Long-term follow-up and mechanisms of obstructive sleep apnea (OSA) and related syndromes through infancy and childhood.
BACKGROUND
Although tonsil and adenoid (T&A) enlargement in children is a leading cause of it, Obstructive Sleep Apnea (OSA) may occur at any age. But even after T&A surgery, some children experience recurrent apneic episodes. The reasons for possible recurrence are unclear.


OBJECTIVE
To quantify the prevalence of recurrent OSA after T&A surgery and find out a common cause of OSA in children from the neonatal period to adulthood.


METHODS
A retrospective report of apneic patients followed in a tertiary-care center is presented. Telephone interviews of parents were performed 3 years after T&A surgery. The questionnaire included night and day symptoms related to sleep-disordered breathing (SDB). A literature review was performed about associated causes of upper airway stenosis.


RESULTS
Out of 59 children who were included to follow up, 5 (8.5%) experienced residual or recurrent symptoms of SDB. The literature suggests the role of skeletal abnormalities in this process through nasal or pharyngeal stenosis. Major craniofacial anomalies are a well-known cause of obstruction. Thickened soft tissue has to be ruled out. Minor stenoses or neuromuscular disorders are less often diagnosed although they seem to be involved as well.


CONCLUSIONS
A longitudinal follow-up of apneic children is able to reveal recurrence of SDB after adenotonsillectomy and often allows the understanding of mechanisms of upstream-induced recurrent pharyngeal obstructions.
Contencin
Philippe
P
Department of Otorhinolaryngology, Necker University Hospital, Paris, France. p.contencin@svp.ap-hop-paris.fr
Guilleminault
Christian
C
Manach
Yves
Y
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D011795:Surveys and Questionnaires