Chiner Eusebi, Sancho-Chust Jose N, Pastor Esther, Esteban Violeta, Boira Ignacio, Castelló Carmen, Celis Carly, Vañes Sandra, Torba Anastasiya
Pulmonology Department, Multidisciplinary Sleep Clinic, San Juan de Alicante University Hospital, 03550 Alicante, Spain.
J Clin Med. 2023 Mar 21;12(6):2418. doi: 10.3390/jcm12062418.
To compare the clinical and polysomnographic features of obstructive sleep apnea (OSA) in children with adenotonsillar hypertrophy (Group A) and comorbidities (Group B).
A five-year prospective study using nocturnal polysomnography before and after treatment.
We included 168 patients: 121 in Group A and 47 in Group B, with differences in age (6.5 ± 3 vs. 8.6 ± 4 years; < 0.001), body mass index (BMI) (18 ± 4 vs. 20 ± 7 kg/m2; < 0.05), neck circumference (28 ± 4 vs. 30 ± 5 cm; < 0.05), and obesity (17% vs. 30%; < 0.05). Group B patients were more likely to have facial anomalies ( < 0.001), macroglossia ( < 0.01), dolichocephaly ( < 0.01), micrognathia ( < 0.001), and prognathism ( < 0.05). Adenotonsillectomy was performed in 103 Group A patients (85%) and 28 Group B patients (60%) ( < 0.001). In B, 13 children (28%) received treatment with continuous positive airway pressure (CPAP) and 2 (4%) with bilevel positive airway pressure (BiPAP), compared with 7 in Group A (6%) ( < 0.001). Maxillofacial surgery was more common in Group B ( < 0.01). Clinical and polysomnography parameters improved significantly in both groups after therapeutic intervention, though Group A showed better results.
Obesity and facial anomalies are more frequent in childhood OSA patients with comorbidities, who often require combination therapy, such as ventilation and surgery.
比较腺样体扁桃体肥大儿童（A组）和合并其他疾病儿童（B组）阻塞性睡眠呼吸暂停（OSA）的临床和多导睡眠图特征。
一项为期五年的前瞻性研究，采用治疗前后的夜间多导睡眠图。
我们纳入了168例患者：A组121例，B组47例，两组在年龄（6.5±3岁 vs. 8.6±4岁；P<0.001）、体重指数（BMI）（18±4 kg/m² vs. 20±7 kg/m²；P<0.05）、颈围（28±4 cm vs. 30±5 cm；P<0.05）和肥胖率（17% vs. 30%；P<0.05）方面存在差异。B组患者更易出现面部畸形（P<0.001）、巨舌症（P<0.01）、长头畸形（P<0.01）、小颌畸形（P<0.001）和凸颌畸形（P<0.05）。103例A组患者（85%）和28例B组患者（60%）接受了腺样体扁桃体切除术（P<0.001）。在B组中，13名儿童（28%）接受持续气道正压通气（CPAP）治疗，2名（4%）接受双水平气道正压通气（BiPAP）治疗，而A组分别为7名（6%）（P<0.001）。颌面外科手术在B组更为常见（P<0.01）。治疗干预后两组的临床和多导睡眠图参数均有显著改善，但A组效果更佳。
合并其他疾病的儿童OSA患者肥胖和面部畸形更为常见，这类患者常需通气和手术等联合治疗。
