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Tracheostomy for paediatric obstructive sleep apnoea: A systematic review

S Fray1, A Biello1, J Kwan1

  • 1School of Medicine,Uniformed Services University of the Health Sciences,Bethesda,Maryland,USA.

The Journal of Laryngology and Otology
|August 4, 2018
PubMed

Insights

Tracheostomy is a successful treatment for obstructive sleep apnea in children, significantly improving breathing metrics. Further research is needed due to limited patient data in existing studies.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Respiratory Medicine

Background:

  • Obstructive sleep apnea (OSA) significantly impacts children's health.
  • Tracheostomy is a potential intervention for severe pediatric OSA.
  • Limited data exists on tracheostomy outcomes in children with OSA.

Purpose of the Study:

  • To systematically review the international literature on tracheostomy outcomes for pediatric obstructive sleep apnea.
  • To synthesize available data on the efficacy and safety of tracheostomy in children with OSA.

Main Methods:

  • Comprehensive literature search across multiple databases (PubMed/Medline, Embase, Scopus, CINAHL, Google Scholar) up to January 20, 2018.
  • Inclusion criteria focused on publications reporting outcomes of tracheostomy for pediatric OSA.
  • Systematic screening and data extraction by four independent authors.

Main Results:

  • 11 studies met inclusion criteria, involving 196 pediatric patients with OSA undergoing tracheostomy.
  • Significant improvements observed: 97% reduction in apnea/hypopnea index and 98% reduction in apnea index.
  • Lowest oxygen saturation improved by 34 points; several patients showed marked breathing improvements.
  • All included patients had syndromic features, comorbidities, or severe OSA.

Conclusions:

  • Tracheostomy demonstrates success as a treatment for obstructive sleep apnea in children based on available pre- and post-operative data.
  • The findings suggest tracheostomy is effective for severe pediatric OSA cases.
  • Further research is recommended to expand the evidence base due to the small number of reported cases.
Abstract

Keywords:
Obstructive Sleep ApnoeaTracheostomy

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