Posted in
Clinical Pediatric, Literature Updates
Posted:
December 28, 2018
Authors: Chi-Chih Lai, MD, FACS, Pei-Wen Lin, MD , Hsin-Ching Lin, MD, FACS, Michael Friedman, MD, FACS, Hsueh-Wen Chang, PhD, Anna M. Salapatas, MS, Meng-Chih Lin, MD and Pa-Chun Wang, MD
Contributors: Denis H Jablonka, Rajeev Subramanyam
Published: Ann Otol Rhinol Laryngol.2018 Sep;127(9):608-613. doi: 10.1177/0003489418781961. Epub 2018 Jun 21.
This is a retrospective study in from Taiwan in children with documented OSAS by PSG. The authors sought to determine which clinical signs would be most significant when building a logistic regression model for pediatric AHI. They propose a formula that takes the child BMI, the degree of snoring and nasal obstruction to estimate the AHI. The authors cautioned that their findings warrant further validation in different world regions and in different race populations.
https://www.ncbi.nlm.nih.gov/pubmed/30550132
Posted in
Clinical Pediatric, Literature Updates
Posted:
December 28, 2018
Authors: George Κ. Mousailidisa , Vasileios A. Lachanasa, Afroditi Vasdekib , Emmanuel I. Alexopoulosc , Athanasios G. Kaditisd , Efthymia Petinakib , Nikolaos Balatsose , John G. Bizakisa , Charalampos E. Skoulakisa
Contributors: Denis H Jablonka, Rajeev Subramanyam
Published: Int J Pediatr Otorhinolaryngol. 2018 Dec;115:149-152. doi: 10.1016/j.ijporl.2018.10.002. Epub 2018 Oct 4.
In this study, the authors measure urinary levels of Cysteine Leukotrienes (CysLT) in children with documented severe OSAS by PSG before and after adenotonsillectomy. CysLT has been previously implicated in the development of adenotonsillar hypertrophy and pediatric OSAS. Children with residual OSAS were excluded. A total of 24 children were included for analysis. The authors suggest further studies in order to determine CysLT as valid biomarker for the presence of OSA in children.
https://www.ncbi.nlm.nih.gov/pubmed/?term=30368376
Posted in
Clinical Pediatric, Literature Updates
Posted:
September 20, 2018
Authors: Kishan M. Thadikonda, Amber D. Schaffer, Amanda L. Stapleton
Contributors: Denis H Jablonka, Rajeev Subramanyam
Published: Int J Pediatr Otorhinolaryngol. 2018 Mar;106:46-49.
Adenoidectomy-alone is a surgical option for young children given its low risk compared to adenotonsillectomy. This retrospective cohort study from Pittsburgh, Pennsylvania, addresses specific outcomes such as the rate of further surgical revisions and or tonsillectomy in children younger than three years of age. Thirty-five percent of children identified in this cohort (n=148) required additional surgical interventions within approximately 24 months of follow-up after adenoidectomy-alone. The most common procedure was adenotonsillectomy. Risk factors associated with residual symptoms following surgery were gastroesophageal reflux and tonsil size.
https://www.ncbi.nlm.nih.gov/pubmed/29447890
Posted in
Clinical Pediatric, Literature Updates
Posted:
September 20, 2018
Authors: Sarah Selvadurai Jason T Maynes Conor McDonnell Sharon L Cushing Evan J Propst Armando Lorenzo Andrew Lim Lisa J Meltzer Zihang Lu Richard L Horner Indra Narang
Contributors: Susana Vacas
Published: Sleep. 2018 Aug 1;41(8).
In this study, general anesthesia did not result in disturbed sleep or associated negative behavioral changes in otherwise healthy children undergoing elective surgeries of low complexity. Physicians can advise parents that a child’s surgery and associated generalanesthetic exposure may not result in significant changes in postoperative sleep patterns.
https://www.ncbi.nlm.nih.gov/pubmed/29741674
Posted in
Clinical Pediatric, Literature Updates
Posted:
June 5, 2018
Authors: Collu MA(1), Esteller E(2), Lipari F (3), Hasper R(4), Mulas D(4), Diaz MA(5), Dwivedi
Contributors: Denis H Jablonka, Rajeev Subramanyam
Published: RC(6) Int J Pediatr Otorhinolaryngol.2018 May;108:113-119. doi: 10.1016/j.ijporl.2018.02.038. Epub 2018 Mar 6.
