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[Obstructive sleep apnea-hypopnea syndromes in children. Therapeutic results]
P Attal1, C Lepajolec, E Harboun-Cohen
1Service ORL, Hôpital de Bicêtre, Kremlin-Bicêtre.
Insights
Pediatric obstructive sleep apnea-hypopnea is often caused by tonsillar hypertrophy. Surgical interventions like tonsillectomy effectively treat these respiratory disorders in children.
Area of Science:
- Pediatrics
- Otolaryngology
- Sleep Medicine
Context:
- Obstructive sleep apnea-hypopnea (OSAH) significantly impacts children's health.
- Clinical suspicion requires thorough investigation including sleep studies.
- Parental questionnaires aid in identifying key nocturnal and diurnal symptoms.
Purpose:
- To investigate the causes and surgical management of obstructive sleep apnea-hypopnea in children.
- To evaluate the efficacy of surgical interventions for pediatric OSAH.
Summary:
- This study analyzed 43 children with suspected OSAH, utilizing clinical exams, parental questionnaires, and polysomnography.
- Tonsillar hypertrophy was the primary cause (33 cases), with other identified etiologies including Pierre Robin syndrome and Prader-Willi syndrome.
- Surgical treatment was performed in 31 children, including tonsillectomies, uvulo-palato-pharyngoplasties, epiglottoplasties, and staphylorrhaphies.
Impact:
- Identifies tonsillar hypertrophy as a leading cause of pediatric OSAH.
- Demonstrates the effectiveness of surgical interventions in managing pediatric OSAH.
- Provides insights into long-term clinical and polysomnographic outcomes following surgery.
Abstract:
43 children with a clinical suspicion of obstructive sleep apnea-hypopnea were studied. All children underwent clinical examination and a standardised questionnaire was completed by their parents in order to investigate the principal nocturnal and diurnal symptoms present. A sleep study was performed. In addition to methods designed to identify the stage of sleep (EEG, EOG, EMG), this included recording of nasal and buccal airflow, thoracic and abdominal respiratory movements and blood gas analysis. 38 children has recordings during their afternoon nap, and 4 children during the night. Tonsillar hypertrophy was the principal etiology responsible for nocturnal respiratory disorders (33 cases). In addition, other etiologies were demonstrated: Pierre Robin syndrome, cranio-facial stenosis, laryngomalacia, Prader-Willi syndrome and Arnold Chiari malformation. Surgery was performed in 31 children: 22 tonsillectomies with or without adenoidectomy, 4 uvulo-palato-pharyngoplasties with tonsillectomy, 3 epiglottoplasties and 2 staphylorrhaphies. Long-term results were studied clinically and in 11 cases by polysomnographic recording.