Surgical management of obstructive sleep apnea in infants and young toddlers.
Otolaryngol Head Neck Surg
; 140(6): 912-6, 2009 Jun.
Article
em En
| MEDLINE
| ID: mdl-19467414
ABSTRACT
OBJECTIVE:
Review surgical management of obstructive sleep apnea (OSA) in infants and young toddlers compared with a medically treated group. STUDYDESIGN:
Case series with chart review of children younger than 24 months treated at a tertiary pediatric hospital between 2000 and 2005. SUBJECTS ANDMETHODS:
Surgical treatment included adenotonsillectomy, adenoidectomy, and tonsillectomy. Polysomnography results, comorbidities, and major complications were recorded. The change in apnea-hypopnea index (AHI) before and after treatment was analyzed. Logistic regression analysis reviewed effects of comorbidities and OSA severity on complications.RESULTS:
A total of 73 children met inclusion criteria. The surgical treatment group (AHI) improved posttreatment mean AHI change was 9.6 (95% CI, 5.8-13.4). The medical treatment group did not improve posttreatment mean AHI change was -3.0 (95% CI, -15.1 to 9.1). The difference in AHI change between surgical and medical groups was 12.56 (95% CI, 2.7-22.4). An independent t test found this difference to be statistically significant (P = 0.01). Eleven (18%) patients suffered significant postoperative surgical complications; 55 surgical patients and 8 medical patients had comorbidities. There were no long-term morbidities or mortalities.CONCLUSIONS:
AHI in the surgically treated group significantly improved. The complication rate for a tertiary pediatric hospital population that included patients with multiple comorbidities was acceptable.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Apneia Obstrutiva do Sono
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Otolaryngol Head Neck Surg
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Estados Unidos