Bluher Andrew E, Ishman Stacey L, Baldassari Cristina M
Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, 600 Gresham Drive, Suite 1100, Norfolk, VA 23507, USA.
Division of Pediatric Otolaryngology-Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC# 2018, Cincinnati, OH 45229-2018, USA; Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC# 2018, Cincinnati, OH 45229-2018, USA.
Otolaryngol Clin North Am. 2019 Oct;52(5):891-901. doi: 10.1016/j.otc.2019.06.004. Epub 2019 Jul 10.
Pediatric obstructive sleep apnea (OSA) affects 2% to 4% of American children, and is associated with metabolic, cardiovascular, and neurocognitive sequelae. The primary treatment for pediatric OSA is adenotonsillectomy. Children with obesity, craniofacial syndromes, and severe baseline OSA are at risk for persistent disease. Evaluation of persistent OSA should focus on identifying the causes of upper airway obstruction. Interventions should be tailored to address the patient's symptomatology, sites of obstruction, and preference for surgical versus medical management. Further research is needed to identify management protocols that result in improved outcomes for children with persistent OSA.
小儿阻塞性睡眠呼吸暂停(OSA)影响2%至4%的美国儿童,并与代谢、心血管和神经认知后遗症相关。小儿OSA的主要治疗方法是腺样体扁桃体切除术。肥胖、颅面综合征和严重基线OSA的儿童有持续性疾病的风险。对持续性OSA的评估应侧重于确定上气道阻塞的原因。干预措施应根据患者的症状、阻塞部位以及对手术与药物治疗的偏好进行调整。需要进一步研究以确定能改善持续性OSA儿童预后的管理方案。