Clinical and polysomnographic correlation in sleep-related breathing disorders in children.

Autor: Esteller E; Servicio de Otorrinolaringología, Hospital General de Catalunya, San Cugat del Vallès, Barcelona, Spain. eesteller@gmail.com, Santos P, Segarra F, Estivill E, Lopez R, Matiñó E, Ademà JM
Jazyk: English; Spanish; Castilian
Zdroj: Acta otorrinolaringologica espanola [Acta Otorrinolaringol Esp] 2013 Mar-Apr; Vol. 64 (2), pp. 108-14. Date of Electronic Publication: 2012 Nov 07.
DOI: 10.1016/j.otorri.2012.08.003
Abstrakt: Introduction: Although polysomnography is the gold standard test for sleep-disordered breathing in children, there is controversy about its indication in all cases. Among the arguments both for and against is the lack of correlation between objective values and the symptoms.
Objective: To evaluate the correlation between clinical data and apnea-hypopnoea index (AHI) in our work environment.
Material and Methods: We compared the preoperative clinical symptoms and AHI statistically in 170 children with sleep-disordered breathing who underwent polysomnography. We also analysed the correlation to postoperative level, with a subgroup of 80 children who underwent adenotonsillectomy with 1 year of polysomnography follow-up.
Results: Before surgery, only the degree of tonsillar hypertrophy was statistically significant correlated with AHI. At post-operative follow-up, evidence of correlation between AHI and apnoea was observed: 38.1% of children improved in the group with persistence and 66.7% in the disease resolution group (P=.023). In addition, the correlations showed the level of improvement of snoring, as assessed by visual analogue scale. The mean was 5 points lower in the persistent group and 6.1 lower in the disease resolution group (P=.047).
Conclusion: Despite the limitations in the correlation between clinical data and polysomnography, especially in preoperative results, polysomnography remains the gold standard diagnostic tool. Efforts should be made to obtain objective parameters that provide higher levels of correlation.
(Copyright © 2012 Elsevier España, S.L. All rights reserved.)
Databáze: MEDLINE