title: Management of obstructive sleep apnea in a developmentally delayed pediatric patient with aggressive behavior and Pierre Robin sequence.
abstract: This is a case of a 15-year-old nonverbal, developmentally delayed boy with history of Fragile X syndrome (FXS), autistic spectrum disorder, Pierre Robin sequence (PRS), subglottic stenosis, and ongoing obstructive sleep apnea (OSA), who required aggressive surgical intervention. OSA related symptoms included loud snoring, apneas, awakenings with gasping breaths, enuresis, and daytime sleepiness. The patient also had a history of behavioral problems including aggressive behavior, which led to his family and his health care providers experiencing challenges caring for him. For example, the patient's behavior made examining him very difficult and prevented ENT exam. Likewise, OSA was difficult to manage due to the patient's inability to cooperate with treatment. The OSA treatment course for this patient is briefly described below.
authors.affiliation: College of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Gainesville, FL.
authors.forename: Holly J
authors.initials: HJ
authors.lastname: Skinner
authors.affiliation: College of Dentistry, Division of Oral & Maxillofacial Surgery, University of Florida, Gainesville, FL.
authors.forename: Russell B
authors.initials: RB
authors.lastname: Walther
authors.affiliation: College of Dentistry, Division of Oral & Maxillofacial Surgery, University of Florida, Gainesville, FL.
authors.forename: M Franklin
authors.initials: MF
authors.lastname: Dolwick
authors.affiliation: College of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Gainesville, FL.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Berry
authors.affiliation: College of Medicine, Department of Pediatrics, Pulmonary and Allergy Division, University of Florida, Gainesville, FL.
authors.forename: Mary H
authors.initials: MH
authors.lastname: Wagner
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D000374:Aggression; D001321:Autistic Disorder / Q000150:complications; D002658:Developmental Disabilities / Q000150:complications*; D005600:Fragile X Syndrome / Q000150:complications; D006801:Humans; D008297:Male; D010855:Pierre Robin Syndrome / Q000150:complications*; D017286:Polysomnography; D012086:Reoperation; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000601:surgery*; D014139:Tracheostomy; D014420:Turbinates / Q000601:surgery