Diagnosis and treatment of obstructive sleep apnea hypopnea syndrome in children with risk factors
10.3321/j.issn:1673-0860.2008.12.012
- VernacularTitle:伴高危因素儿童阻塞性睡眠呼吸暂停低通气综合征的手术治疗
- Author:
Da-Bo LIU
1
;
Shu-Yao QIU
;
Jian-Wen ZHONG
;
Zhen-Yun HUANG
;
Qian CHEN
;
Zong-Yu TAN
Author Information
1. 广州市儿童医院
- Keywords:
Sleep apnea,obstructive;
Tonsillectomy;
Adenoids;
Intraoperative period;
Child
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2008;43(12):924-928
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyse the clinical features of children with obstructive sleep apneahypopnea syndrome(OSAHS),accompanying with risk factors.Methods The clinic data of 19 patients treated in the Department of Otorhinolaryngology of Guangzhou Children's Hospital between January 2005 to January 2008 were investigated retrospectively.Among them,5 were＜2 years old,6 with craniofacial deformity:small mandible and(or)mandibular retrusion(5 cases),transverse facial cleft(1 case),Down's syndrome(2 cases),cerebral palsy(2 cases),chronic bronchitis(3 cases)and mucopolysaccharidoses(1 case).Nineteen patients with symptoms of snoring, mouth breathing,were diagnosised as OSAHS by polysemnography(PSG)and treated by tonsillectomy and(or)adenoidectomy in hospital.All patients were closely followed-up.Results Fourteen patients underwent PSG 6 months to 1 year after operation,11 patients recovered,the median [percentiles 25;percentiles 75]apnea-hypopnea index(AHI)decreased from the pre-operative 22.5[16.5;24.3]times/h to 2.0[1.5;4.3]times/h,and the lowest oxygen saturation(LSaO2)before operation was 0.63,and was higher than 0.92 after operation,1 case accompanying with chronic bronchitis,the pulmonary hypertension was improved after operation.One case with Down's syndrome wag not significantly impmved,preoperative AHI and LSaO2 was 22.4 times/h and 0.67,and after operation was 14.2 and 0.84;2 cases accepted adenoidectomy only,snoring,mouth breathing reappeared 3 mornths after operation.pre-operative PSG results showed AHI 24.6 times/h and 26.6 times/h,LSaO2 was 0.69 and 0.73,after operation the AHI was 10.6 times/h and 8.5 times/h,LSaO2 was 0.90 and 0.88,the symptoms disappeared after adenotonsillectomy.Five cases did not have PSG because they lived far away in the other cities,their pre-operative PSG showed AHI 16.4 to 26.2 times/h,LSaO2 was 0.65 to 0.76.One year after operation,these patients were followed-up by telephone,4 children were significantly improved,1 case with mandibular symptoms showed no improvement.Conclusions For OSAHS children accompanying with risk factors,if they have adenoid and tonsil hypertrophy,adenotonsillectomy is the major treatment.Because of the existence of risk factors,perioperative risk increased,even the failure of operation.so these patients must be comprehensively assessed before operation.Satisfied results Can be achieved by close observation after operation and management of complications as soon as possible.
