Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA.
Division of Pediatric Otolaryngology, Seattle Children's Hospital, Seattle, WA, USA.
Acta Otolaryngol. 2021 Apr;141(4):397-402. doi: 10.1080/00016489.2020.1863465. Epub 2020 Dec 29.
Obstructive sleep apnea affects approximately 1-4% of all children, with increased prevalence amongst overweight and obese children.
To assess the effects of drug-induced sleep endoscopy (DISE)-directed surgery on polysomnography parameters in obese and overweight children.
MATERIAL/METHODS: A retrospective case-series was performed on obese and overweight pediatric patients who underwent clinically indicated DISE-directed surgery. Forty children met the inclusion criteria, including: body mass index ≥85%, DISE-study, and pre- and post-DISE polysomnography. Patients were divided into surgically naïve ( = 23) and prior adenotonsillectomy ( = 17) groups. Demographic and clinical characteristics were examined with chi-square and Wilcoxon rank-sum test. Polysomnography parameters were compared with Wilcoxon signed rank test.
Of 40 children with mean BMI 94% and mean age 8 ± 6 years old, 17 (43%) underwent a previous adenotonsillectomy. Overall, significant improvements were observed in the apnea-hypopnea index (AHI; 25.0 to 9.9 events/hour, < .01) and oxygen nadir (82.7% to 88.5%, < .01). A similar pattern was observed among the surgically naïve (AHI: 35.9 to 12.7 events/hour, = .04; oxygen nadir: 79.7% to 86.4%, = .2) and post-adenotonsillectomy groups (AHI: 10.4 to 6.2 events/hour, = .02; oxygen nadir: 86.7% to 91.2%, < .01).
CONCLUSIONS/SIGNIFICANCE: Polysomnography parameters significantly improved following DISE-directed interventions in obese and overweight children with obstructive sleep apnea.
阻塞性睡眠呼吸暂停影响约 1-4%的所有儿童，超重和肥胖儿童的患病率增加。
评估药物诱导睡眠内镜（DISE）指导手术对肥胖和超重儿童多导睡眠图参数的影响。
材料/方法：对接受临床指示 DISE 指导手术的肥胖和超重儿科患者进行回顾性病例系列研究。40 名患者符合纳入标准，包括：体重指数≥85%、DISE 研究以及术前和术后多导睡眠图。患者分为手术初治组（ = 23）和既往腺样体扁桃体切除术组（ = 17）。使用卡方检验和 Wilcoxon 秩和检验比较了患者的人口统计学和临床特征。使用 Wilcoxon 符号秩检验比较了多导睡眠图参数。
40 名儿童的平均 BMI 为 94%，平均年龄为 8±6 岁，其中 17 名（43%）患者行过腺样体扁桃体切除术。总体而言，呼吸暂停低通气指数（AHI；25.0 至 9.9 次/小时， < .01）和氧饱和度最低点（82.7%至 88.5%， < .01）均显著改善。手术初治组（AHI：35.9 至 12.7 次/小时， = .04；氧饱和度最低点：79.7%至 86.4%， = .2）和腺样体扁桃体切除术组（AHI：10.4 至 6.2 次/小时， = .02；氧饱和度最低点：86.7%至 91.2%， < .01）也观察到类似的模式。
结论/意义：肥胖和超重的阻塞性睡眠呼吸暂停儿童在接受 DISE 指导干预后，多导睡眠图参数显著改善。