Adenotonsillar hypertrophy is the most common cause but not the only cause for OSAS in children. This study looked at the role of DISE in 3 different categories of pediatric OSAS, “conventional”, “disproportional” and “persistent” OSAS. All subjects had preoperative confirmatory polysomnograms. The authors observed that, in otherwise healthy children, DISE changed the surgical plan more frequently in children with “disproportional” and “persistent” OSAS. Additional procedures included functional endoscopic sinus surgery (FESS) for polyp removal and pharyngoplasty for lateral pharyngeal wall collapse correction.
https://www.ncbi.nlm.nih.gov/pubmed/?term=29605338
Posted in
Clinical Pediatric, Literature Updates
Posted:
June 5, 2018
Authors: Hinkle J(1), Connolly HV(2), Adams HR(3), Lande MB(4).
Contributors: Denis H Jablonka, Rajeev Subramanyam
Published: J Am Soc Hypertens. 2018 Mar;12(3):204-210. doi: 10.1016/j.jash.2017.12.010. Epub 2018 Jan 3.
In summary, habitual snoring is common in children referred for elevated BP, and those with severe OSA are at higher risk of significantly increased BP.
https://www.ncbi.nlm.nih.gov/pubmed/29373256
Posted in
Clinical Pediatric, Literature Updates
Posted:
June 5, 2018
Authors: Macey PM, Kheirandish-Gozal L, Prasad JP, Ma RA, Kumar R, Philby MF, Gozal D
Contributors: Susana Vacas
Published: Front Neurol. 2018 Jan 22;9:4
Changes in cortical thickness are present in children with OSA and likely indicate disruption to neural developmental processes, including maturational patterns of cortical volume increases and synaptic pruning. Regions with thicker cortices may reflect inflammation or astrocyte activation. Both the thinning and thickening associated with OSA in children may contribute to the cognitive and behavioral dysfunction frequently found in the condition.
https://www.ncbi.nlm.nih.gov/pubmed/29403430
Posted in
Clinical Pediatric, Literature Updates
Posted:
March 27, 2018
Authors: Zeng G, Teng Y, Zhu J, Zhu D, Yang B, Hu L, Chen M, Fu X.
Contributors: Rajeev Subramanyam, Denis Jablonka
Published: Medicine (Baltimore). 2018 Jan;97(4):e9680
“Stenosis of the nasopalatine pharyngeal cavity in children with adenoidal hypertrophy was greatest at the end-expiration phase during sleep. The end-expiratory Sa/Snp obtained by a combination of MRI and respiratory gating technology has potential as an important imaging index for diagnosing and evaluating severity in pediatric OSAHS.”
https://www.ncbi.nlm.nih.gov/pubmed/29369187
Posted in
Clinical Pediatric, Literature Updates
Posted:
March 27, 2018
Authors: Dirain CO, Silva RC, Collins WO, Antonelli PJ.
Contributors: Rajeev Subramanyam, Denis Jablonka
Published: J Int Adv Otol. 2017 Dec;13(3):333-339.
“Microbes are present on all adenoid specimens, though the microbial profile differs between recurrent AOM and OSA. The clinical significance of these differences remains to be determined.”
https://www.ncbi.nlm.nih.gov/pubmed/29360088
Posted in
Clinical Pediatric, Literature Updates
Posted:
March 27, 2018
Authors: Narang I, McCrindle BW, Manlhiot C, Lu Z, Al-Saleh S, Birken CS, Hamilton J.
Contributors: Rajeev Subramanyam, Denis Jablonka
Published: Sleep Breath. 2018 Jan 22.
“Intermittent nocturnal hypoxia rather than the OAHI was associated with metabolic risk in obese youth after adjusting for WHtR. Measures of abdominal adiposity such as WHtR should be considered in future studies that evaluate the impact of OSA on metabolic health.”
https://www.ncbi.nlm.nih.gov/pubmed/29357088See comment in PubMed Commons below
