Vagal nerve stimulator-associated sleep disordered breathing secondary to vagal-induced laryngospasm in pediatric populations: Case presentation and systematic review.

Autor: Sharma S; Department of Otolaryngology, Head and Neck Surgery, University of Nebraska Medical Center, Omaha, NE, USA. Electronic address: shrsharma@unmc.edu., Nouri MN; Department of Pediatrics, Children's Hospital, Western University, London, Ontario, Canada; Division of Pediatric Neurology, Children's Hospital, London, Ontorio, Canada., St-Laurent A; Department of Pediatrics, Children's Hospital, Western University, London, Ontario, Canada; Division of Respiratory Medicine, Children's Hospital, London, Ontario, Canada., Wiedermann J; Department of Otolaryngology, Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA.
Jazyk: angličtina
Zdroj: International journal of pediatric otorhinolaryngology [Int J Pediatr Otorhinolaryngol] 2023 Oct; Vol. 173, pp. 111701. Date of Electronic Publication: 2023 Aug 25.
DOI: 10.1016/j.ijporl.2023.111701
Abstrakt: Objectives: Sleep disordered breathing (SDB) is a well-documented complication of vagus nerve stimulation (VNS) in the literature. Yet, a formal consensus on its management has not been established, particularly in the pediatric population. This study aims to evaluate the current literature on VNS-associated SDB in order to further characterize its presentation, pathogenesis, diagnosis, and treatment.
Methods: A literature review from 2001 to November 8, 2021 was conducted to search for studies on SDB during vagal nerve stimulation in pediatric populations.
Results: Of 277 studies screened, seven studies reported on pediatric patients with VNS-associated SDB. Several investigators found on polysomnogram that periods of apnea/hypopnea correlated with VNS activity. When VNS settings were lowered or turned off, symptoms would either improve or completely resolve.
Conclusion: VNS-associated SDB is a well described complication of VNS implantation, occurring due to an obstructive process from vagal stimulation and laryngeal contraction. Diagnosis can be made via polysomnogram. Recommended treatment is through adjustment of VNS settings. However, those who are unable to tolerate this, or who have had pre-existing obstructive issues prior to VNS, should pursue other treatment options such as non-invasive positive pressure or surgery directed by DISE findings.
Competing Interests: Declaration of competing interest None
(Crown Copyright © 2023. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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