1. Changes during medical treatments before adenotonsillectomy in children with obstructive sleep apnea
- Author
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Mariko Hiyama, Taisuke Kobayashi, Masamitsu Hyodo, Taihei Kajiyama, and Masahiro Komori
- Subjects
Pediatrics ,medicine.medical_specialty ,Tonsillitis ,Polysomnography ,Severity of Illness Index ,Adenoidectomy ,stomatognathic system ,medicine ,Humans ,Outpatient clinic ,Prospective Studies ,Child ,Sinusitis ,Prospective cohort study ,Tonsillectomy ,Sleep Apnea, Obstructive ,medicine.diagnostic_test ,Medical treatment ,business.industry ,General Medicine ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Obstructive sleep apnea ,Otorhinolaryngology ,Surgery ,business ,Adenoid hypertrophy - Abstract
The severity of pediatric obstructive sleep apnea (OSA) can vary from mild to very severe (AHI ≥ 30 events/h) with the seasons. The efficacy of medical treatment has been investigated in cases of mild and moderate pediatric OSA, but not in severe cases thoroughly.Our prospective cohort study involved 205 children who visited our outpatient clinic between December 2014 and May 2020. We performed home sleep tests after the initial visit, and then polysomnography after optimizing the control of rhinitis, sinusitis, adenoid hypertrophy, and tonsillitis by using medical treatments.The respective proportions of patients who improved to obstructive AHI (O-AHI)1/h or who proceeded to surgery were 43.4% and 62.3% in mild cases; 43.3% and 52.2% in moderate cases; 30.2% and 68.4% in severe cases; and 0.0% and 100% in very severe cases. Additionally, nadir SaOMedical treatment instituted before a surgical decision is made can provide substantial benefits and avoid unnecessary surgery if there is time for such treatments. In contrast, it may be difficult to normalize the O-AHI in pediatric patients with very severe OSA or a nadir SaO
- Published
- 2022