Aubertin G, Akkari M, Andrieux A, Colas des Francs C, Fauroux B, Franco P, Gagnadoux F, de Santerre O Gallet, Grollemund B, Hartley S, Jaffuel D, Lafond L, Schröder C M, Schweitzer C, Charley-Monaca C
Pediatric Pulmonology, Armand Trousseau Hospital, AP-HP Hospital, Sorbonne University, Paris, 75012, France; Centre de recherche Saint Antoine (CRSA), INSERM UMR-S 938, Paris, 75012, France; Centre de pneumologie de l'enfant, Ramsay Générale de Santé, Boulogne-Billancourt, 92100, France.
Ear, Nose and Throat & Head and Neck Surgery, University Hospital Gui de Chauliac, University of Montpellier, Montpellier, 34000, France.
Arch Pediatr. 2023 Oct;30(7):510-516. doi: 10.1016/j.arcped.2023.06.009. Epub 2023 Aug 2.
This document is the outcome of a group of experts brought together at the request of the French Society of Sleep Research and Medicine to provide recommendations for the management of obstructive sleep apnea syndrome type 1 (OSA) in children. The recommendations are based on shared experience and published literature. OSA is suspected when several nighttime respiratory symptoms related to upper airway obstruction are identified on clinical history taking. A specialist otolaryngologist examination, including nasofibroscopy, is essential during diagnosis. A sleep study for OSA is not mandatory when at least two nighttime symptoms (including snoring) are noted. Therapeutic management must be individualized according to the location of the obstruction. Ear, nose, and throat (ENT) surgery is often required, as hypertrophy of the lymphoid tissues is the main cause of OSA in children. According to clinical findings, orthodontic treatment generally associated with specialized orofacial-myofunctional therapy might also be indicated. Whatever treatment is chosen, follow-up must be continuous and multidisciplinary, in a network of trained specialists.
本文件是应法国睡眠研究与医学协会的要求，召集一组专家为儿童1型阻塞性睡眠呼吸暂停综合征（OSA）的管理提供建议的成果。这些建议基于共同经验和已发表的文献。当在临床病史采集过程中发现与上气道阻塞相关的几种夜间呼吸症状时，怀疑患有OSA。诊断期间，由专科耳鼻喉科医生进行检查，包括鼻纤维镜检查，这至关重要。当至少注意到两种夜间症状（包括打鼾）时，OSA的睡眠研究并非必需。治疗管理必须根据阻塞部位个体化。由于淋巴组织肥大是儿童OSA的主要原因，通常需要进行耳鼻喉（ENT）手术。根据临床发现，通常与专门的口面肌功能治疗相关的正畸治疗也可能适用。无论选择何种治疗方法，都必须在经过培训的专家网络中进行持续的多学科随访。
