In a preliminary retrospective review of our patient population and surgical volume, we examined the electronic medical record of all patients who underwent AT over a 12 month period. 498 patients were identified, operated on by the four pediatric otolaryngologists in the group. Approximately 200 (40%) of these were performed for OSAS in patients that could be considered high risk for residual post-AT OSAS and would meet inclusion/exclusion criteria described below.