Lan Ming-Chin, Hsu Yen-Bin, Lan Ming-Ying, Chiu Tsan-Jen, Huang Tung-Tsun, Wong Shi-Bing, Chen Yu-Cheng, Tsai Li-Ping
Department of Otolaryngology-Head and Neck Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Sleep Breath. 2016 Sep;20(3):1029-34. doi: 10.1007/s11325-016-1338-8. Epub 2016 Apr 8.
Review drug-induced sleep endoscopy (DISE) findings in children with Prader-Willi syndrome (PWS) and correlate the patterns of airway collapse with apnea-hypopnea index (AHI) and body mass index (BMI).
A total of nine children with PWS underwent DISE. DISE findings were recorded using the VOTE classification system. The relationship between different patterns of airway collapse with AHI and BMI was analyzed.
The majority of children with PWS were found to have multilevel obstruction (six out of nine children, 66.6 %). The velum was the most common site of obstruction (nine out of nine children, 100 %). All of the patients had positional obstructive sleep apnea (OSA). Patients with partial or complete anterior-posterior tongue base collapse were associated with a significantly higher AHI (P = 0.016) compared to patients with no anterior-posterior tongue base collapse. Apart from tongue base collapse, no other patterns of airway collapse showed a consistent association with AHI in our results. No patterns of airway collapse showed a significant association with BMI in our study.
In our study, partial or complete anterior-posterior tongue base collapse was associated with higher AHI values in children with PWS. Therefore, careful attention should be addressed to the management of tongue base collapse. Positional therapy could be a potential treatment for patients with PWS since it may alleviate the severity of tongue base collapse.
回顾普拉德-威利综合征（PWS）患儿的药物诱导睡眠内镜检查（DISE）结果，并将气道塌陷模式与呼吸暂停低通气指数（AHI）和体重指数（BMI）进行关联分析。
共有9名PWS患儿接受了DISE检查。使用VOTE分类系统记录DISE检查结果。分析不同气道塌陷模式与AHI和BMI之间的关系。
发现大多数PWS患儿存在多平面梗阻（9名患儿中有6名，66.6%）。软腭是最常见的梗阻部位（9名患儿均有，100%）。所有患者均有体位性阻塞性睡眠呼吸暂停（OSA）。与无前后位舌根塌陷的患者相比，部分或完全性前后位舌根塌陷的患者AHI显著更高（P = 0.016）。在我们的结果中，除舌根塌陷外，没有其他气道塌陷模式与AHI存在一致的关联。在我们的研究中，没有气道塌陷模式与BMI存在显著关联。
在我们的研究中，PWS患儿部分或完全性前后位舌根塌陷与较高的AHI值相关。因此，应仔细关注舌根塌陷的处理。体位治疗可能是PWS患者的一种潜在治疗方法，因为它可能减轻舌根塌陷的严重程度。
