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Published on: December 6, 2016
Polysomnography Outcomes after Supraglottoplasty in Children with Obstructive Sleep Apnea
Bharat Bhushan1,2, James W Schroeder1,2, Kathleen R Billings1,2
1Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Supraglottoplasty significantly improved polysomnography (PSG) outcomes for children with laryngomalacia-related obstructive sleep apnea (OSA). However, residual OSA suggests multifactorial causes in these patients.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Respiratory Physiology
Background:
- Laryngomalacia is a known contributor to obstructive sleep apnea (OSA) severity in children.
- The efficacy of surgical intervention for laryngomalacia in improving OSA, as measured by polysomnography (PSG), remains unclear.
Purpose of the Study:
- To evaluate the impact of supraglottoplasty on PSG parameters in pediatric patients with laryngomalacia-associated OSA.
- To determine if surgical correction of laryngomalacia improves objective sleep study outcomes.
Main Methods:
- Retrospective case series design.
- Historical cohort study of 41 children with laryngomalacia undergoing supraglottoplasty.
- Comparison of pre- and post-operative overnight PSG data.
Main Results:
- Significant reduction in obstructive apnea-hypopnea index (26.6 to 7.3 events/h, P = .003) and respiratory disturbance index (27.3 to 7.8 events/h, P = .003).
- Decrease in percentage of REM sleep (30.1% to 24.8%, P = .04) and improved sleep efficiency (P = .05).
Conclusions:
- Supraglottoplasty offers significant PSG improvements for children with laryngomalacia-related OSA.
- Persistent mild to moderate OSA post-surgery indicates multifactorial etiologies in this pediatric population.
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