Di Filippo Paola, Orlandi Greta, Neri Giampiero, Di Pillo Sabrina, Chiarelli Francesco, Rossi Nadia, Attanasi Marina
Department of Pediatrics, University of Chieti, Chieti, Italy.
Department of Otorhinolaryngology, University of Chieti, Chieti, Italy.
Front Pediatr. 2023 Jan 25;10:1101267. doi: 10.3389/fped.2022.1101267. eCollection 2022.
Obstructive sleep apnea (OSA) is an increasingly recognized disorder in children. Adenotonsillectomy is the primary surgical treatment for OSA in children with adenotonsillar hypertrophy (ATH). We present the case of an obese 4-year-old boy hospitalized for severe desaturation during sleep and severe ATH. Nasal steroid therapy proved ineffective with persistent symptoms. Polygraphy documented severe OSA with an apnea-hypopnea index (AHI) equal to 11. Tonsillectomy resulted in prompt symptom improvement and a substantial reduction of the AHI (2.2). In this case, tonsillectomy alone resulted effective in treating OSA, despite obesity. We concluded that the presence of obesity should not postpone/exclude surgical treatment of preschool children for whom ATH is the most important cause of OSA.
阻塞性睡眠呼吸暂停（OSA）在儿童中是一种越来越受到认可的疾病。腺样体扁桃体切除术是患有腺样体扁桃体肥大（ATH）的儿童OSA的主要外科治疗方法。我们报告了一名4岁肥胖男孩的病例，该男孩因睡眠期间严重低氧血症和严重ATH住院。鼻用类固醇治疗效果不佳，症状持续存在。多导睡眠监测记录显示严重OSA，呼吸暂停低通气指数（AHI）等于11。扁桃体切除术后症状迅速改善，AHI大幅降低（2.2）。在本病例中，尽管患儿肥胖，但仅扁桃体切除术就有效治疗了OSA。我们得出结论，对于ATH是OSA最重要病因的学龄前儿童，肥胖的存在不应推迟/排除手术治疗。
