Pateron B, Marianowski R, Monteyrol P-J, Couloigner V, Akkari M, Chalumeau F, Fayoux P, Leboulanger N, Franco P, Mondain M
Service de chirurgie ORL et cervico-faciale, hôpital universitaire Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
Service de chirurgie ORL et cervico-faciale, CHU de Brest, 29000 Brest, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Aug;135(4):265-268. doi: 10.1016/j.anorl.2018.04.005. Epub 2018 May 3.
The authors present the guidelines of the French Society of ENT and Head & Neck Surgery (SFORL) on the role of the ENT physician in childhood obstructive sleep apnea-hypopnea syndrome (OSAHS). This section of the guidelines concerns the roles of the various medical and surgical treatment options.
A multidisciplinary work-group was entrusted with a review of the scientific literature on the topic. Based on the retrieved articles and the group members' own experience, guidelines were drawn up, then read over by a reading group independent of the work-group. An editorial meeting then produced the final text.
Adenotonsillectomy is the reference treatment for childhood OSAHS with adenotonsillar hypertrophy. Respiratory assistance is recommended in children with severe OSAHS without nasal and/or oropharyngeal obstacle, after surgery in case of persistent OSAHS, in case of contraindications to surgery, in complex obstruction related to pharyngolaryngeal or laryngeal pathology or comorbidity, or as an alternative to tracheotomy. Nasal route corticosteroids may be used in childhood OSAHS in with associated nasal obstruction.
作者介绍了法国耳鼻咽喉科及头颈外科学会（SFORL）关于耳鼻咽喉科医生在儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）中作用的指南。本指南的这一部分涉及各种药物和手术治疗选择的作用。
委托一个多学科工作小组对该主题的科学文献进行综述。根据检索到的文章和小组成员自身的经验，制定了指南，然后由一个独立于工作小组的阅读小组进行审阅。随后召开编辑会议，形成最终文本。
腺样体扁桃体切除术是治疗伴有腺样体扁桃体肥大的儿童OSAHS的参考疗法。对于严重OSAHS且无鼻腔和/或口咽阻塞的儿童、手术后持续性OSAHS患儿、存在手术禁忌症的患儿、与咽喉或喉部病变或合并症相关的复杂阻塞患儿，或作为气管切开术的替代方法时，建议采用呼吸辅助治疗。鼻用糖皮质激素可用于伴有鼻腔阻塞的儿童OSAHS。
