Videonasopharyngoscopy is useful for identifying children with Pierre Robin sequence and severe obstructive sleep apnea.
BACKGROUND
Obstructive sleep apnea syndrome (OSAS) commonly appears in patients with Pierre Robin sequence (PR). Polysomnography (PS) is the gold standard for the diagnosis of OSAS. Videonasopharyngoscopy (VNP) is the best diagnostic tool for visualizing the vocal tract and detecting structural abnormalities which can be associated with OSAS.


OBJECTIVE
The purpose of this paper is to study whether VNP can be useful for identifying severe OSAS in a population of children with PR.


METHODS
Fifty-two children with PR who were present with sleep-disordered breathing were studied. All the parents completed a questionnaire concerning the children's sleeping habits and sleep complaints before consultation. Each child underwent a general pediatric examination and an evaluation of craniofacial features and upper airway permeability. In all children, a PS was performed. Also, all children underwent a VNP.


RESULTS
The diagnosis of OSAS was confirmed by PS in 31 patients. VNP showed 87% sensitivity and 100% specificity for the detection of OSAS. VNP findings showed a significant correlation with apnea-hypopnea index, arousal index, snoring time, percentage of sleep time spent at saturation of oxygen <90% and a significant inverse correlation with total sleep time, sleep efficiency and the mean saturation of oxygen during sleep.


CONCLUSIONS
This study shows that in children with PR, airway obstruction as detected by VNP seems to be a risk factor for OSAS. VNP appears to be a safe and reliable tool for the evaluation of sleep-disordered breathing in children with PR.
Bravo
Gerardo
G
Cleft Palate Clinic, Hospital Gea González, 4800 Calzada Tlalpan, Mexico City 14000, D.F., Mexico.
Ysunza
Antonio
A
Arrieta
José
J
Pamplona
Ma C
MC
D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010855:Pierre Robin Syndrome / Q000175:diagnosis*; D017286:Polysomnography; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D014743:Videotape Recording