[Adolescent obstructive sleep apnoea syndrome: Characteristics and treatment]. / Syndrome d'apnées obstructives du sommeil de l'adolescent : particularités et prise en charge.

Although the prevalence of the obstructive sleep apnoea syndrome (OSAS) is high in adolescents, studies pertaining to adolescent OSAS are less numerous than childhood studies. Cases of adolescent OSAS may consist of residual OSAS after adenotonsillectomy, but most often are de novo cases. Major pathophysiological factors are weight excess or even high-grade obesity, and the association of upper airway narrowing and tonsillar hypertrophy (pharyngeal, palatal or even lingual). ENT and systematic orthodontic assessments are the main points. In case of predisposing factors such as dental, occlusal or dento-facial abnormalities, a specific orthodontic treatment can be discussed. First line treatment is surgical adenotonsillectomy; surgical reduction of the lingual tonsils is seldom required. CPAP treatment may be indicated in the case of severe comorbidities (craniofacial malformations, neuromuscular diseases…) or in obese adolescents with severe residual OSAS. Treatment of adolescent OSAS has to be comprehensive and multidisciplinary, taking into account the specific treatments of obesity and abnormal sleep/wake rhythms.

[Vertical control and orthopedic therapy]. / Contrôle vertical et thérapeutique orthopédique.

Control of the vertical development of the face is a key element in assuring the success of orthopedic treatment, as much for its effects on anterior vertical dimension as for its influence on correction of the sagittal discrepancy between the jaws. An effective management of this control demands respect for the equilibrium between posterior and anterior face, as described by Schudy. The authors review the details of the application of orthopedic therapy on the different elements of this equilibrium and then, present the modalities of vertical control appropriate to each appliance.