Drug-induced sleep endoscopy (DISE) is used for directly visualizing sites of obstruction among patients with obstructive sleep apnea (OSA). Owing to the scarcity of data, there is still no consensus on the anesthetic regimen for conducting pediatric DISE.

This paper presents a 5-year-old patient who underwent DISE using an opioid-sparing regimen with dexmedetomidine and propofol infusion.

Simultaneous dexmedetomidine and propofol infusion is a promising opioid-sparing regimen for pediatric DISE.

Objective:To determine the sensitivity, specificity and positive predictive value of the STOP BANG questionnaire in diagnosing Obstructive Sleep Apnea (OSA) in adults admitted for polysomnography at the Rizal Medical Center from January 2019 to June 2024

Methods:
Design:Review of Records
Setting:Tertiary Government Training Hospital
Participants:166 adult patients

Results:A total of 166 patient records were included with an average age of 35.6 ± 12 years, BMI of 29.3 ± 6.44 and 67% were male. The STOP-BANG questionnaire had a sensitivity of 77% to screen for all (AHI ≥ 5), mild (AHI = 5-14.9), moderate (AHI = 15-19.9), and severe OSA (AHI > 30), respectively. The specificity was 62% and the area under the curve was 0.717 for all, mild, moderate and severe OSA

Conclusion:A STOP-BANG score of 3/8 can predict the presence of OSA with a sensitivity of 77% and specificity of 62% with AUC of 0.717. The increase in score does not predict the severity. Further research can be done to identify other co-morbidities associated with OSA.

Humans ; Sleep Apnea, Central/therapy* ; Hypoventilation/congenital* ; Homeodomain Proteins

Objective: Our study aimed to identify and describe pulmonary complications and its associated risk factors in children with suspected or confirmed obstructive sleep apnea (OSA) who underwent tonsillectomy or adenotonsillectomy in a tertiary government hospital. Methods: We conducted a retrospective cohort study. Medical charts of pediatric patients with suspected or confirmed OSA who were admitted for tonsillectomy or adenotonsillectomy from January 1, 2016 to December 31, 2020 were retrieved and reviewed. Information of the individual patients including the demographic data, clinical profile, polysomnography results, and presence of postoperative pulmonary complications were recorded. Descriptive statistics was utilized to present continuous data while frequency and percentage for categorical data. Fisher exact test was used to compare the demographic profile of patients with postoperative pulmonary complications from those without. Results: A total of 90 patient records were analyzed. The mean age of the patient population was 7.87 years, 55.6% were male, 17.8% of patients were classified as obese. Thirty-four children had preoperative polysomnography and of these, 47.1% were classified as severe. Only two (2.2%) patients had postoperative pulmonary complications, which were bronchospasm and desaturation, respectively. There were no statistically significant differences noted in comparing the clinicodemographic profile of patients with postoperative pulmonary complications from those without complications. Conclusion Our results showed that most pediatric patients with suspected or confirmed OSA who underwent adenotonsillectomy did not have pulmonary complications.
Sleep Apnea, Obstructive ; Tonsillectomy

OBJECTIVE

Our study aimed to identify and describe pulmonary complications and its associated risk factors in children with suspected or confirmed obstructive sleep apnea (OSA) who underwent tonsillectomy or adenotonsillectomy in a tertiary government hospital.

We conducted a retrospective cohort study. Medical charts of pediatric patients with suspected or confirmed OSA who were admitted for tonsillectomy or adenotonsillectomy from January 1, 2016 to December 31, 2020 were retrieved and reviewed. Information of the individual patients including the demographic data, clinical profile, polysomnography results, and presence of postoperative pulmonary complications were recorded. Descriptive statistics was utilized to present continuous data while frequency and percentage for categorical data. Fisher exact test was used to compare the demographic profile of patients with postoperative pulmonary complications from those without.

A total of 90 patient records were analyzed. The mean age of the patient population was 7.87 years, 55.6% were male, 17.8% of patients were classified as obese. Thirty-four children had preoperative polysomnography and of these, 47.1% were classified as severe. Only two (2.2%) patients had postoperative pulmonary complications, which were bronchospasm and desaturation, respectively. There were no statistically significant differences noted in comparing the clinicodemographic profile of patients with postoperative pulmonary complications from those without complications.

