Effects of adeno-tonsillectomy on polysomnography patterns in Down syndrome children with obstructive sleep apnea: a comparative study with children without Down syndrome.

Autor: Shete MM; Otolaryngology & Head and Neck Surgery, University Tennessee Health Science Center, 910 Madison Ave, Suite 429, Memphis, TN 38163, USA. mshete@utmem.edu, Stocks RM, Sebelik ME, Schoumacher RA
Jazyk: angličtina
Zdroj: International journal of pediatric otorhinolaryngology [Int J Pediatr Otorhinolaryngol] 2010 Mar; Vol. 74 (3), pp. 241-4. Date of Electronic Publication: 2010 Jan 25.
DOI: 10.1016/j.ijporl.2009.11.006
Abstrakt: Objective: To determine if adeno-tonsillectomy (T&A) in children with Down syndrome (DS) improves breathing, measured by apnea hypopnea index (AHI), rapid eye movement AHI (REM-AHI) and the lowest oxygen desaturation (SaO2), and sleep disruption, measured by arousal index (ArI) and time spent in stages 1-4 and rapid eye movement (REM) sleep and compare these results with a group of non-DS children with obstructive sleep apnea (OSA).
Study Design: Retrospective chart review at pediatric sleep center.
Patients: Eleven DS and nine non-DS children underwent pre- and post-T&A polysomnography between 1997 and 2005.
Outcome Measures: Pre- and post-T&A polysomnography parameters were compared using paired t-test and independent samples test.
Results: Mean age in DS group was 101 months and non-DS group was 80 months (64% males in DS and 88% in non-DS group). The average BMI was 29.8 and 27.6 for DS and non-DS group. The total AHI showed significant improvement after T&A but this was not as marked as the non-DS group. REM-AHI and lowest SaO2 did not show significant change in the DS children. The non-DS group showed significant improvement in all respiratory parameters. Both groups showed mild improvement in sleep parameters. With the modest overall improvement, 27% of the DS children required no further treatment. However, 73% required CPAP, BiPAP or oxygen for persistent OSA.
Conclusion: This study supports the fact that T&A in DS children improves some parameters of OSA, however not as markedly as in non-DS children.
(Copyright 2010. Published by Elsevier Ireland Ltd.)
Databáze: MEDLINE
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