Pijpers Marloes, Poels Patrick J P, Vaandrager J Michiel, de Hoog Matthijs, van den Berg Sandra, Hoeve Hans J, Joosten Koen F M
Departments of Pediatric Intensive Care, Erasmus Medical Center-Sophia, Rotterdam, The Netherlands.
J Craniofac Surg. 2004 Jul;15(4):670-4. doi: 10.1097/00001665-200407000-00026.
Children with syndromal craniofacial synostosis have a high risk for obstructive sleep apnea syndrome. Early diagnosis and treatment can relieve symptoms and morbidity. Little is known about the development and natural history of obstructive sleep apnea syndrome through life. The aim of this study was to investigate our experience of clinical history and treatment modalities concerning obstructive sleep apnea syndrome from birth until the current age in children with syndromal craniofacial synostosis. Children with one of the three syndromal craniofacial synostoses (Apert, Crouzon, or Pfeiffer) born between 1984 and 2001 were evaluated. The medical history and symptoms of obstructive sleep apnea syndrome were assessed by retrospective analysis of the medical records. The present and past complaints were explored by means of a questionnaire. Retrospective analysis of the medical records showed a suspicion for obstructive sleep apnea syndrome in 26% of the children compared with 53% in the questionnaire. The severity and presentation of obstructive sleep apnea syndrome were not related to the age of the child. Obstructive sleep apnea syndrome symptoms occurred in almost half of the children during colds. Several symptoms were significantly more common in children with a high suspicion for obstructive sleep apnea syndrome. Treatment modalities consisted of adenotonsillectomies, continuous positive airway pressure, and Le Fort III surgery. Use of a standard questionnaire showed that the suspicion for obstructive sleep apnea syndrome in children with syndromal craniofacial synostosis is much higher than reported in the medical records. Regular screening for obstructive sleep apnea syndrome with a standard questionnaire could be of additional value for the detection of obstructive sleep apnea syndrome in children with syndromal craniofacial synostosis.
患有综合征性颅面骨缝早闭的儿童患阻塞性睡眠呼吸暂停综合征的风险很高。早期诊断和治疗可以缓解症状并降低发病率。关于阻塞性睡眠呼吸暂停综合征在整个生命过程中的发展和自然史，人们了解甚少。本研究的目的是调查我们在患有综合征性颅面骨缝早闭的儿童中，从出生到目前年龄有关阻塞性睡眠呼吸暂停综合征的临床病史和治疗方式的经验。对1984年至2001年期间出生的患有三种综合征性颅面骨缝早闭（Apert、Crouzon或Pfeiffer）之一的儿童进行了评估。通过对病历的回顾性分析评估阻塞性睡眠呼吸暂停综合征的病史和症状。通过问卷调查来探究当前和过去的症状。病历的回顾性分析显示，26%的儿童疑似患有阻塞性睡眠呼吸暂停综合征，而问卷调查显示这一比例为53%。阻塞性睡眠呼吸暂停综合征的严重程度和表现与儿童年龄无关。几乎一半的儿童在感冒期间出现阻塞性睡眠呼吸暂停综合征症状。在高度疑似患有阻塞性睡眠呼吸暂停综合征的儿童中，几种症状明显更为常见。治疗方式包括腺样体扁桃体切除术、持续气道正压通气和勒福III型手术。使用标准问卷显示，患有综合征性颅面骨缝早闭的儿童中阻塞性睡眠呼吸暂停综合征的疑似率远高于病历报告。使用标准问卷定期筛查阻塞性睡眠呼吸暂停综合征，对于检测患有综合征性颅面骨缝早闭的儿童的阻塞性睡眠呼吸暂停综合征可能具有额外价值。
