scholarly journals Evaluation of neurocognitive abilities in children affected by obstructive sleep apnea syndrome before and after adenotonsillectomy

2020 ◽  
Vol 40 (2) ◽  
pp. 122-132 ◽  
Author(s):  
Domenico Testa ◽  
Marco Carotenuto ◽  
Francesco Precenzano ◽  
Alessia Russo ◽  
Anna Donadio ◽  
...  
2020 ◽  
Vol 10 (18) ◽  
pp. 6485
Author(s):  
Vincenzo Quinzi ◽  
Sabina Saccomanno ◽  
Rebecca Jewel Manenti ◽  
Silvia Giancaspro ◽  
Licia Coceani Paskay ◽  
...  

Aim: To systematically review international literature related to rapid maxillary expansion (RME) as the treatment for obstructive sleep apnea syndrome (OSAS) in children less than 18 years-old, followed by a meta-analysis of the apnea-hypopnea index (AHI) before and after RME, with or without a previous adenotonsillectomy (AT). Methods: Literature on databases from PubMed, Wiley online library, Cochrane Clinical Trials Register, Springer link, and Science Direct were analyzed up to March 2020. Two independent reviewers (S.G. and R.J.M.) screened, assessed, and extracted the quality of the publications. A meta-analysis was performed to compare AHI values before and after the treatment with RME. Results: Six studies reported outcomes for 102 children with a narrow maxillary arch suffering from OSAS with a mean age of 6.7 ± 1.3. AHI improved from a M ± SD of 7.5 ± 3.2/h to 2.5 ± 2.6/h. A higher AHI change in patients with no tonsils (83.4%) and small tonsils (97.7%) was detected when compared to children with large tonsils (56.4%). Data was analyzed based on a follow-up duration of ≤3 year in 79 children and >3 years in 23 children. Conclusion: Reduction in the AHI was detected in all 102 children with OSAS that underwent RME treatment, with or without an adenotonsillectomy. Additionally, a larger reduction in the AHI was observed in children with small tonsils or no tonsils. A general improvement on the daytime and nighttime symptoms of OSAS after RME therapy was noted in all the studies, demonstrating the efficacy of this therapy.


1995 ◽  
Vol 113 (3) ◽  
pp. 888-894
Author(s):  
Ricardo Castro Barbosa ◽  
Flávio Aloe ◽  
Stella Tavares ◽  
Ademir Baptista Silva

Dental devices have been employed in the treatment of snoring and obstructive sleep apnea syndrome (OSAS) of mild to moderate degrees. The authors disclose the preliminary results in 8 patients with clinically diagnosed obstructive sleep apnea polisomnographically confirmed and treated with a dental device (Mandibular-Lingual Repositioning Device - MLRD) developed by one of the authors (RCB). Cephalometrics was performed before usage of MLRD, Epworth Sleepiness Scale (ESS) tests were conducted before and after the MLRD and a questionnaire that subjectively qualified the Overall Subjective Improvement of the patient (OSI) was filled out. The tests were repeated 4 weeks after the application of the MLRD. The average subjective overall improvement was 73.75% and the Epworth Sleepiness Scale was 13.88 (pre - MLRD) and 6.63 (post - MLRD) representing a significant statistical variation (p=0.05). The authors discuss probable factors involved in the improvement of the subjective measurements of excessive sleepiness.


2015 ◽  
Vol 118 (4) ◽  
pp. 400-407 ◽  
Author(s):  
Ignacio E. Tapia ◽  
Joseph M. McDonough ◽  
Jingtao Huang ◽  
Carole L. Marcus ◽  
Paul R. Gallagher ◽  
...  

