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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
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Published on: December 6, 2016

Surgical management of obstructive sleep apnea in infants and young toddlers

Joseph S Brigance1, R Christopher Miyamoto, Peter Schilt

  • 1Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|May 27, 2009
PubMed

Insights

Surgical intervention significantly improved obstructive sleep apnea (OSA) in young children compared to medical management. While complications occurred, the overall outcomes for pediatric OSA patients were favorable.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Pediatric Surgery

Background:

  • Obstructive sleep apnea (OSA) is a significant health concern in infants and young toddlers.
  • Management strategies for pediatric OSA require careful consideration of efficacy and safety.

Purpose of the Study:

  • To compare the effectiveness of surgical management versus medical management for obstructive sleep apnea (OSA) in children younger than 24 months.
  • To evaluate the complication rates associated with surgical interventions for pediatric OSA.

Main Methods:

  • A retrospective case series involving chart review of 73 children under 24 months with OSA.
  • Surgical treatments included adenotonsillectomy, adenoidectomy, and tonsillectomy.
  • Apnea-hypopnea index (AHI) changes were analyzed pre- and post-treatment; logistic regression assessed complication factors.

Main Results:

  • Surgical treatment led to a significant improvement in AHI (mean change of 9.6), while medical treatment showed no significant improvement (mean change of -3.0).
  • The difference in AHI change between surgical and medical groups was statistically significant (P = 0.01).
  • 18% of surgically treated patients experienced significant postoperative complications; comorbidities were common in both groups, but no long-term morbidities or mortalities were reported.

Conclusions:

  • Surgical intervention is an effective treatment for improving AHI in infants and young toddlers with obstructive sleep apnea.
  • The complication rate in this tertiary pediatric hospital setting, including patients with comorbidities, was deemed acceptable.
Abstract

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