Obstructive sleep apnoea syndrome in morbidly obese children with tibia vara

Area of Science:

• Pediatric Orthopedics
• Sleep Medicine
• Pediatric Surgery

Background:

• Morbid obesity and obstructive sleep apnea syndrome (OSAS) are increasingly recognized in children.
• Orthopedic surgeons manage tibia vara in children, a condition linked to obesity, but may lack sleep apnea expertise.
• OSAS can lead to perioperative complications, especially in obese patients undergoing surgery.

Purpose of the Study:

• To determine the incidence of OSAS in surgically treated pediatric tibia vara patients.
• To assess the association between morbid obesity, snoring, and OSAS in this cohort.
• To highlight the need for pre-operative screening and management of OSAS in affected children.

Main Methods:

• Retrospective review of pediatric patients with tibia vara undergoing surgical treatment over five years.
• Analysis of patient demographics, obesity status, snoring history, and polysomnography results.
• Evaluation of pre-operative airway management, including non-invasive positive-pressure ventilation and surgical interventions.

Main Results:

• Of 37 patients, 18 were aged nine years or older.
• Among these 18 patients, 13 (72%) had morbid obesity and a history of snoring.
• Eleven children (61% of the older group) were diagnosed with OSAS via polysomnography.
• All patients with OSAS required pre-operative non-invasive positive-pressure ventilation; five underwent tonsillectomy and adenoidectomy.

Conclusions:

• There is a high incidence of OSAS in morbidly obese pediatric patients with tibia vara.
• Pre-operative screening for snoring and subsequent evaluation for OSAS are recommended for these patients.
• Timely diagnosis and management of OSAS can mitigate perioperative airway risks in this population.