Can Drug- Induced Sleep Endoscopy in children predict OSA persistence after adenotonsillectomy
| Autor: | Silke Anna Theresa Weber, Jefferson Luis de Barros, Antonio Carlos Marão |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Epiglottis
Pediatrics medicine.medical_specialty medicine.diagnostic_test business.industry Polysomnography nervous system diseases respiratory tract diseases Muscle hypertrophy Persistence (computer science) medicine.anatomical_structure stomatognathic system Sleep endoscopy Tongue Complete obstruction medicine Prospective cohort study business |
| Zdroj: | Paediatric respiratory physiology and sleep. |
| DOI: | 10.1183/13993003.congress-2018.pa553 |
| Popis: | Introduction: OSA in children is related to hypertrophy of the tonsils, however, OSA persists in 10 to 35% after adenotonsillectomy (AT) Sleep endoscopy (DISE) may help to identify sites of obstruction and preview OSA persistence. Objectives: to correlate sites of obstruction of UA with the polysomnopraphy before and after adenotonsillectomy(. Methods: In this prospective study, children with hypertrophy of the tonsils were invited to perform polysomnography before surgery, DISE at anesthesia induction during surgery and a second polysomnography 3 to 6 months after AT. DISE was scored by VOTE scale. We analyzed correlation of OSA severity and complex obstructions, and of OSA persistence and non- tonsillar obstruction. Results: 20 children, 13 male, aged 3 to 9 years old, completed the protocol. Median AHI improved from 20.41 (4.5-46.5) to 4.98 (0.5-18.2), after surgery, OSA persisted in 45%. DISE showed obstruction of tongue or epiglottis in 12 (60%) children with no correlation to OSA severity at pre-operative evaluation. Out of the 9 children with persistent OSA, 6 showed obstruction at tongue or epiglottis and only one being obese. Out of 5 children with tongue level obstruction, 1 persisted with severe and 2 with moderate OSA, out of 4 children with epiglottis obstruction, 2 persisted with severe OSA. Conclusion: DISE shows a high frequency of partial or complete obstruction at tongue or epiglottis level. In our case serie, obstruction of tongue or epiglottis showed a higher correlation to OSA persistence than obesity, DISE may be a tool for prediction. |
| Databáze: | OpenAIRE |
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