Contribution of drug-induced sleep endoscopy to the management of pediatric obstructive sleep apnea/hypopnea syndrome

被引:15
|
作者
Blanc, F. [1 ]
Kennel, T. [1 ]
Merklen, F. [1 ]
Blanchet, C. [1 ]
Mondain, M. [1 ]
Akkari, M. [1 ]
机构
[1] Univ Montpellier, Serv ORL & Chirurg Cerv Faciale, CHU Montpellier, UAM ORL Pediat,Hop Gui de Chauliac, 80 Ave Augustin Fliche, F-34295 Montpellier 5, France
关键词
Drug-induced sleep endoscopy; Pediatric obstructive sleep apnea/hypopnea syndrome; Tongue base; Epiglottis; Occult laryngomalacia; Lingual tonsillectomy; Epiglottopexy; Aryepiglottic fold division; INDUCED SEDATION ENDOSCOPY; APNEA; CHILDREN; ADENOTONSILLECTOMY; LARYNGOMALACIA; OUTCOMES; AWAKE;
D O I
10.1016/j.anorl.2019.09.001
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objectives: The role of drug-induced sleep endoscopy (DISE) in the management of obstructive sleep apnea/hypopnea syndrome (OSAHS) is not precisely defined in children. The primary objective of this study was to describe DISE-induced revision of airway obstruction site location and the ensuing treatment changes in children with OSAHS. Secondary objectives were to analyze the correlation of number of obstruction sites found on DISE with apnea-hypopnea index (AHI) and with type of OSAHS. Material and methods: A retrospective single-center study included 31 children (mean age: 5.5 +/- 2.6 years) undergoing DISE for management of OSAHS between 2015 and 2018. Revisions of airway obstruction site location and in treatment were noted. The correlation of number of obstruction sites with AHI and with type of OSAHS was analyzed. Results: Airway obstruction site location was reconsidered in 77% of children (n = 24), modifying treatment in 45.2% (n = 14). There was no significant correlation between number of obstruction sites and AHI: Spearman coefficient 0.20 (P = 0.26). Patients with type-III OSAHS did not show more obstruction sites than others: respectively, 2.0 versus 1.8 (P = 0.40). Conclusion: DISE induced significant revision of the location and change in treatment of obstruction sites in children with OSAHS. Systematic implementation, especially in type-I OSAHS, would allow more precise pre-therapeutic classification and treatment adapted to actual airway obstruction. (C) 2019 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:447 / 454
页数:8
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