Annie N Farrell1, Steven L Goudy2, Marianne E Yee3, Roberta M Leu4, April M Landry2. 1. Emory University School of Medicine, 1648 Pierce Drive NE, Atlanta, GA, 30307, USA. Electronic address: Farrell.annie@gmail.com. 2. Emory University School of Medicine, 1648 Pierce Drive NE, Atlanta, GA, 30307, USA; Children's Hospital of Atlanta, Department of Otolaryngology, Division of Pediatric Otolaryngology, 2015 Uppergate Drive, Atlanta, GA, 30322, USA. 3. Emory University School of Medicine, 1648 Pierce Drive NE, Atlanta, GA, 30307, USA; Children's Hospital of Atlanta, Department of Pediatrics, Division of Hematology/Oncology, 2015 Uppergate Drive, Atlanta, GA, 30322, USA; Children's Hospital of Atlanta, Aflac Cancer and Blood Disorders Center, 1405 Clifton Road, Atlanta, GA, 30329, USA. 4. Emory University School of Medicine, 1648 Pierce Drive NE, Atlanta, GA, 30307, USA; Children's Hospital of Atlanta, Department of Pediatrics, Division of Pulmonary, Allergy/Immunology, Cystic Fibrosis, and Sleep, 1605 Chantilly Drive NE, Atlanta, GA, 30324, USA.
Abstract
INTRODUCTION: Obstructive sleep apnea (OSA) is prevalent and may be more severe in children with Sickle Cell Disease (SCD) compared to the general pediatric population. OBJECTIVES: The objective of this study was to describe the therapeutic effects and complications of tonsillectomy and adenoidectomy (T&A) for treatment of OSA in children with SCD. METHODS: A comprehensive database of pediatric SCD patients was reviewed to identify all patients who underwent T&A between 2010 and 2016. An IRB-approved, retrospective review of laboratory values, perioperative course, pre- and post-T&A hospital utilization, and polysomnography was conducted. RESULTS: There were 132 SCD children (108 HbSS) who underwent T&A. Mean age was 7.6 ± 4.6 years. The mean baseline hemoglobin of these patients was 9.3 ± 1.4 g/dL; 72.7% of patients had pre-operative transfusion, such that the mean Hb at time of T&A was 11.4 ± 1.0 g/dL. The average admission length surrounding T&A was 3.5 ± 1.2 days. Complications were documented in 11.4% of operative cases. Polysomnography was available in 104 pre-T&A and 45 post-T&A. The Apnea-Hypopnea Index decreased on post-T&A polysomnogram (7.6 ± 8.7 vs. 1.3 ± 1.9, p = 0.0001). The O2 nadir improved on post-T&A polysomnogram (81.2 ± 10.8 vs. 89.3 ± 7, p = 0.0003). Emergency room visits (mean events per year) decreased post-operatively (2.6 ± 2.8 vs. 1.8 ± 2.2, p = 0.0002). CONCLUSIONS: T&A can be a safe and effective option to treat OSA in pediatric patients with SCD and was significantly associated with reduced AHI and fewer ER visits post-operatively.
INTRODUCTION:Obstructive sleep apnea (OSA) is prevalent and may be more severe in children with Sickle Cell Disease (SCD) compared to the general pediatric population. OBJECTIVES: The objective of this study was to describe the therapeutic effects and complications of tonsillectomy and adenoidectomy (T&A) for treatment of OSA in children with SCD. METHODS: A comprehensive database of pediatric SCDpatients was reviewed to identify all patients who underwent T&A between 2010 and 2016. An IRB-approved, retrospective review of laboratory values, perioperative course, pre- and post-T&A hospital utilization, and polysomnography was conducted. RESULTS: There were 132 SCDchildren (108 HbSS) who underwent T&A. Mean age was 7.6 ± 4.6 years. The mean baseline hemoglobin of these patients was 9.3 ± 1.4 g/dL; 72.7% of patients had pre-operative transfusion, such that the mean Hb at time of T&A was 11.4 ± 1.0 g/dL. The average admission length surrounding T&A was 3.5 ± 1.2 days. Complications were documented in 11.4% of operative cases. Polysomnography was available in 104 pre-T&A and 45 post-T&A. The Apnea-Hypopnea Index decreased on post-T&A polysomnogram (7.6 ± 8.7 vs. 1.3 ± 1.9, p = 0.0001). The O2 nadir improved on post-T&A polysomnogram (81.2 ± 10.8 vs. 89.3 ± 7, p = 0.0003). Emergency room visits (mean events per year) decreased post-operatively (2.6 ± 2.8 vs. 1.8 ± 2.2, p = 0.0002). CONCLUSIONS: T&A can be a safe and effective option to treat OSA in pediatric patients with SCD and was significantly associated with reduced AHI and fewer ER visits post-operatively.
Authors: A Parker Ruhl; S Christy Sadreameli; Julian L Allen; Debra P Bennett; Andrew D Campbell; Thomas D Coates; Dapa A Diallo; Joshua J Field; Elizabeth K Fiorino; Mark T Gladwin; Jeffrey A Glassberg; Victor R Gordeuk; Leroy M Graham; Anne Greenough; Jo Howard; Gregory J Kato; Jennifer Knight-Madden; Benjamin T Kopp; Anastassios C Koumbourlis; Sophie M Lanzkron; Robert I Liem; Roberto F Machado; Alem Mehari; Claudia R Morris; Folasade O Ogunlesi; Carol L Rosen; Kim Smith-Whitley; Danna Tauber; Nancy Terry; Swee Lay Thein; Elliott Vichinsky; Nargues A Weir; Robyn T Cohen; Elizabeth S Klings Journal: Ann Am Thorac Soc Date: 2019-09
Authors: Ilaria Liguoro; Michele Arigliani; Bethany Singh; Lisa Van Geyzel; Subarna Chakravorty; Cara Bossley; Maria Pelidis; David Rees; Baba P D Inusa; Atul Gupta Journal: ERJ Open Res Date: 2020-10-26