Airway obstruction in children with cerebral palsy: Need for tracheostomy?

Kontorinis, Georgios; Thevasagayam, Mahilravi; Bateman, Neil

doi:10.1016/j.ijporl.2013.07.017

Cited by 32 publications

(19 citation statements)

References 13 publications

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“…In this study, all children had received a tracheostomy. Because the severity of airway obstruction with aspiration in children with CP tends to increase with age, children with CP are likely to require a tracheostomy as they get older [19]. In general, transitioning from mechanical ventilation using an endotracheal tube to tracheostomy is helpful to improve oral hygiene [20].…”

Section: Discussionmentioning

confidence: 99%

Oral hygiene and oral status of institutionalized children with motor and intellectual disabilities

et al. 2020

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The oral hygiene and oral status of children with severe disabilities with both nutritional and respiratory complications who were institutionalized at Karugamonoie (KNI), a facility for children with disabilities, were investigated in this study. Their oral hygiene management was solely dependent on caregivers and nurses at the institution. Thirty children (13 females, 17 males; average age, 7.6 years) who had a tracheotomy and feeding tube (gastrostomy, nasogastric, or jejunostomy feeding tube) were included in the study. As for oral characteristics, poor control of tongue movement, anterior open-bite, abnormal strain of facial muscles, dry mouth, and swallowing dysfunction were found in 63.3%, 63.3%, 13.3%, 20.0%, and 100.0%, of the children, respectively. The mean ± standard deviation Decayed, Missing, Filled Teeth score was 0.13 ± 0.57. The Gingival Index (GI) showed that the children had mild (53.3%) to moderate (46.7%) gingivitis. The Simplified Oral Hygiene Index was excellent in 50.0% of the children, good in 23.3%, fair in 20.0%, and poor in 6.7% of the children. These indices were satisfactory in general except for GI management, which may have been hampered by abnormal oral functions and anterior open-bite. In conclusion, oral hygiene management of children with nutritional and respiratory complications at KNI was shown to be of high quality even without on-site intervention by dental specialists.

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Section: Discussionmentioning

confidence: 99%

Oral hygiene and oral status of institutionalized children with motor and intellectual disabilities

et al. 2020

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“…Management can include surgery, non‐invasive ventilation, or tracheostomy in very severe cases . The requirement for tracheostomy might increase with age . Positioning and tone management are also important treatment strategies that can normalize the breathing pattern in individual patients.…”

Section: Recurrent Aspirationmentioning

confidence: 99%

“…6 The requirement for tracheostomy might increase with age. 38 Positioning and tone management are also important treatment strategies that can normalize the breathing pattern in individual patients. Although upper airway obstruction, both during sleep and wakefulness, is prevalent in patients with CP with a clear association with lower quality of life, the link with recurrent respiratory infection is not well investigated.…”

Section: Upper Airway Obstruction and Hypoventilationmentioning

confidence: 99%

Respiratory morbidity in children with cerebral palsy: an overview

Boel

Pernet²,

Toussaint³

et al. 2018

Develop Med Child Neuro

121

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Respiratory problems have a significant impact on morbidity and mortality in patients with cerebral palsy (CP). In particular, recurrent aspiration, impaired airway clearance, spinal and thoracic deformity, impaired lung function, poor nutritional status, and recurrent respiratory infections negatively affect respiratory status. Bronchopulmonary dysplasia may contribute to pulmonary problems, but asthma is not more common in CP than in the general population. We discuss treatment options for each of these factors. Multiple coexisting and interacting factors that influence the respiratory status of patients with CP should be recognized and effectively addressed to reduce respiratory morbidity and mortality. What this paper adds Respiratory problems are a significant cause of morbidity in patients with cerebral palsy (CP). Respiratory status in patients with CP is influenced by recurrent aspiration and impaired airway clearance. Spinal and thoracic deformity, impaired lung function, poor nutrition, and respiratory infections also negatively affect respiratory status. These factors should all be addressed to reduce respiratory problems in patients with CP.

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“…In children with cerebral palsy and OSAS, benefits in some aspects of health (OSAS symptoms, sleep disturbance, daytime functioning, and caregiver concern) were obtained after AT . Kontorinis et al summarized findings in 15 children with cerebral palsy and upper airway obstruction. AT was performed in 73.3% of patients, but more than half of them required tracheostomy despite AT after an average time interval of 1.9 years.…”

Section: Factors Associated With Persistent Osas After Adenotonsillecmentioning

confidence: 99%

Adenotonsillectomy to treat obstructive sleep apnea: Is it enough?

Boudewyns

Abel

Alexopoulos

et al. 2017

Pediatric Pulmonology

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Although adenotonsillectomy is the first line treatment for children with obstructive sleep apnea syndrome (0SAS), improvement in objectively documented outcomes is often inadequate and a substantial number of children have residual disease. Early recognition and treatment of children with persistent OSAS is required to prevent long-term morbidity. The management of these children is frequently complex and a multidisciplinary approach is required as most of them have additional risk factors for OSAS and comorbidities. In this paper, we first provide an overview of children at risk for persistent disease following adenotonsillectomy. Thereafter, we discuss different diagnostic modalities to evaluate the sites of persistent upper airway obstruction and the currently available treatment options. Pediatr Pulmonol. 2017;52:699-709. © 2016 Wiley Periodicals, Inc.

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Airway obstruction in children with cerebral palsy: Need for tracheostomy?

Cited by 32 publications

References 13 publications

Oral hygiene and oral status of institutionalized children with motor and intellectual disabilities

Oral hygiene and oral status of institutionalized children with motor and intellectual disabilities

Respiratory morbidity in children with cerebral palsy: an overview

Adenotonsillectomy to treat obstructive sleep apnea: Is it enough?

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