Reema Padia1, Harlan Muntz1, Kathleen Pfeffer2, Jeremy Meier1. 1. 1 Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA. 2. 2 Department of Pediatrics, Pediatric Pulmonology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Abstract
OBJECTIVES: (1) Review effectiveness of adenotonsillectomy (T&A) for obstructive sleep apnea (OSA) in children with Prader-Willi syndrome (PW). (2) Examine the incidence of velopharyngeal insufficiency (VPI) after T&A in this population. (3) Compare outcomes of T&A in PW and Trisomy 21 (T21) patients. METHODS: Outcomes after T&A in a PW cohort were retrospectively reviewed and compared to those in patients with T21. RESULTS: The study cohort included 22 PW patients. They were compared to 47 T21 patients who also underwent T&A. Eighteen percent (N = 4) of the PW patients had postoperative VPI requiring a corrective procedure, while there were no patients within the T21 cohort who had identified VPI ( P < .05). In those patients that had a postoperative polysomnogram, the mean decrease in obstructive apnea-hypopnea index (OAHI) of the PW and T21 patients measured 8.4 and 4.7 points, respectively ( P = .3). CONCLUSIONS: This study demonstrated a higher rate of VPI after T&A in PW children as compared to another at-risk cohort, T21 patients. While the OAHI decreased after T&A in both groups, a significant number of children with PW or T21 had persistent OSA. Further investigation into the optimal management of OSA, while preventing treatment complications such as VPI, is needed for children with these high-risk conditions.
OBJECTIVES: (1) Review effectiveness of adenotonsillectomy (T&A) for obstructive sleep apnea (OSA) in children with Prader-Willi syndrome (PW). (2) Examine the incidence of velopharyngeal insufficiency (VPI) after T&A in this population. (3) Compare outcomes of T&A in PW and Trisomy 21 (T21) patients. METHODS: Outcomes after T&A in a PW cohort were retrospectively reviewed and compared to those in patients with T21. RESULTS: The study cohort included 22 PW patients. They were compared to 47 T21 patients who also underwent T&A. Eighteen percent (N = 4) of the PW patients had postoperative VPI requiring a corrective procedure, while there were no patients within the T21 cohort who had identified VPI ( P < .05). In those patients that had a postoperative polysomnogram, the mean decrease in obstructive apnea-hypopnea index (OAHI) of the PW and T21 patients measured 8.4 and 4.7 points, respectively ( P = .3). CONCLUSIONS: This study demonstrated a higher rate of VPI after T&A in PW children as compared to another at-risk cohort, T21 patients. While the OAHI decreased after T&A in both groups, a significant number of children with PW or T21 had persistent OSA. Further investigation into the optimal management of OSA, while preventing treatment complications such as VPI, is needed for children with these high-risk conditions.
Authors: Jessica Duis; Lara C Pullen; Maria Picone; Norman Friedman; Stephen Hawkins; Elise Sannar; Anna C Pfalzer; Althea Robinson Shelton; Deepan Singh; Phyllis C Zee; Daniel G Glaze; Amee Revana Journal: J Clin Sleep Med Date: 2022-06-01 Impact factor: 4.324