Surgery for Obstructive Sleep Apnea in Children With Down Syndrome in an Australian Population.

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

Annals of Otology Rhinology and Laryngology Pub Date : 2025-01-03 DOI:10.1177/00034894241309213

Rebecca Kim, Arthur Teng, Marlene Soma

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引用次数: 0

Abstract

Objectives: The prevalence of obstructive sleep apnea (OSA) is known to be higher in children with Down syndrome (DS) than the general pediatric population, with lower rates of surgical cure. This study aims to determine the prevalence and predictors of OSA and evaluate the outcomes of surgical intervention for OSA in a cohort of Australian children with DS.

Methodology: A retrospective chart review was conducted on 156 patients with DS from 0 to 18 years who had undergone overnight, attended polysomnography (PSG) at Sydney Children's Hospital from January 2010 to July 2023. Logistic regression was used to assess associations between OSA and age, gender, body mass index (BMI), and tonsillar size. The outcomes of surgery were determined by comparing the pre-operative and post-operative PSG results.

Results: The prevalence of OSA at first PSG was 65.8%, defined by an obstructive apnea-hypopnea index (OAHI) ≥1 event/hour. Elevated BMI in children above 2 years was associated with the presence of OSA (odds ratio [OR] = 1.32; 95% confidence interval [CI] = 1.02-1.71). Male gender was a predictor for an OAHI >5 events/hour (OR = 4.01, 95% CI = 1.09-14.78). Among 35 patients who underwent adenotonsillectomy and had a valid pre-operative and post-operative PSG, median OAHI was reduced from 12.6 to 3.8 events/hour (P = .002). In 13 patients who had secondary upper airway surgery, median OAHI was reduced from 8.5 to 2.6 events/hour (P = .075).

Conclusion: Children with DS and OSA who undergo surgical intervention may experience improvements to their PSG parameters.

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手术治疗澳大利亚唐氏综合症儿童的阻塞性睡眠呼吸暂停

目的：阻塞性睡眠呼吸暂停（OSA）在唐氏综合症（DS）患儿中的患病率高于普通儿科人群，手术治愈率较低。本研究旨在确定阻塞性睡眠呼吸暂停的患病率和预测因素，并评估手术干预阻塞性睡眠呼吸暂停的结果。方法：对2010年1月至2023年7月在悉尼儿童医院接受过夜多导睡眠描记术（PSG）的156例0 - 18岁DS患者进行回顾性图表回顾。采用Logistic回归评估OSA与年龄、性别、体重指数（BMI）和扁桃体大小之间的关系。通过比较术前和术后PSG结果确定手术结果。结果：首次PSG时OSA患病率为65.8%，阻塞性呼吸暂停低通气指数(OAHI)≥1次/小时。2岁以上儿童BMI升高与OSA存在相关(优势比[OR] = 1.32；95%置信区间[CI] = 1.02-1.71)。男性性别是OAHI bb50事件/小时的预测因子（OR = 4.01, 95% CI = 1.09-14.78）。在35名接受腺扁桃体切除术并进行有效术前和术后PSG的患者中，OAHI中位数从12.6下降到3.8事件/小时（P = 0.002）。在13例接受二次上呼吸道手术的患者中，OAHI中位数从8.5事件/小时降低到2.6事件/小时（P = 0.075）。结论：接受手术干预的DS和OSA患儿PSG参数可得到改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Otology Rhinology and Laryngology 医学-耳鼻喉科学

CiteScore

3.10

自引率

7.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.