title: Individualized therapy for treating obstructive sleep apnea in pediatric Crouzon syndrome patients.
abstract: OBJECTIVE
  Pediatric patients with Crouzon syndrome have great possibilities of suffering from obstructive sleep apnea (OSA), which is mainly due to midfacial hypoplasia and facial deformities. For most patients, a multidisciplinary and sequential treatment plan is necessary to make for Crouzon syndrome often has different phenotypes of different severity in OSA and facial deformities. Typical patients were selected in this paper to illustrate the necessity of individualized therapy for treating OSA.
  
  
  METHODS
  In this paper, we have introduced four Crouzon syndrome children of different severity in suffering from OSA and maxillofacial deformities. Detailed information was given including clinical manifestations, radiological findings, and polysomnography detections. Based on the above findings, different but effective treatment options for these children's OSA problems were adopted, either by surgeries including distraction osteogenesis and craniomaxillofacial surgeries with or without tonsillectomy or by noninvasive continuous positive airway pressure (CPAP) therapy.
  
  
  RESULTS
  Follow-up studies for more than 1 year showed problems of OSA and nocturnal hypoxia of those four patients were all alleviated greatly, as well as maxillofacial deformities. Combined with pre-operative and post-operative orthodontics, one patient also got optimal results in better facial profile and dental occlusion.
  
  
  CONCLUSIONS
  Thus, based on adequate clinical evaluations and patients' conditions including age, disease severity, and esthetic considerations, individualized therapy should be made and performed carefully to obtain optimized results in treating OSA for pediatric Crouzon syndrome patients.
authors.affiliation: Center of Sleep Disordered Breathing, Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
authors.forename: Wenwen
authors.initials: W
authors.lastname: Yu
authors.affiliation: Center of Sleep Disordered Breathing, Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Wang
authors.affiliation: Center of Sleep Disordered Breathing, Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
authors.forename: Kan
authors.initials: K
authors.lastname: Yao
authors.affiliation: Center of Sleep Disordered Breathing, Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Cai
authors.affiliation: Center of Sleep Disordered Breathing, Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
authors.forename: Hongxia
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Stomatology, Tenth People's Hospital, Tong Ji University School of Medicine, Shanghai, 200072, China.
authors.forename: Liyan
authors.initials: L
authors.lastname: Lu
authors.affiliation: Center of Craniofacial Orthodontics, Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Center of Sleep Disordered Breathing, Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China. lukeluxf@163.com.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D002648:Child; D002681:China; D003131:Combined Modality Therapy; D045422:Continuous Positive Airway Pressure; D003394:Craniofacial Dysostosis / Q000150:complications* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D008297:Male; D009971:Orthodontics, Corrective; D017286:Polysomnography; D057285:Precision Medicine / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D013515:Surgery, Oral
keywords: Continuous positive airway pressure therapy; Crouzon syndrome; Distraction osteogenesis; Individualized therapy; Obstructive sleep apnea; Orthodontics