Drug-Induced Sleep Endoscopy in Pediatric Obstructive Sleep Apnea.
Otolaryngol Head Neck Surg
; 164(2): 414-421, 2021 02.
Article
em En
| MEDLINE
| ID: mdl-32777981
ABSTRACT
OBJECTIVE:
To describe drug-induced sleep endoscopy (DISE) findings in children with obstructive sleep apnea and to differentiate them between surgically naïve children and children who had adenotonsillectomy performed. STUDYDESIGN:
Retrospective case series with chart review.SETTING:
Secondary care hospital. SUBJECTS ANDMETHODS:
A cohort of 56 children with the diagnosis of obstructive sleep apnea was submitted to DISE and subsequent upper airway surgery 23 were surgically naïve, and 33 had persistent obstructive sleep apnea after adenotonsillectomy. Comparisons between groups were calculated with chi-square test and Student's t test. Simple linear regression was used to model polysomnographic indices.RESULTS:
In surgically naïve children, the most common sites of obstruction were the adenoids (78.2%) and the lateral pharyngeal walls/tonsils (82.6%). In children with persistent obstructive sleep apnea after adenotonsillectomy, the most common sites of obstruction were the adenoids (54.5%), followed by the supraglottis (48.5%) and the tongue base (45.5%). No correlation was found between obstructive apnea-hypopnea index and DISE findings. Simple linear regression revealed that the degree of obstruction at the tongue base (ß = -0.73; 95% CI, -1.22 to -0.25; P = .004) and the presence of multilevel obstruction (ß = -1.75; 95% CI, -3.20 to -0.30; P = .02) predicted saturation nadir in children with persistent obstructive sleep apnea after adenotonsillectomy.CONCLUSION:
DISE findings differed between surgically naïve children and children with persistent obstructive sleep apnea after adenotonsillectomy. Increased obstruction at the level of the tongue base and the presence of multilevel obstruction predicted a lower saturation nadir in children with persistent obstructive sleep apnea after adenotonsillectomy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sono
/
Tonsilectomia
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Adenoidectomia
/
Propofol
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Apneia Obstrutiva do Sono
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Obstrução das Vias Respiratórias
/
Endoscopia
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Otolaryngol Head Neck Surg
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Portugal