Managing the Child with Persistent Sleep Apnea

Andrew E Bluher; Stacey L Ishman; Cristina M Baldassari

doi:10.1016/j.otc.2019.06.004

Managing the Child with Persistent Sleep Apnea

Otolaryngol Clin North Am. 2019 Oct;52(5):891-901. doi: 10.1016/j.otc.2019.06.004. Epub 2019 Jul 10.

Authors

Andrew E Bluher¹, Stacey L Ishman², Cristina M Baldassari³

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, 600 Gresham Drive, Suite 1100, Norfolk, VA 23507, USA.
² Division of Pediatric Otolaryngology-Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC# 2018, Cincinnati, OH 45229-2018, USA; Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, MLC# 2018, Cincinnati, OH 45229-2018, USA.
³ Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, 600 Gresham Drive, Suite 1100, Norfolk, VA 23507, USA; Departments of Pediatric Otolaryngology and Pediatric Sleep Medicine, Children's Hospital of the King's Daughters, 601 Children's Lane, 2nd Floor, Norfolk, VA 23507, USA. Electronic address: baldassc@gmail.com.

PMID: 31301824
DOI: 10.1016/j.otc.2019.06.004

Abstract

Pediatric obstructive sleep apnea (OSA) affects 2% to 4% of American children, and is associated with metabolic, cardiovascular, and neurocognitive sequelae. The primary treatment for pediatric OSA is adenotonsillectomy. Children with obesity, craniofacial syndromes, and severe baseline OSA are at risk for persistent disease. Evaluation of persistent OSA should focus on identifying the causes of upper airway obstruction. Interventions should be tailored to address the patient's symptomatology, sites of obstruction, and preference for surgical versus medical management. Further research is needed to identify management protocols that result in improved outcomes for children with persistent OSA.

Keywords: DISE; Pediatric obstructive sleep apnea; Persistent OSA; Tongue base obstruction.

Publication types

Review

MeSH terms

Adenoidectomy
Airway Obstruction / diagnosis*
Airway Obstruction / etiology
Airway Obstruction / surgery*
Child
Endoscopy
Humans
Magnetic Resonance Imaging
Polysomnography
Sleep Apnea, Obstructive / diagnosis*
Sleep Apnea, Obstructive / etiology
Sleep Apnea, Obstructive / surgery*
Tonsillectomy