Purpose: Obstructive apnea is sometimes seen in patients with Beckwith- Wied emann syndrome. The cause of apnea is not limited to macroglossia, and the surgi cal indication for obstructive apnea has not yet been estab...Purpose: Obstructive apnea is sometimes seen in patients with Beckwith- Wied emann syndrome. The cause of apnea is not limited to macroglossia, and the surgi cal indication for obstructive apnea has not yet been established. The authors p erformed polysomnography for the assessment of apnea. Method: Overnight polysomn ograms were obtained in 2 patients who developed obstructive apnea after 1- sta ge repair for omphalocele. Case 1: Apnea index (AI), de fined as apneic events per hour, indicated 17.3, and SpO2 below 95% occupie d 80% of the total sleep time. Computed tomography and magnetic resonance imag ing indicated obstruction of the airway between macroglossia and the hypopharynx . Central tongue resection and the division of the frenulum linguae for associat ed ankyloglossia were performed 97 days after birth. One month after surgery, ap neic events disappeared and SpO2 below 95% occupied only 1% of the total sle ep time. Case 2: Obstructive AI indicated 28.1. Division of the frenulum linguae and anterior glossopexy were performed 55 days after birth. Postoperative polys omnogram indicated a marked reduction of AI. Conclusions: These results indicate d that polysomnography was useful for evaluating obstructive apnea and that adva ncement of the tongue by division of the frenulum linguae may be recommended for the treatment of obstructive apnea in patients with Beckwith- Wiedemann syndro me.展开更多
Aims:To assess the presence of a first night effect(FNE)in children and adolescents and to examine if a single night polysomnography(PSG)is sufficient for diagnosing obstructive sleep apnoea syndrome(OSAS).Methods:Pro...Aims:To assess the presence of a first night effect(FNE)in children and adolescents and to examine if a single night polysomnography(PSG)is sufficient for diagnosing obstructive sleep apnoea syndrome(OSAS).Methods:Prospective case study of 70 patients(group 1:2-6 years,n = 22;group 2:7-12 years,n = 32;group 3:13-17 years,n = 16)referred for OSAS.Diagnostic criteria for OSAS:one or more of the following:(1)obstructive apnoea index(OAI)≥1;(2)obstructive apnoea hypopnoea index(oAHI)≥2;(3)SaO2 ≤89%in association with obstruction.Results:In all age groups,but mainly in the oldest children,REMS increased during the second night,mainly at the expense of stage 2 sleep.The first night PSG correctly identified OSAS in 86%,91%,and 100%of the children for groups 1,2,and 3 respectively.This represents 9%false negatives for OSAS when only the first night PSG was used.All cases missed had mild OSAS,except for one with oAHI > 5 on night 2.There were also seven patients with OSAS on night 1 but with a normal PSG on night 2:all had oAHI < 5.Conclusion:There is a FNE in children and adolescents.A single night PSG is sufficient for diagnosing OSAS,but in cases with a suggestive history and examination and with a negative first night,a second night study might be advisable.展开更多
文摘Purpose: Obstructive apnea is sometimes seen in patients with Beckwith- Wied emann syndrome. The cause of apnea is not limited to macroglossia, and the surgi cal indication for obstructive apnea has not yet been established. The authors p erformed polysomnography for the assessment of apnea. Method: Overnight polysomn ograms were obtained in 2 patients who developed obstructive apnea after 1- sta ge repair for omphalocele. Case 1: Apnea index (AI), de fined as apneic events per hour, indicated 17.3, and SpO2 below 95% occupie d 80% of the total sleep time. Computed tomography and magnetic resonance imag ing indicated obstruction of the airway between macroglossia and the hypopharynx . Central tongue resection and the division of the frenulum linguae for associat ed ankyloglossia were performed 97 days after birth. One month after surgery, ap neic events disappeared and SpO2 below 95% occupied only 1% of the total sle ep time. Case 2: Obstructive AI indicated 28.1. Division of the frenulum linguae and anterior glossopexy were performed 55 days after birth. Postoperative polys omnogram indicated a marked reduction of AI. Conclusions: These results indicate d that polysomnography was useful for evaluating obstructive apnea and that adva ncement of the tongue by division of the frenulum linguae may be recommended for the treatment of obstructive apnea in patients with Beckwith- Wiedemann syndro me.
文摘Aims:To assess the presence of a first night effect(FNE)in children and adolescents and to examine if a single night polysomnography(PSG)is sufficient for diagnosing obstructive sleep apnoea syndrome(OSAS).Methods:Prospective case study of 70 patients(group 1:2-6 years,n = 22;group 2:7-12 years,n = 32;group 3:13-17 years,n = 16)referred for OSAS.Diagnostic criteria for OSAS:one or more of the following:(1)obstructive apnoea index(OAI)≥1;(2)obstructive apnoea hypopnoea index(oAHI)≥2;(3)SaO2 ≤89%in association with obstruction.Results:In all age groups,but mainly in the oldest children,REMS increased during the second night,mainly at the expense of stage 2 sleep.The first night PSG correctly identified OSAS in 86%,91%,and 100%of the children for groups 1,2,and 3 respectively.This represents 9%false negatives for OSAS when only the first night PSG was used.All cases missed had mild OSAS,except for one with oAHI > 5 on night 2.There were also seven patients with OSAS on night 1 but with a normal PSG on night 2:all had oAHI < 5.Conclusion:There is a FNE in children and adolescents.A single night PSG is sufficient for diagnosing OSAS,but in cases with a suggestive history and examination and with a negative first night,a second night study might be advisable.
