Nasal and sinus surgery in children with sleep disordered breathing (SDB) is a relatively new concept. As with anything new, most of us are initially skeptical. However, the pathophysiology of SDB in children is well known and well described in the pediatric and dental literature. However, the otolaryngology literature is void of such information. Our studies and research have mainly focused on tonsillectomy and adenoidectomy as the main targets to correct SDB in children. Review of the literature demonstrates that adenotonsillectomy can reduce the apnea-hypopnea index (AHI) in children with OSA and provide short-term improvement in SDB symptoms. However, a complete cure is not achieved in most cases [1] with a relapse rate of 50% over a subsequent two-year period. In addition, it has also been shown that in approximately 20% of children with OSA and SDB, the main cause of obstruction was not adenotonsillar hypertrophy [2, 3].