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Table 13 Guidance statements for tonsillectomy and/or adenoidectomy, tracheostomy and insertion of ventilation tubes

From: Recommendations for the management of MPS VI: systematic evidence- and consensus-based guidance

Statement Percentage consensus
Tonsillectomy and/or adenoidectomy is recommended in patients with MPS VI who display upper airway obstruction, recurrent otitis media, snoring and/or OSA, as early as possible following diagnosis without waiting for disease progression
Evidence Grade: C (level 2/3/4 studies)
Tracheostomy is recommended in patients with MPS VI who exhibit severe upper airway obstruction that cannot be treated by an alternative approach, and in patients with severe sleep apnoea that is not treatable by CPAP or tonsillectomy and/or adenoidectomy
Evidence Grade: D (limited published evidence)
Insertion of ventilation tubes is recommended for patients with MPS VI with otitis media with effusion and/or recurrent otitis media to maintain hearing and/or prevent recurrent acute otitis media
Evidence Grade: D (limited published evidence)