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Medical management of severe obstructive sleep apnoea in two cases during the coronavirus disease 2019 pandemic

H S Gajaweera1, C Griffiths1, L H Everitt1

  • 1Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK.

The Journal of Laryngology and Otology
|March 21, 2022
PubMed

Insights

Continuous positive airway pressure (CPAP) therapy was poorly tolerated in children with severe obstructive sleep apnoea due to adenotonsillar hypertrophy. Surgery remains the most effective treatment for this condition.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Respiratory Medicine

Background:

  • Severe pediatric obstructive sleep apnea (OSA) in children with adenotonsillar hypertrophy is typically treated with surgery.
  • During the COVID-19 pandemic, non-emergency ENT surgeries were paused, leading to the use of medical management for pediatric OSA.

Purpose of the Study:

  • To evaluate the effectiveness of continuous positive airway pressure (CPAP) combined with medical management for severe pediatric OSA when surgery was unavailable.

Main Methods:

  • A service evaluation was conducted over five months in 2020.
  • Two children with severe OSA secondary to adenotonsillar hypertrophy were offered CPAP and medical treatments.

Main Results:

  • Both children failed to tolerate CPAP therapy due to disturbed sleep.
  • Both children subsequently underwent adenotonsillectomy, leading to improved Sleep-Related Breathing Disorder scale scores.

Conclusions:

  • CPAP therapy is poorly tolerated in children with severe OSA caused by adenotonsillar hypertrophy.
  • Surgical intervention, such as adenotonsillectomy, remains the most appropriate and effective treatment for this condition.
Abstract

Keywords:
AdenoidectomyApnea, SleepCOVID-19ChildMedical Practice ManagementTonsillectomyVentilators, Mechanical

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