药物诱导睡眠内镜用于儿童患者的目标睡眠手术
Theresa A Schneider1, Anya Costeloe2, Ani Mnatsakanian1
1Otolaryngology, Ascension Health, Warren, USA.
Cureus
|June 16, 2025
概括
药物诱导睡眠内镜 (DISE) 有助于确定儿童的呼吸道阻塞. 由DISE指导的手术改善了阻塞性睡眠呼吸暂停 (OSA) 症状,腺切除术显示了最显著的改善.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 睡眠医学 睡眠医学
- 手术创新 在外科创新.
背景情况:
- 儿童的阻塞性睡眠呼吸暂停 (OSA) 通常涉及多层次的呼吸道阻塞.
- 标准的外科手术方法可能无法有效地解决所有阻塞部位.
- 药物诱导睡眠内镜 (DISE) 提供了一种在睡眠期间可视化动态气道崩的方法.
研究的目的:
- 评估DISE向手术在识别阻塞位置方面的有效性.
- 确定DISE发现如何影响手术决策,包括腺切除术的执行.
- 评估DISE指导手术对儿科OSA症状的影响.
主要方法:
- 一个学术儿童医院42名儿科患者的前性队列研究.
- 患者接受了多睡眠学和DISE,以评估桃体/腺体大小,舌头底部,侧壁 (LPW) 崩和喉.
- 手术干预是基于DISE识别的突出阻塞部位;用于评估OSA症状可能性的密歇根大学儿科睡眠问卷 (UMPSQ) 术前和术后得分.
主要成果:
- 外科手术包括桃切除术,腺切除术,舌腔桃切除术等.
- 整体UMPSQ分数在手术后显著改善 (13.36至5.68,P=0.05).
- 腺切除术导致了更大的UMPSQ得分下降 (P=0.03) ,并且在具有显著LPW崩的患者中更有可能发生 (P=0.001),而较高的Yellon舌头基数得分降低了可能性 (P=0.005).
结论:
- DISE对于评估儿童多级呼吸道阻塞有价值.
- DISE的发现改变了手术规划,特别是对于没有桃体扩大的儿童.
- 腺切除术提供了最多的症状缓解,但主要用于显著的LPW崩.
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