Drug-Induced Sleep Endoscopy in Children With Positional Obstructive Sleep Apnea.

Autor: Kirkham EM; Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA., Melendez JB; University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA., Hoi K; University of Michigan Medical School, University of Michigan, Ann Arbor, Michigan, USA., Chervin RD; Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2021 Jan; Vol. 164 (1), pp. 191-198. Date of Electronic Publication: 2020 Aug 04.
DOI: 10.1177/0194599820941018
Abstrakt: Objective: Positional obstructive sleep apnea (POSA)-defined as obstructive sleep apnea twice as severe supine than nonsupine-may offer clues to the underlying pattern of upper airway collapse in children. We compared drug-induced sleep endoscopy (DISE) findings in children with and without POSA. We hypothesized that children with POSA would have significantly higher obstruction at the gravity-dependent palate and tongue base but not at the adenoid, lateral wall, or supraglottis.
Study Design: Retrospective case series.
Setting: Tertiary pediatric hospital.
Subjects and Methods: We included children aged 1 to 12 years with obstructive sleep apnea diagnosed by polysomnography who underwent DISE from July 2014 to February 2019. Scores were dichotomized as ≥50% obstruction (Chan-Parikh 2 or 3) vs <50% obstruction (Chan-Parikh 0 or 1).
Results: Of 99 children included, 32 (32%) had POSA and 67 (68%) did not. Children with POSA did not differ from children without POSA in age, overall apnea-hypopnea index, sex, race, syndromic diagnoses, obesity, or history of adenotonsillectomy. In logistic regression models, odds of ≥50% obstruction were significantly higher at the tongue base (odds ratio, 2.77; 95% CI, 1.04-7.39) after adjustment for age, sex, obesity, previous adenotonsillectomy, and syndrome. No difference was noted at the adenoid, velum, lateral wall, or supraglottis.
Conclusion: POSA was associated with higher odds of obstruction on DISE at the tongue base but not at other levels.
Databáze: MEDLINE
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