| Obstructive sleep apnea in children with syndromic craniosynostosis: long-term respiratory outcome of midface advancement. | |
| | |
MedLine Citation:
|
PMID: 20056390 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Almost 50% of patients with Apert, Crouzon or Pfeiffer syndrome develop obstructive sleep apnea (OSA), mainly due to midface hypoplasia. Midface advancement is often the treatment of choice, but the few papers on long-term outcome report mixed results. This paper aimed to assess the long-term respiratory outcome of midface advancement in syndromic craniosynostosis with OSA and to determine factors contributing to its efficacy. A retrospective study was performed on 11 patients with moderate or severe OSA, requiring oxygen, continuous positive airway pressure (CPAP), or tracheostomy. Clinical symptoms, results of polysomnography, endoscopy and digital volume measurement of the upper airways on CT scan before and after midface advancement were reviewed. Midface advancement had a good respiratory outcome in the short term in 6 patients and was ineffective in 5. In all patients without respiratory effect or with relapse, endoscopy showed obstruction of the rhino- or hypopharynx. The volume measurements supported the clinical and endoscopic outcome. Despite midface advancement, long-term dependence on, or indication for, CPAP or tracheostomy was maintained in 5 of 11 patients. Pharyngeal collapse appeared to play a role in OSA. Endoscopy before midface advancement is recommended to identify airway obstruction that may interfere with respiratory improvement after midface advancement. |
| | |
Authors:
|
N Bannink; E Nout; E B Wolvius; H L J Hoeve; K F M Joosten; I M J Mathijssen |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-01-06 |
Journal Detail:
|
Title: International journal of oral and maxillofacial surgery Volume: 39 ISSN: 1399-0020 ISO Abbreviation: Int J Oral Maxillofac Surg Publication Date: 2010 Feb |
Date Detail:
|
Created Date: 2010-02-17 Completed Date: 2010-05-18 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8605826 Medline TA: Int J Oral Maxillofac Surg Country: Denmark |
Other Details:
|
Languages: eng Pagination: 115-21 Citation Subset: D; IM |
Copyright Information:
|
Copyright 2009 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
|
Dutch Craniofacial Center, Erasmus Medical Center Sophia Children's Hospital, Rotterdam, The Netherlands. n.bannink@erasmusmc.nl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acrocephalosyndactylia
/
complications*,
surgery Adolescent Airway Obstruction / etiology Child Child, Preschool Continuous Positive Airway Pressure Craniofacial Dysostosis / complications*, surgery Endoscopy Facial Bones / abnormalities, surgery* Female Follow-Up Studies Humans Hypopharynx / physiopathology Longitudinal Studies Male Nasopharyngeal Diseases / etiology Oxygen Inhalation Therapy Pharyngeal Diseases / etiology Polysomnography Reconstructive Surgical Procedures / methods* Respiration* Respiratory Function Tests Retrospective Studies Sleep Apnea, Obstructive / etiology*, therapy Tomography, X-Ray Computed Tracheostomy Treatment Outcome Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A nonparametric two-sample comparison for skewed data with unequal variances.
Next Document: Cognitive remediation therapy in schizophrenia: Cost-effectiveness analysis.