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[Obstructive sleep apnea syndrome in childhood: study of three cases]
J López-Herce Cid1, M A García Teresa, A Ruiz Beltrán
1Servicio de Cuidados Intensivos Pediátricos, Hospital del Niño Jesús, Universidad Autónoma de Madrid.
Insights
Obstructive sleep apnea syndrome in children can stem from pharyngeal obstruction or laryngomalacia. Adenotonsillectomy resolved symptoms in two cases, while one required a tracheostomy.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Otolaryngology
Background:
- Obstructive sleep apnea syndrome (OSAS) is a significant condition in children.
- Causes of pediatric OSAS can include upper airway obstruction.
- Understanding the specific etiologies is crucial for effective management.
Observation:
- Three children with OSAS were studied.
- Two cases involved pharyngeal obstruction; one involved laryngomalacia.
- Patients exhibited respiratory distress, stridor, hypoxemia, and sleep disturbances.
Findings:
- Symptoms included excessive daytime sleepiness, behavioral issues, and developmental delays.
- One child presented with borderline intellectual functioning and cardiac arrhythmias.
- Adenotonsillectomy resolved OSAS and associated symptoms in two patients.
- The child with laryngomalacia required a tracheostomy for airway management.
Implications:
- Surgical intervention, such as adenotonsillectomy, can be highly effective for certain pediatric OSAS cases.
- Laryngomalacia presents a more complex airway challenge requiring alternative management.
- Early diagnosis and treatment of pediatric OSAS are vital for preventing long-term health consequences.
Abstract:
We report three children with obstructive sleep apnea syndrome, two secondary to pharyngeal obstruction and the third secondary to laryngomalacia. All patients presented important respiratory efforts with inspiratory stridor during sleep, frequent obstructive apneas with important hipoxemia, sweating, and arousal episodes. Two patients suffered excessive daytime sleepiness, behavioral disturbances and development delay, and the third, intelligence in the borderline retardation range, and important heart arritmias (bradycardia with ventricular extrasystoles) during obstructive apneas. In two children the Obstructive Sleep Apnea Syndrome and the secondary symptoms disappeared after adenotonsillectomy. The patient with laryngomalacia required tracheostomy.