Sleep endoscopy findings in children with persistent obstructive sleep apnea after adenotonsillectomy.
Publication/Presentation Date
4-1-2018
Abstract
OBJECTIVES: Describe the patterns of obstruction in persistent pediatric OSA and their relationship with patient weight.
STUDY DESIGN: Retrospective review.
METHODS: All pediatric DISE procedures performed at a tertiary care hospital between October 2010 and October 2015 were reviewed. Patients had polysomnography after adenotonsillectomy that confirmed persistent obstructive sleep apnea (OSA). Variables included age, gender, co-morbidities, and AHI. DISE findings focused on inferior turbinates, adenoid, tongue base, epiglottis, aryepiglottic (AE) folds, arytenoids, lingual tonsil and their contributions to obstruction.
RESULTS: 34 patients were included with mean age of 7.85 (2-16) years, mean BMI of 23.15 (13.6-44.8) and mean AHI of 6.34 (1.5-25.2) events per hour. Obstruction occurred at the level of the epiglottis in 97%, with retropositioning by tongue base (73.6%) or lingual tonsil enlargement (70.5%). Obstruction occurred at the inferior turbinates in 76.5%, the adenoid in 64.7% and the palate in 58.8%. Shortened AE folds were less often identified (15%). Multiple sites of partial or complete obstruction were found in 97% of patients. Overweight or obese patients had a mean of 3 sites of complete obstruction and 4.69 sites of partial or complete obstruction as compared to 2.33 and 4.52 in underweight or normal weight children. Overweight or obese children were more likely to have obstruction at the lingual tonsil or adenoid than normal/underweight children.
CONCLUSION: Multiple sites of obstruction in persistent pediatric OSA were found. Children with higher BMIs had slightly different findings, suggesting that attention to adenoid regrowth and lingual tonsil hypertrophy is important.
Volume
107
First Page
190
Last Page
193
ISSN
1872-8464
Published In/Presented At
Coutras, S. W., Limjuco, A., Davis, K. E., & Carr, M. M. (2018). Sleep endoscopy findings in children with persistent obstructive sleep apnea after adenotonsillectomy. International journal of pediatric otorhinolaryngology, 107, 190–193. https://doi.org/10.1016/j.ijporl.2018.01.029
Disciplines
Medicine and Health Sciences
PubMedID
29501304
Department(s)
Department of Surgery
Document Type
Article