Predicting the effect of treatment in paediatric OSA by clinical examination and functional respiratory imaging

Slaats, M.; Vos, Wim; Holsbeke, Cedric Van; Backer, Jan De; Loterman, Dieter; Backer, Wilfried De; Boudewyns, An; Verhulst, Stijn

doi:10.1002/ppul.23684

Cited by 11 publications

(11 citation statements)

References 29 publications

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“…Slaats et al 22 and wake. During the sleep condition participants were tested in the sleep laboratory before and after a PSG.…”

Section: Treatment Of Osasmentioning

confidence: 99%

“…Slaats et al in Antwerp, Belgium prospectively studied 91 normal weight children with OSAS diagnosed by PSG, to assess the predictive value of functional respiratory imaging, using ultra low‐dose CT of the upper airway combined with computational fluid dynamics, for response to treatment. A second PSG was done 3‐12 months after treatment.…”

Section: Introductionmentioning

confidence: 99%

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Pediatric pulmonology year in review 2017: Part 4 (Sleep medicine)

Tapia

Noah

2018

Pediatric Pulmonology

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Pediatric Pulmonology publishes original research, case reports and review articles on topics related to a wide range of children's respiratory disorders. In this article (Part 4 of a 5-part series), we summarize the past year's publications in sleep medicine, in the context of selected literature in this area from other journals. Articles are highlighted on topics including diagnosis and treatment of OSAS, sleep duration and position, and sleep disorders in chronic disease.

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“…Slaats et al 22 and wake. During the sleep condition participants were tested in the sleep laboratory before and after a PSG.…”

Section: Treatment Of Osasmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pediatric pulmonology year in review 2017: Part 4 (Sleep medicine)

Tapia

Noah

2018

Pediatric Pulmonology

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“…This study was approved by the ethics committee of the Antwerp University Hospital (Edegem, Belgium). This study is based on retrospective analyses of data from previous research [15]. A detailed description of the methodology is described elsewhere with the primary outcomes of normal-weight children with OSA [15].…”

mentioning

confidence: 99%

“…This study is based on retrospective analyses of data from previous research [15]. A detailed description of the methodology is described elsewhere with the primary outcomes of normal-weight children with OSA [15]. All obese and nonobese children of various ethnicities diagnosed with OSA by polysomnography were included.…”

mentioning

confidence: 99%

“…A three-dimensional model of the UA was extracted from these images and combined with computational fluid dynamics (CFD) for FRI before treatment. Extraction of the UA morphology from the CT scan and extraction of UA characteristics from CFD have been described previously [15]. A paediatric otolaryngologist made the decision about the need for and type of surgery by using the combination of a detailed history, clinical assessment, polysomnography data and drug-induced sedation endoscopy.…”

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confidence: 99%

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The role of ethnicity in the upper airway in a Belgian paediatric population with obstructive sleep apnoea

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Association of Preoperative, Subjective Pediatric Tonsil Size With Tonsillectomy Outcomes

Pierce

Brietzke

2019

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Tonsil size assessment on physical examination is often used as a key component of clinical decision-making, specifically in estimating the success or failure of adenotonsillectomy surgery. The accuracy of this approach is not specifically known.OBJECTIVE To systematically review the biomedical literature for data comparing subjective preoperative tonsil (and adenoid) size (0-to >4-point scale) with adenotonsillectomy outcomes using polysomnography and/or quality of life outcomes. EVIDENCE REVIEW A PubMed and Embase search was conducted from June 1, 2018, through November 1, 2018, to identify articles comparing preoperative subjective tonsil and adenoid size with surgical outcomes. Key search terms included adenotonsillectomy, tonsil size, Brodsky scale, apnea-hypopnea index, OSA-18, polysomnography, and quality of life, with limits of 0 to 18 years of age. Inclusion criteria included articles on pediatric patients only, articles on patients who underwent tonsillectomy or adenotonsillectomy, and articles that included presurgical and postsurgical data. Exclusion criteria included patients who received surgery beyond adenotonsillectomy and studies that did not compare tonsil and adenoid size grades with surgical outcomes. FINDINGS A total of 27 studies were included in the final data set. The mean sample size was 79.7 (range, 17-250), and the mean age was 6.3 years (range, 4.2-12.8 years). Case series was the predominant study design (20 studies). Fourteen studies specifically excluded obesity and craniofacial syndromes, whereas 2 studies addressed patients with trisomy 21 only, and 5 studies focused on patients with obesity. Outcome measures included polysomnography (19 studies), Obstructive Sleep Apnea 18 survey (4 studies), Obstructive Sleep Apnea 6 (1 study), oxygen desaturation index (1 study), and overnight pulse oximetry (1 study). Ten studies conducted postoperative evaluations within 90 days of the intervention, and 17 studies had greater than 90-day follow-up. A total of 22 of the 27 studies (81.5%) concluded that there was no association between tonsil and adenoid size and surgical outcome, whereas 5 studies (18.5%) concluded that there was an association. Studies that found no association had a higher mean quality score than those that found an association (15.6 vs 14.5; difference in means, 1.13; 95% CI, 0.07-2.19). CONCLUSIONS AND RELEVANCEMost published clinical evidence suggests that subjective tonsil and adenoid size is not reliably associated with adenotonsillectomy success or failure because success rates are typically high regardless of tonsil size. Physicians should understand the potential limitations of using tonsil size alone as the key component of clinical decision-making for adenotonsillectomy.

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Predicting the effect of treatment in paediatric OSA by clinical examination and functional respiratory imaging

Abstract: 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.

Cited by 11 publications

References 29 publications

Pediatric pulmonology year in review 2017: Part 4 (Sleep medicine)

Pediatric pulmonology year in review 2017: Part 4 (Sleep medicine)

The role of ethnicity in the upper airway in a Belgian paediatric population with obstructive sleep apnoea

Association of Preoperative, Subjective Pediatric Tonsil Size With Tonsillectomy Outcomes

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