Mauer K W, Staats B A, Olsen K D
Mayo Clin Proc. 1983 Jun;58(6):349-53.
Fourteen children with disordered breathing during sleep (obstructive apnea, obstructive hypopnea, or snoring) and anatomic obstruction of the upper airway were studied. Twelve children had hypertrophied tonsils and adenoids, and two had a deviated nasal septum. No child had sequelae of severe sleep apnea--that is, cor pulmonale, pulmonary hypertension, or alveolar hypoventilation. Results of polysomnographic studies were abnormal in all and revealed that obstructive hypopnea (increased respiratory effort with decreased airflow) was more common than obstructive apnea (increased respiratory effort without airflow). Surgical removal or correction of the upper airway obstructive lesion in 12 children resulted in normal nocturnal respiration. Surgical intervention was declined in two patients, and their symptoms persist. We conclude that surgical removal of upper airway obstructive lesions in children with disturbed nocturnal sleep should not be reserved only for those with serious sequelae of obstructive sleep apnea; considerable benefit is gained in selected patients with mild obstructive sleep apnea or hypopnea.
对14名睡眠期间呼吸紊乱（阻塞性呼吸暂停、阻塞性呼吸不足或打鼾）且存在上呼吸道解剖性阻塞的儿童进行了研究。12名儿童患有扁桃体和腺样体肥大，2名儿童患有鼻中隔偏曲。没有儿童出现严重睡眠呼吸暂停的后遗症，即肺心病、肺动脉高压或肺泡通气不足。所有多导睡眠图研究结果均异常，显示阻塞性呼吸不足（气流减少时呼吸努力增加）比阻塞性呼吸暂停（无气流时呼吸努力增加）更常见。12名儿童的上呼吸道阻塞性病变经手术切除或矫正后，夜间呼吸恢复正常。两名患者拒绝手术干预，其症状持续存在。我们得出结论，对于夜间睡眠受扰的儿童，不应仅将上呼吸道阻塞性病变的手术切除保留给那些患有阻塞性睡眠呼吸暂停严重后遗症的儿童；对于某些轻度阻塞性睡眠呼吸暂停或呼吸不足的患者，也能获得相当大的益处。
