Dr. Badi is a Member of American Academy of Otolaryngology Head Neck Surgery and is additionally qualified as a Fellow of the American Academy of Pediatrics (subspecialty otolaryngology head neck surgery and sleep medicine).
He's also board-certified in Sleep Medicine. He treats the whole spectrum of Pediatric Sleep disorders including Pediatric sleep apnea and Pediatric insomnia in addition to:
A diagnosis of chronic rhino-sinusitis is arrived at as per the Lund–Kennedy criteria (1995) i.e., patients having 8 weeks or more of persistent symptoms and signs of sinusitis, not resolving with 3 weeks of medications or 4 episodes per year or more of recurrent acute sinusitis, each lasting at least 10 days, in association with persistent changes noted on CT sinus scan.
Tonsils and adenoids serve to fight infection in the upper airway. However, if they are recurrent or chronically infected; cause snoring and sleep apnea due to upper airway obstruction; tonsillectomy adenoidectomy is recommend. Most cases do not require an overnight stay after surgery. Recovery is usually well tolerated with medications, adequate hydration and plenty of ice cream and popsicles.
Ear infections are frequent in children. Initial treatment is usually medical. Tubes are generally indicated for recurrent and chronic ear infections. Three to four recurrent ear infections in a six-month period usually qualify for ear tubes. Persistent fluid in the ear for about 8 weeks along with a hearing loss also qualify for ear tubes.
Tubes are installed in a relatively simple surgery under mask anesthesia. Tubes usually stay in place 6 to 12 months and almost always fall out by themselves. Vast majority of the kids usually require only one set of tubes.
Research driven data indicates that adenoidectomy is indicated in the rare instance of second set of tubes.
Sinusitis is defined by the presence of at least two of the following symptoms: nasal obstruction, nasal discharge, facial pain, or changes in smell. Due to overlap with other common conditions, objective confirmation of sinonasal mucosal inflammation is required using nasal endoscopy or CT scan.
Sinusitis in children is a complex clinical syndrome that results from multiple potential causes. Medical therapy is the accepted primary treatment and surgery is considered only after failure of medical therapy. Adenoidectomy is the first-line surgical therapy, and the addition of balloon dilation to adenoidectomy improves outcomes.
Balloon sinus procedure is a safe and effective technique for pediatric sinusitis resistant to medical therapy. Balloon dilation is considered prior to proceeding to traditional sinus surgery in children with sinusitis.
Functional endoscopic sinus surgery (FESS) in children is safe and effective but is considered as last option in more complicated sinus disease.
Chronic rhinosinusitis (CRS) and asthma frequently coexist in children and adults. Asthma in these patients is caused or worsened by sinusitis.
It has been reported that 27% of a series of pediatric patients admitted with severe asthma had radiologic evidence of sinusitis.
Direct measurements of airway inflammation in children suggests that treating sinus disease is paramount in the management of chronic asthma in children.
Several authors present very good evidence that recommend treating sinus disease in children with asthma in order to achieve better or full control of asthma symptoms.
It has been shown that surgical management improves asthma symptoms and reduces emergency visits in children with both diseases.
An adenoidectomy apart from balloon sinus dilation is recommended in children with sinusitis as adenoids act as a bacterial reservoir in these children and removing the adenoids improved outcomes.
Balloon sinus procedure is a safe and effective technique for pediatric sinusitis resistant to medical therapy.
Obstructive sleep apnea (OSA) may be central neurologic (<5%) or obstructive (>95%) in origin and is a relatively prevalent condition in children. It affects 1%-5% of children aged 2-8 years and is caused by a variety of different pathophysiologic abnormalities. Cardiovascular, metabolic, and neurocognitive comorbidities can occur children when left untreated. It also can cause severe behavioral problems in children.
OSA should be suspected when there are symptoms of snoring, gasping, increased work of breathing or paradoxical breathing, restless sleep, witnessed apnoeas or mouth breathing are reported.
Some children with OSA will also sleep with their neck in a hyperextended position to maintain their airway.
Daytime symptoms of OSA include hyperactivity, difficulty concentrating/learning difficulties, behavioural difficulties, excessive daytime sleepiness, and moodiness.
The American Academy of Pediatrics recommends that all children be screened with an appropriate history and physical examination for symptoms and signs suggestive of OSAS. The diagnosis is primarily made clinically and confirmed by polysomnographic findings.
Treatment depends on the child's age, underlying medical problems, polysomnography findings, and whether or not there is upper airway obstruction usually secondary to enlarged adenoids and/or tonsils, allergic and nonallergic rhinitis, acute and chronic sinusitis, and other upper airway pathology.
If enlarged adenoid or tonsils or both conditions exist, an adenoidectomy, tonsillectomy, or adenotonsillectomy remains the treatment of choice.
In otherwise healthy children, without a syndrome, with mild to moderate OSA by PSG, there is good evidence that adenotonsillectomy provides benefit.