NEMOURS/Alfred I. duPont
Hospital for Children introduced
a unique programme for children
with sleep disordered breathing.
The Complex Sleep Disordered
Breathing Clinic is a collaboration of their Otolaryngology and
For some children, even after
their tonsils and adenoids are
removed, sleep apnea can persist.
This clinic allows care to occur in
a more team-oriented fashion, since Otolaryngology and
Pulmonary are seeing the family
the same day in the same clinic.
Many of these children will be
candidates for a procedure called
drug-induced sleep endoscopy,
during which the level or levels
of obstruction of the upper airway can be defined. With this
information in mind, a treatment
plan can be made, whether medical, surgical or a combination of
Zion, of Harrington, Delaware,
is a loving 9-year-old with Down
syndrome. She adores bowling,
her Wii U and her six stuffed
animals, who absolutely must
sleep with her every night.
Since birth, Zion has dealt with
congestion—stuffy nose, ear
infections, sinus infections and
even snoring—all not surprising,
since ear, nose and throat (ENT)
problems are common in people
with Down syndrome. Although
medications helped, it was clear
they weren’t enough. Between 1
and 2 years old, Zion had surger-ies to insert ear tubes as well as
remove her tonsils and adenoids.
Those procedures definitely
helped. Zion’s ear infections
cleared up, and her sinus infections became seasonal rather than
But as Zion got older, her mom
noticed she was always waking up saying she was tired. A
diagnostic procedure called a
drug-induced sleep endoscopy
revealed that Zion wasn’t getting
enough air as she slept, which
was causing severe sleep apnea
(ceasing to breathe during sleep).
Despite the fact that Zion had
already undergone a tonsillectomy and adenoidectomy, there was
now another option: transoral
robotic surgery (TORS). This
operation uses the latest robotic
surgical technologies to remove
the lingual tonsils.
TORS is being performed on
children at only a few hospitals in
the United States, and Nemours/
Alfred I. duPont Hospital for
Children is the only one in the
region. As part of her sleep apnea
care, Zion was seen at Nemours
by pulmonologist Aaron Chidekel,
MD, nurse practitioner Kim
Young-Conner and ENT sur-
geon Richard Schmidt, MD.
“As a mother, I just didn’t want
Zion to have to have any type of
surgery—and this one sounded
serious,” says her mom Pamela.
“However, Dr. Schmidt was
respectful to any questions I had
and responded…to all of my
concerns. Even after the surgery,
he was there to reassure us that
the surgery was successful.”
Zion had the TORS operation in
November 2015. Pamela says the
results have been amazing. “She
is better rested now and does not
wake up saying she is still tired
like before,” Pamela says.
Zion’s pediatrician noted at a
recent well visit that she could
definitely hear and notice the
improvement in Zion’s breathing.
Zion has become more active and
lost weight, as well.
“We have received so much support
here at Nemours. Dr. Chidekel
was with us every step of the way
during her sleep studies,” Pamela
says. “Kim Young-Conner is an
absolute angel… To me, she will
always be a part of our family.
She listens and truly cares about
her patients and parents’ concerns
so [we are all] working together
for the best results.”
To learn more about the full-service offerings of the Division of
Otolaryngology at Nemours/Alfred
I. duPont Hospital for Children,
visit us at Nemours.org/ent.
Life-changing surgery helps a 9-year-old girl
with Down syndrome to breathe easy