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一例软骨发育不全小儿患者阻塞性睡眠呼吸暂停的病例报告。

A Case Report on Obstructive Sleep Apnea in a Pediatric Patient with Achondroplasia.

作者信息

Yee Eljohn C, Remulla Agnes T

机构信息

Department of Otolaryngology - Head and Neck Surgery, College of Medicine and Philippine General Hospital, University of the Philippines Manila.

出版信息

Acta Med Philipp. 2023 Aug 29;57(8):69-75. doi: 10.47895/amp.vi0.4969. eCollection 2023.

Abstract

A 22-month-old male diagnosed with achondroplasia was referred for difficulty in sleeping and was diagnosed to have severe obstructive sleep apnea (OSA) on polysomnography (PSG) (AHI 50.1). This patient had macrocephaly, midface hypoplasia, flat nasal bridge, relative macroglossia and enlarged palatine and adenoid tonsils. The patient underwent bilateral tonsillectomy with adenoidectomy without complication. Six months post-op, repeat polysomnography revealed a still severe (AHI 15.7) OSA with preferential recovery of REM and N3 sleep. Further outpatient follow-up and management is warranted. OSA despite being common in this subset of patients remains overlooked and not prioritized because of the multitude of coexisting concerns. Management of OSA in children with achondroplasia shows improved sleep structure and is helpful for further growth and development.

摘要

一名22个月大的男性被诊断为软骨发育不全,因睡眠困难前来就诊,经多导睡眠图(PSG)检查诊断为重度阻塞性睡眠呼吸暂停(OSA)(呼吸暂停低通气指数[AHI]为50.1)。该患者有巨头畸形、面中部发育不全、鼻梁扁平、相对巨舌以及腭扁桃体和腺样体肿大。患者接受了双侧扁桃体切除术和腺样体切除术,未出现并发症。术后6个月,重复多导睡眠图检查显示仍为重度OSA(AHI为15.7),快速眼动(REM)睡眠和N3睡眠优先恢复。需要进一步的门诊随访和管理。尽管OSA在这类患者中很常见,但由于存在众多并存问题,仍被忽视且未被列为优先处理事项。对软骨发育不全儿童的OSA进行治疗可改善睡眠结构,有助于其进一步生长发育。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3cb5/11522604/0433cd831b53/AMP-57-8-4969-g001.jpg

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