Kosko J R, Derkay C S
Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk 23507, USA.
Int J Pediatr Otorhinolaryngol. 1995 Jul;32(3):241-6. doi: 10.1016/0165-5876(95)01178-e.
Bona fide obstructive sleep apnea is rare in the pediatric age group. Traditional surgical management for pediatric obstructive sleep apnea (OSA) is adenotonsillectomy alone, however, severely affected children may require uvulopalatopharyngoplasty (UPPP) or tracheostomy to relieve their obstruction. Children with OSA along with other medical maladies (e.g. cerebral palsy, down syndrome) pose an additional challenge to the otolaryngologist due to poor muscular tone and other medical problems which may complicate postoperative management. We report on 15 children (aged 23 months-13 years, mean 7.4 years), 12 with severe mental insufficiency, with documented OSA who underwent classical or modified UPPP. Twelve of 15 had clinical and/or objective improvement. We conclude that UPPP has a role in the management of neurologically-impaired children with OSA.
真正的阻塞性睡眠呼吸暂停在儿童年龄组中很少见。小儿阻塞性睡眠呼吸暂停（OSA）的传统手术治疗方法是单纯腺样体扁桃体切除术，然而，病情严重的儿童可能需要进行悬雍垂腭咽成形术（UPPP）或气管切开术来缓解阻塞。患有OSA并伴有其他疾病（如脑瘫、唐氏综合征）的儿童，由于肌张力差和其他可能使术后管理复杂化的医疗问题，给耳鼻喉科医生带来了额外的挑战。我们报告了15名儿童（年龄在23个月至13岁之间，平均7.4岁），其中12名有严重智力缺陷，记录显示他们患有OSA并接受了经典或改良的UPPP。15名儿童中有12名有临床和/或客观改善。我们得出结论，UPPP在治疗患有OSA的神经功能受损儿童中具有作用。
