Monique Slaats1,2, Wim Vos3, Cedric Van Holsbeke3, Jan De Backer3, Dieter Loterman3, Wilfried De Backer2,4, An Boudewyns5, Stijn Verhulst1,2. 1. Department of Paediatrics, Antwerp University Hospital, Edegem, Belgium. 2. Laboratory of Experimental Medicine and Paediatrics (LEMP), University of Antwerp, Universiteitsplein 1, Antwerp, Belgium. 3. FLUIDDA, Kontich, Belgium. 4. Department of Respiratory Medicine, Antwerp University Hospital, Edegem, Belgium. 5. Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium.
Abstract
OBJECTIVE: The aim of this study was to investigate whether functional respiratory imaging (FRI) or clinical examination could predict treatment outcome for obstructive sleep apnea (OSA) in normal-weight, non-syndromic children. METHODS: Normal weight children diagnosed with OSA by polysomnography were prospectively included. All children got a thorough evaluation and an ultra-low dose computed tomography scan of the upper airway (UA). A 3-D reconstruction was built combined with computational fluid dynamics for FRI. Decisions on the need and type of surgery were based upon findings during drug-induced sleep endoscopy. A second polysomnography was performed 3-12 months after surgery. RESULTS: Ninety-one children were included: 62 boys, 5.0 ± 2.7 years, and BMI z-score of -0.1 ± 1.2. Children with more severe OSA had a smaller volume of the overlap region between the adenoids and tonsils. Nineteen out of 60 patients had persistent OSA (oAHI >2/h). A lower conductance in the UA and a higher tonsil score predicted successful treatment. CONCLUSIONS: A less constricted airway, as characterized by both FRI and a lower tonsil score, was associated with a less favorable response to (adeno) tonsillectomy. Further studies after treatment using FRI and DISE are warranted to further characterize the UA of these subjects.
OBJECTIVE: The aim of this study was to investigate whether functional respiratory imaging (FRI) or clinical examination could predict treatment outcome for obstructive sleep apnea (OSA) in normal-weight, non-syndromic children. METHODS: Normal weight children diagnosed with OSA by polysomnography were prospectively included. All children got a thorough evaluation and an ultra-low dose computed tomography scan of the upper airway (UA). A 3-D reconstruction was built combined with computational fluid dynamics for FRI. Decisions on the need and type of surgery were based upon findings during drug-induced sleep endoscopy. A second polysomnography was performed 3-12 months after surgery. RESULTS: Ninety-one children were included: 62 boys, 5.0 ± 2.7 years, and BMI z-score of -0.1 ± 1.2. Children with more severe OSA had a smaller volume of the overlap region between the adenoids and tonsils. Nineteen out of 60 patients had persistent OSA (oAHI >2/h). A lower conductance in the UA and a higher tonsil score predicted successful treatment. CONCLUSIONS: A less constricted airway, as characterized by both FRI and a lower tonsil score, was associated with a less favorable response to (adeno) tonsillectomy. Further studies after treatment using FRI and DISE are warranted to further characterize the UA of these subjects.
Authors: Monique A L J Slaats; Dieter Loterman; Cedric van Holsbeke; Wim Vos; Kim Van Hoorenbeeck; Jan de Backer; Wilfried de Backer; Marek Wojciechowski; An Boudewyns; Stijn Verhulst Journal: J Clin Sleep Med Date: 2018-04-15 Impact factor: 4.062