Our results showed that most pediatric patients with suspected or confirmed OSA who underwent adenotonsillectomy did not have pulmonary complications.

Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common sleep respiratory disorder characterized by upper respiratory collapse during sleep, with a high prevalence and potentially fatal complications. Currently, maxillary transverse deficiency are considered to be an important pathogenic factor of OSAHS. For patients with poor compliance with positive airway pressure therapy, rapid maxillary expansion can increase the volume and ventilation of the upper respiratory tract, which is an alternative treatment. This paper reviewed the current research on surgically assisted rapid palatal expansion, miniscrew assisted rapid palatal expansion, and distraction osteogenesis maxillary expansion in the treatment of adult OSAHS. By comparing the indications, contraindications, complications, efficacy and long-term stability of the three treatment methods, it provided reference for treatment of patients with OSAHS.
Adult ; Humans ; Nose ; Palatal Expansion Technique ; Palate ; Sleep Apnea, Obstructive/surgery* ; Syndrome

Humans ; Metabolic Syndrome/therapy* ; Consensus ; Sleep Apnea, Obstructive/therapy* ; Risk Factors

Humans ; Uric Acid ; Sleep Apnea, Obstructive ; Risk Factors

Objective:This study aims to investigate the clinical effectiveness of muscle function training combined with occlusal inducers in the treatment for children's malocclusion after obstructive sleep apnea（OSA） surgery. Methods:A total of 40 pediatric patients who underwent surgery for OSA at Shanghai Children's Medical Center, affiliated with Shanghai Jiao Tong University School of Medicine, from January 2020 to December 2021 were involved in this study. They were divided into a treatment group（n=20） and a control group（n=20）. The treatment group received muscle function training combined with occlusal inducers, while the control group received muscle function training alone. Cephalometric measurements of hard tissues were compared between the two groups before and 12 months after surgery. Additionally, the OSA-18 questionnaire, which includes 18 items to assess the life quality of children with OSA, was filled out before surgery, 6 months after surgery, and 12 months after surgery by these patients. Results:①The scores of sleep disorders, physical symptoms, emotional status, daytime sleepiness and energy status and the degree of influence on guardians in the two groups were significantly improved at 12 months after operation（P<0.05）. The scores of sleep disorders, physical symptoms, emotional status and the degree of influence on guardians in the treatment group were better than those in the control group（P<0.05）. ②Cephalometric data at 12 months after operation showed that the upper and lower alveolar seat angle（ANB）, Overbite, upper and lower central incisor angle（U1-L1） and Overjet in the treatment group were lower than those in the control group at 12 months after operation, and the difference was statistically significant（P<0.05）. Conclusion:Children with OSA can improve the dentition irregularity by muscle function training combined with occlusal inducer after operation, and the effect is better than that of muscle function training alone.
Humans ; Child ; China ; Malocclusion ; Sleep Apnea, Obstructive/diagnosis* ; Treatment Outcome ; Muscles

Two children with late-onset congenital central hypoventilation syndrome were reported, one of whom was male and had no abnormal manifestations after birth, respiratory failure occurs at the age of 1 year and 6 months. After being hospitalized, he was treated with oxygen inhalation and non-invasive ventilation, but carbon dioxide retention could not be corrected. After one month of tracheal intubation, he was failure to wean from ventilator, so tracheostomy was performed. He needs a ventilator to help breath while sleeping, and can breath autonomously during the day without ventilator. The other case was a female, with no abnormalities after birth. At the age of 11 months, she developed respiratory failure. During sleep, the child needs non-invasive assisted ventilation through a nasal mask, and during the day, she breathed autonomously.Two patients were followed up forever 2 years and their growth and development were normal.
Humans ; Child ; Male ; Female ; Infant ; Sleep Apnea, Central/therapy* ; Respiration, Artificial ; Hypoventilation/congenital* ; Oxygen