Evaluation of obstructive sleep apnea in pediatric patients with facio-craniostenosis: a brief communication.
OBJECTIVE
This study aimed to evaluate our experience in treating cranio-maxillo-mandibular malformations with hypoplasia of the upper and middle third of the face. We wished to determine a new diagnostic path involving a new clinical questionnaire for obstructive sleep apnea (OSA) evaluation, which we have developed by merging existing tests, literature findings, and our clinical experience to obtain a high level of information with minimal cost. This questionnaire is an improvement of the other anamnestic tests in the literature.


METHODS
The study was carried out on 17 pediatric patients affected by syndromic craniofacial malformations and treated with surgical advancement of the middle third of the face, associated with or without upper third advancement, through osteodistraction. We used the obstructive airway child test (OACT) for clinical evaluation. The OACT is an OSA assessment test based on questions proposed to the patient's relatives. All patients underwent polysomnography for instrumental assessment of OSA. These patients were also required to have a computed tomography scan for surgical planning. At the start of the treatment, 11 patients had severe OSA, 4 patients had moderate OSA, and 2 patients had slight OSA.


RESULTS
At the end of the treatment, 6 patients had slight OSA and 11 patients had no OSA; these data were confirmed with OACT and polysomnography.


CONCLUSIONS
Based on our results, we suggest the following flowchart: OACT for OSA clinical evaluation; CT scan for evaluation of the volume of the rhinoropharyngeal air column, anatomical obstruction detection, and surgical planning; and polysomnography for diagnostic confirmation.
Maxillo Facial Surgery Unit, Complesso Integrato Columbus, Catholic University of Sacred Heart, Via Giuseppe Moscati 31-33, 00168 Rome, Italy.
Giulio
G
Gasparini
Concezio
C
Di Rocco
Gianmarco
G
Saponaro
Tito Matteo
TM
Marianetti
Enrico
E
Foresta
Francesca Maria Denise
FM
Rinaldo
Daniele
D
Cervelli
Gianpiero
G
Tamburrini
Sandro
S
Pelo
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003398:Craniosynostoses / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000209:etiology*; D011795:Surveys and Questionnaires