Achondroplasia and obstructive sleep apnea: surgical outcomes and comparison to general population

Study Objectives: The objective was to compare demographics between children with achondroplasia and obstructive sleep apnea (OSA) with the general pediatric population with OSA, as well as present treatment outcomes for children with achondroplasia. Methods: Retrospective chart review of 22 children with achondroplasia and OSA and 141 children with OSA without achondroplasia. Parameters from polysomnography were analyzed. Values before and after surgery were compared for the achondroplasia group, while baseline values were compared between the control group and achondroplasia group. Results: Preintervention in the adenotonsillectomy achondroplasia group, 0 children had mild OSA, 1 had moderate OSA, and 10 had severe OSA. In the comparative group 16 had mild OSA, 11 had moderate OSA, and 114 had severe OSA. The achondroplasia population had a much younger age at adenotonsillectomy compared to the control population-3.1 vs 6.8 years. When comparing baseline data in the achondroplasia population with respective adenotonsillectomy outcomes, obstructive apnea-hypopnea index and oxygen saturation percentage were improved. For the adenoidectomy group, there were no significant changes in OSA after surgery. For the cervicomedullary decompression group, there was a decrease in obstructive apnea-hypopnea index after surgery. Conclusions: Patients with achondroplasia and OSA have an earlier age of onset compared to children without achondroplasia. For these patients with moderate to severe OSA, treatment with adenotonsillectomy leads to significant improvement. Treatment with adenoidectomy showed no significant change in OSA. Cervicomedullary decompression also led to an improvement in obstructive apnea-hypopnea index.