Premium
Surgical therapy of obstructive sleep apnea in children with severe mental insufficiency
Author(s) -
Seid Allan B.,
Martin Peter J.,
Pransky Seth M.,
Kearns Donald B.
Publication year - 1990
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-199005000-00013
Subject(s) - medicine , uvulopalatopharyngoplasty , obstructive sleep apnea , failure to thrive , tracheotomy , airway obstruction , pediatrics , macroglossia , apnea , airway , surgery , polysomnography , anesthesia , tongue , pathology
Obstructive sleep apnea is the underlying cause of a variety of pediatric maladies, including pulmonary hypertension and failure to thrive. In children, unlike adults, obstruction secondary to lymphoid hyperplasia is often encountered; adenotonsillectomy restores airway patency. Patients who fail this procedure, such as children with cerebral palsy and associated muscular hypotonia, may face tracheotomies. We report on 10 pediatric patients with severe mental insufficiency and obstructive sleep apnea in whom palatal hypotonicity and lack of adenotonsillar hypertrophy was identified. Uvulopalatopharyngoplasty was performed in conjunction with adenotonsillectomy to enlarge the diameter of the nasopharyngeal inlet with successful resolution of the obstructive symptoms in eight patients. The remaining two children required more surgery. This procedure is presented as a possible alternative to tracheotomy in selected patients.