Sleep endoscopy as a diagnostic tool in pediatric obstructive sleep apnea

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• 作者：Mai Thy Truong^a ; ^b ; ^{mtruong@ohns.stanford.edu} ; Victoria G. Woo^a ; ^{woo.victoria@gmail.com} ; Peter J. Koltai^a ; ^{pkoltai@ohns.stanford.edu}
• 关键词：Sleep endoscopy ; Obstructive sleep apnea ; Pediatrics ; Adenotonsillectomy
• 刊名：International Journal of Pediatric Otorhinolaryngology
• 出版年：2012
• 期刊代码：135_01655876
• 类别：med
• 出版时间：May, 2012
• 卷：76
• 期：5
• 页码：722-727
• 文件大小：1138 K

摘要

Objectives

Ten to twenty percent of children have persistent obstructive sleep apnea (OSA) after adenotonsillectomy (T&A). We hypothesize that sleep endoscopy, a flexible fiberoptic examination of the pharynx under anesthesia, is an effective tool for identifying sites of persistent obstruction.

Methods

In this retrospective cohort study, we reviewed records of children who had symptoms consistent with OSA and a positive polysomnogram (PSG) who underwent sleep endoscopy followed by sleep endoscopy directed surgery. Data collection included age, BMI and co-morbidities. Apnea-hypopnea index (AHI) was compared to pre and post surgery for each child using a paired t-test.

Results

Of the 80 children who underwent sleep endoscopy followed by directed surgery, 65%were male, mean age was 6 years (SD 3.75 years), average BMI was 19 (SD 0.43 years) and 28%had co-morbidities. For the 51%of patients who had persistent OSA after T&A, the mean AHI after sleep endoscopy directed surgery was significantly lower then before surgery (7.9 vs. 15.7, p < .01). For the 49%of patients who had never undergone surgery for OSA, or who were surgically na茂ve, and underwent sleep endoscopy directed surgery, the mean AHI was significantly lower then before surgery (8.0 vs. 13.8, p < .01).

Conclusions

Sleep endoscopy is a consistently reliable tool for identifying the sites of obstruction in both surgically naive children and those with persistent OSA after T&A.