Introduction: Obstructive sleep apnea syndrome (OSAS) commonly appears in patients with Pierre Robin sequence (PR). Polysomnography (PS) is the gold standard for the diagnosis of OSAS. Videonasopharyngoscopy (VNP) is the best diagnostic tool for visualizing the vocal tract and detecting structural abnormalities which can be associated with OSAS.
Objective: The purpose of this paper is to study whether VNP can be useful for identifying severe OSAS in a population of children with PR.
Materials And Methods: Fifty-two children with PR who were present with sleep-disordered breathing were studied. All the parents completed a questionnaire concerning the children's sleeping habits and sleep complaints before consultation. Each child underwent a general pediatric examination and an evaluation of craniofacial features and upper airway permeability. In all children, a PS was performed. Also, all children underwent a VNP.
Results: The diagnosis of OSAS was confirmed by PS in 31 patients. VNP showed 87% sensitivity and 100% specificity for the detection of OSAS. VNP findings showed a significant correlation with apnea-hypopnea index, arousal index, snoring time, percentage of sleep time spent at saturation of oxygen <90% and a significant inverse correlation with total sleep time, sleep efficiency and the mean saturation of oxygen during sleep.
Conclusion: This study shows that in children with PR, airway obstruction as detected by VNP seems to be a risk factor for OSAS. VNP appears to be a safe and reliable tool for the evaluation of sleep-disordered breathing in children with PR.
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http://dx.doi.org/10.1016/j.ijporl.2004.07.009 | DOI Listing |
BMJ Support Palliat Care
December 2024
Université de Franche-Comté, UMR 1098, Besancon, France.
Background: Although the benefit of supportive care in the postcancer period is now well demonstrated, its implementation in the patient journey remains challenging. This article describes the development, since 2015 and in routine care, of supportive postcancer care comprising a multidisciplinary rehabilitation programme (MRP) based on exercise for patients with early breast cancer.
Methods: As part of quality control, we reviewed all patient files since the programme was implemented.
Early Hum Dev
December 2024
Perth Children's Hospital, Perth, Western Australia, Australia; University of Western Australia, Perth, Western Australia, Australia. Electronic address:
Objective: To estimate the global prevalence of neurodevelopmental impairment in children with Robin sequence (RS) at one year or more of age.
Study Design: Electronic databases such as PubMed, Embase, CINAHL, APA PsycInfo, Emcare, MedNAR and Cochrane library were searched systematically from inception to 31st May 2024. Studies reporting on the neurodevelopmental (global, cognitive, or motor) outcomes in children with RS were included.
We present a case of an infant patient with Robin sequence (Pierre Robin sequence; PRS) who underwent general anesthesia for a glossopexy procedure. Pediatric patients with PRS are prone to upper airway obstruction during general anesthesia induction and intubation difficulties due to micrognathia and glossoptosis. In this case, we facilitated mask ventilation by inserting a nasopharyngeal airway before induction and successfully intubated the patient using a 2-person technique that combined the use of a video laryngoscope and a flexible fiber-optic scope.
View Article and Find Full Text PDFJ Clin Sleep Med
December 2024
Department of Surgery, Division of Plastic and Reconstructive Surgery, Section of Craniofacial Airway Orthodontics, Stanford University School of Medicine, Palo Alto, California.
Cleft Palate Craniofac J
December 2024
Department of Surgery, Division of Plastic and Reconstructive Surgery, Section of Craniofacial Airway Orthodontics, Stanford University School of Medicine, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA.
Objective: To assess craniofacial and upper airway growth in infants with Robin sequence (RS) during the 1 year of life when their severe upper airway obstruction was treated non-surgically with the Stanford orthodontic airway plate treatment program (SOAP).
Design: Retrospective longitudinal cohort study comparing SOAP-treated infants with RS (treatment group) with age-matched healthy controls (HC) using computed tomography (CT).
Setting: Single tertiary referral hospital.
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