apnea to identify the level of obstruction is now gaining traction though it is difficult to link this relatively noninvasive procedure to improved outcomes yet (Manickam et al 2016).

For sleep endoscopies during which the patient will be mask ventilated during flexible fiberoptic exam through the mask, you will need a special type of connector for your mask. It has a port in the elbow that your bronch can fit through. Alternatively it is possible to place the bronch through while using nasal cannula only.

Trach Swivel Connector: item number 906857. It is clear with a tan piece for the bronch to go into.

This is the piece you want.

Here it is connected to a mask for mask ventilation. The other end will fit the vent tubing.

This is the piece you DON'T want if you can help it. It's also called a swivel connector but it won't fit into a mask directly without an interposed straight connector. It's less than ideal but it will work in a pinch if your flexible bronch is long enough.