Children with the obstructive sleep apnea syndrome (OSAS) have impaired respiratory afferent cortical processing during sleep that persists after treatment of OSAS. However, it is unknown whether this impairment is present during wakefulness and, if so, whether it improves after OSAS treatment. We hypothesized that children with OSAS, during wakefulness, have abnormal cortical processing of respiratory stimuli manifested by blunted respiratory-related evoked potentials (RREP) and that this resolves after OSAS treatment. We measured RREP during wakefulness in 26 controls and 21 children with OSAS before and after treatment. Thirteen participants with OSAS repeated testing 3–6 mo after adenotonsillectomy. RREP were elicited by interruption of inspiration by total occlusion and 30 and 20 cmH2O/l per s resistances. Nf at Fz latency elicited by occlusion was longer in children with OSAS at baseline compared with controls (78.8 ± 24.8 vs. 63.9 ± 19.7 ms, P = 0.05). All other peak amplitudes and latencies were similar between the two groups. After OSAS treatment, Nf at Fz latency elicited by 30 cmH2O/l per s decreased significantly (before, 88 ± 26 vs. after, 71 ± 25 ms, P = 0.02), as did that elicited by 20 cmH2O/l per s (85 ± 27 vs. 72 ± 24 ms, P = 0.004). The amplitude of N1 at Cz elicited by occlusion increased from −3.4 ± 5.6 to −7.4 ± 3 μV ( P = 0.049) after treatment. We concluded that children with OSAS have partial delay of respiratory afferent cortical processing during wakefulness that improves after treatment.


2008 ◽  
Vol 9 (1) ◽  
pp. 69-70
Author(s):  
O.K. Nikitidou ◽  
E.G. Daskalopoulou ◽  
E.G. Vlachogiannis ◽  
E.K. Kosmidou ◽  
E.K. Mastrogiannidou ◽  
...  

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Ali Seyed Resuli ◽  
Hasan Samur

Objectives: The goal of this practice was to explore whether the changes in arrhythmias after uvulopalatopharyngoplasty (UPPP) in patients with moderate obstructive sleep apnea syndrome (OSAS) who continued cardiac arrhythmias despite the use of antiarrhythmic drugs and those who could not tolerate the continuous positive airway pressure (CPAP) device. In addition, we evaluated the correlation between arrhythmias before and after UPPP. Methods: This retrospective study included patients who have OSAS and cardiac arrhythmias, between 2008 - 2017 by the cardiology clinic and consulted by the ear, nose, and throat (ENT) clinic. Thirty eight patients were selected and underwent UPPP operation. The rhythm Holter follow-ups of the patients in the 1st month before UPPP (pre-UPPP) and after UPPP (post-UPPP) 6th month were performed. The recordings were transferred to the computer and evaluated with the Holter program, then visually examined and the parasitic regions were excluded. Sinus bradycardia (SB), atrioventricular block (AVB), atrial premature beat (APB), supraventricular tachycardia (SVT), and ventricular extrasystole (VES) parameters were recorded for arrhythmia. Results: Statistically significant differences were observed in the changes in SB, AVB, APB, SVT and VE arrhythmia values in pre-UPPP and post-UPPP periods. Also, in one case the values of arrhythmia in the pre-UPPP period had a positive correlation with the values of the same arrhythmia in the post-UPPP period (P < 0.001). Conclusions: In this study, new information about the effects of UPPP which is one of OSAS treatment methods on cardiac arrhythmias is presented. According to our results, UPPP reduces the rate of SB, AVB, APB, SVT and VES arrhythmias in OSAS patients.


2014 ◽  
Vol 155 (18) ◽  
pp. 703-707 ◽  
Author(s):  
Pálma Benedek ◽  
Gabriella Kiss ◽  
Eszter Csábi ◽  
Gábor Katona

Introduction: Treatment of pediatric obstructive sleep apnea syndrome is surgical. The incidence of postoperative respiratory complications in this population is 5–25%. Aim: The aim of the authors was to present the preoperative evaluation and monitoring procedure elaborated in Heim Pál Children Hospital, Budapest. Method: 142 patients were involved in the study. Patient history was obtained and physical examination was performed in all cases. Thereafter, polysomnography was carried out, the severity of the obstructive sleep apnea syndrome was determined, and the patients underwent tonsilloadenotomy. Results: 45 patients with mild, 50 patients with moderate and 47 patients with severe obstructive sleep apnea syndrome were diagnosed. There was no complication in patients with mild disease, while complications were observed in 6 patients in the moderate group and 24 patients in the severe group (desaturation, apnea, stridor, stop breathing) (p<0.000). In patients with severe obstructive sleep apnea syndrome, no significant difference was noted in preoperative apnoea-hypapnea index (p = 0.23) and in nadir oxygen saturation values (p = 0.73) between patients with and without complication. Conclusions: Patients with severe obstructive sleep apnea syndrome should be treated in hospital where pediatric intensive care unit is available. Orv. Hetil., 2014, 155(18), 703–707.


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