학술논문
Does drug induced sleep endoscopy-directed surgery improve polysomnography measures in children with Down Syndrome and obstructive sleep apnea?
Document Type
Article
Author
Source
Subject
*DIAGNOSIS of Down syndrome
*ADENOIDECTOMY
*CARBON dioxide
*ENDOSCOPY
*LONGITUDINAL method
*OXYGEN
*POSTOPERATIVE period
*SLEEP apnea syndromes
*T-test (Statistics)
*TONSILLECTOMY
*POLYSOMNOGRAPHY
*DOWN syndrome
*TREATMENT effectiveness
*MEDICAL records
*RETROSPECTIVE studies
*PREOPERATIVE period
*DIAGNOSIS
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Language
ISSN
0001-6489
Abstract
Background: Children with Down Syndrome (DS) and obstructive sleep apnea (OSA) are difficult to treat, as first line therapies may not lead to significant improvement. Drug-induced sleep endoscopy (DISE) directed surgery may be particularly beneficial for these patients. Objective: To assess change in polysomnography (PSG) measures of patients with DS who underwent DISE-directed surgery. Methods: Retrospective chart review was performed on patients with DS who underwent DISE-directed surgery and had pre- and post-surgery PSG. Patients were analyzed in groups defined by previous adenotonsillectomy. Two-sided t-tests with equal variances were used to assess statistical significance. Results: Of 24 patients reviewed, 14 were surgically naïve and 10 had undergone prior adenotonsillectomy. The primary outcome was change in PSG parameters including apnea hypopnea index, obstructive apnea hypopnea index, oxygen nadir, oxygen desaturation index, and mean carbon dioxide level. While improvement was seen in all PSG parameters, only improvement in oxygen nadir in children who had undergone prior adenotonsillectomy was statistically significant (88.5% to 90.9%, p = .04). Conclusions and Significance: DISE-directed surgery may be beneficial for children with DS and OSA, with improvement in the means of main PSG measures observed. A larger, prospective study is warranted to further explore DISE utility. [ABSTRACT FROM AUTHOR]