Tracheostomy for paediatric obstructive sleep apnoea: A systematic review

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.