Related Experiment Videos
Resolution of obstructive sleep apnoea with growth in the Robin sequence
J L Kiely1, P C Deegan, W T McNicholas
1Dept of Respiratory Medicine, St Vincent's Hospital, Dublin, Ireland.
The European Respiratory Journal
|September 4, 1998
Summary
Nasal continuous positive airway pressure effectively treated severe obstructive sleep apnea in a child with Robin sequence. Mandibular growth led to resolution of sleep apnea, allowing discontinuation of therapy.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Craniofacial Anomalies
Background:
- Robin sequence is a congenital condition often associated with airway obstruction.
- Obstructive sleep apnea syndrome (OSAS) is a common complication in children with Robin sequence.
- Previous surgical interventions included cleft palate repair, tonsillectomy, adenoidectomy, and revision palatoplasty.
Observation:
- A 12-year-old female with Robin sequence presented with a year of snoring, witnessed apneas, and daytime sleepiness.
- Polysomnography revealed severe OSAS (AHI 49 events/h) with significant oxygen desaturations.
- Nasal continuous positive airway pressure (nCPAP) effectively managed the sleep abnormalities.
Findings:
- After 3 years of nCPAP, the patient's sleep study showed resolution of OSAS (AHI <5 events/h) without desaturations.
- Cephalometric analysis indicated increased mandibular length and posterior airway space, with reduced soft palate length.
- The patient remained asymptomatic 9 months after nCPAP discontinuation.
Implications:
- Nasal continuous positive airway pressure is an effective non-surgical treatment for OSAS in children with Robin sequence.
- Mandibular growth and airway space enlargement likely contributed to the spontaneous resolution of OSAS in this case.
- This case highlights the potential for natural resolution of OSAS in pediatric Robin sequence patients due to craniofacial development.