Management of obstructive sleep apnea-hypopnea syndrome in children: what is the role of orthodontics? A scoping review.

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Sleep and Breathing Pub Date : 2025-03-13 DOI:10.1007/s11325-025-03288-1

Margaux Picherit, Thomas Trentesaux, Amandine Ternisien, Nathalie Foumou, Caroline Delfosse, Thomas Marquillier

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引用次数: 0

Abstract

Purpose: Obstructive sleep apnoea syndrome (OSAHS) is a respiratory disorder that greatly affects the health and quality of life of patients. OSAHS affects up to 5.7% of children aged up to 18 years old, and its prevalence is doubled in children with risk factors such as obesity, craniofacial syndromes, Prader-Willi syndrome or trisomy 21. The most common aetiology of OSAHS in children is tonsil hypertrophy, and the first line treatment proposed for the majority of patients is the surgical removal of these tonsils. However, the risk of residual OSAHS after surgery is approximately 10-20%, and, thus, other therapeutic options are being developed to improve patient care. The objective of this scoping review is to assess the extent of the evidence regarding the effectiveness of the different types of treatments offered for OSAHS in children.

Methods: Relevant studies over a 13 year period were identified using three search engines: PubMed, Scopus and Web of Science. The selection of studies was made using previously defined inclusion and exclusion criteria based on a review of the title and abstracts initially, followed by a full reading of the texts. The studies were classified based on their design and following the grades and level of scientific proof defined by the Health High Authority.

Results: Twenty-nine manuscripts were included for synthesis. The first-line treatment proposed for the majority of patients with OSAHS is surgical removal of the tonsils, but the risk of residual OSAHS after surgery remains significant, and other less invasive options, such as orthodontics, are also useful for improving the management of these patients.

Conclusion: OSAHS treatment recommendations should consider orthodontic treatment as a minimally invasive approach with beneficial effects.

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儿童阻塞性睡眠呼吸暂停低通气综合征的治疗：正畸的作用是什么？范围审查。

目的：阻塞性睡眠呼吸暂停综合征（OSAHS）是一种严重影响患者健康和生活质量的呼吸系统疾病。OSAHS影响高达5.7%的18岁以下儿童，在肥胖、颅面综合征、Prader-Willi综合征或21三体等危险因素的儿童中，其患病率翻了一番。儿童OSAHS最常见的病因是扁桃体肥大，大多数患者的一线治疗建议是手术切除这些扁桃体。然而，术后残留OSAHS的风险约为10-20%，因此，正在开发其他治疗方案以改善患者护理。本综述的目的是评估不同类型治疗儿童OSAHS的有效性证据的程度。方法：通过三个搜索引擎：PubMed、Scopus和Web of Science，确定了13年来的相关研究。研究的选择是根据先前定义的纳入和排除标准进行的，该标准最初是基于对标题和摘要的审查，然后是对文本的全面阅读。这些研究是根据其设计并遵循卫生高级当局确定的科学证据的等级和水平进行分类的。结果：纳入29篇文献进行综合。大多数OSAHS患者的一线治疗建议是手术切除扁桃体，但术后残留OSAHS的风险仍然很大，其他侵入性较小的选择，如正畸治疗，也有助于改善这些患者的管理。结论：OSAHS的治疗建议应考虑将正畸治疗作为一种微创、有益的治疗方法。

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

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.