Dutch Craniofacial Center, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Int J Oral Maxillofac Surg. 2010 May;39(5):421-3. doi: 10.1016/j.ijom.2010.02.001. Epub 2010 Mar 4.
Obstructive sleep apnea (OSA) is a clinical syndrome characterized by snoring, apneas and difficulty in breathing. These symptoms can be rated and a risk score (Brouillette score) can be calculated to estimate the likelihood of OSA. This study aimed at establishing the predictive value of the Brouillette score and observation by parents at home in children with syndromic or complex craniosynostosis, compared with ambulatory polysomnography. This prospective study included 78 patients (37 boys, mean age 7.3 years). Sensitivity and negative predictive values were calculated. Polysomnography showed clinically significant OSA in 11 children. The Brouillette score had a negative predictive value of 90% and a sensitivity of 55% in comparison with polysomnography. More than three-quarters of all patients snored. The single question 'Is there difficulty with breathing during sleep?' showed a sensitivity of 64% and a high negative predictive value of 91%. Thus, asking parents whether the child has difficulty in breathing during sleep can exclude the presence of clinical significant OSA and avoid polysomnography in children with syndromic and complex craniosynostosis.
阻塞性睡眠呼吸暂停（OSA）是一种以打鼾、呼吸暂停和呼吸困难为特征的临床综合征。这些症状可以进行评估，并计算出风险评分（Brouillette 评分）来估计 OSA 的可能性。本研究旨在比较家庭中父母观察和 Brouillette 评分与动态多导睡眠图（PSG）在综合征或复杂颅面骨缝早闭儿童中的预测价值。这项前瞻性研究共纳入 78 例患儿（37 名男孩，平均年龄 7.3 岁）。计算了敏感性和阴性预测值。PSG 显示 11 例儿童存在临床显著的 OSA。与 PSG 相比，Brouillette 评分的阴性预测值为 90%，敏感性为 55%。超过四分之三的患儿有打鼾。“患儿在睡眠中是否有呼吸困难？”这一单一问题的敏感性为 64%，阴性预测值高达 91%。因此，询问父母患儿在睡眠中是否有呼吸困难，可以排除临床显著 OSA 的存在，避免对综合征和复杂颅面骨缝早闭的患儿进行 PSG。
