AI Article Synopsis
- - Obstructive sleep apnoea (OSA) in children is commonly caused by adenotonsillar hypertrophy, leading to a need for effective treatment options and comparisons among them.
- - A network meta-analysis involving 14 trials with 1064 participants assessed ten interventions, showing that surgical approaches were generally the most effective for reducing apnoea-hypopnea index (AHI), while rapid maxillary expansion (RME) showed significant improvement in lowest arterial oxygen saturation (SaO).
- - Despite the interventions studied, most trials did not achieve complete resolution of OSA, highlighting the ongoing challenge in effectively treating this condition in children.
Article Abstract
Background: Obstructive sleep apnoea (OSA) affects many children, and adenotonsillar hypertrophy is the most common cause of paediatric OSA.
Aim: Despite the growing treatment options, there is no comprehensive comparison of all interventions. We aimed to compare and rank the effectiveness of various treatments in a network meta-analysis.
Design: Literature was searched from inception to 13 May 2018 for paediatric OSA with adenotonsillar hypertrophy. The outcomes were the changes in apnoea-hypopnea index (AHI), oxyhaemoglobin desaturation index (ODI), and lowest arterial oxygen saturation (SaO ). Frequentist approach to network meta-analysis was used. Treatment hierarchy was summarized according to the surfaces under the cumulative ranking curves.
Results: Fourteen trials comprising 1064 paediatric OSA participants evaluating ten interventions (adenotonsillectomy, adenotonsillectomy + pharyngoplasty, adenotonsillotomy, antimicrobial therapy, steroids, leukotriene receptor antagonists [LTRAs], steroids + LTRAs, rapid maxillary expansion [RME], placebo, and no treatment) were identified for network meta-analysis. In terms of effectiveness in AHI reduction, surgical approach was still the most effective intervention than no treatment. RME was one of the most effective interventions to improve lowest SaO . No comparisons showed statistical significance in reducing ODI.
Conclusions: Irrespective of the intervention used, complete resolution of OSA was not achieved in most trials.
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| http://dx.doi.org/10.1111/ipd.12593 | DOI Listing |
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