Kirurgi for obstruktiv søvnapné hos små barn

Forskere fra Lovisenberg sykehus, Oslo universitetssykehus og Universitetet i Oslo har i denne prospektive studien undersøkt effekten av kirurgi for obstruktiv søvnapné (OSA) hos 56 barn under 5 år målt med polysomnografi (PSG) og foreldrerapporterte symptomer fra spørreskjema. I tillegg var målet med studien å identifisere prediktorer for gjenværende symptomer på OSA etter operasjonen. Studien viste gode resultater etter operasjon for OSA hos små barn under 5 år. Resultatene viste signifikante forbedringer i obstruktiv apné-hypopné-indeks (OAHI) målt med PSG og i foreldreapporterte symptomer. Høyere preoperativ OAHI var eneste kliniske prediktor for gjenværende OSA etter operasjonen.

Surgery for obstructive sleep apnea in young children: Outcome evaluated by polysomnograhy and quality of life

Britt Øverland, Hanne Berdal, Harriet Akre

Studien er publisert i International Journal of Pediatric otorhinolaryngologi

Purpose: Hypertrophy of adenoid and tonsils is the most common risk factor for OSA in children, and adenotonsillectomy is considered the first-line treatment. The effect of surgery for OSA in children varies considerably between studies, and few studies have focused on the effect in young children under 5 years of age. Thus, the aim of this study was to: 1) evaluate the effect of surgery for OSA in young children using objective data from polysomnography and parent-reported symptoms using questionnaires, and 2) identify predictors of residual OSA following surgery.
Methods: This is a prospective cohort study of children aged 2-4 years who were referred for surgery to treat OSA. Measures collected before and after surgery included polysomnography (PSG), Pediatric Sleep Questionnaire (PSQ), OSA-18 and clinical data.
Results: 56 children completed a preoperative and postoperative PSG. Their median age was 3.1 (IQR 2.6-3.1) years. After surgery, 63% had an obstructive apnea hypopnea index (OAHI) < 1, 82% had an OAHI < 2 and 95% had an OAHI < 5. Parent-reported OSA-18 and PSQ scores improved significantly after surgery. In logistic regression analyses, higher preoperative OAHI was the only significant clinical predictor of residual OSA after surgery.
Conclusion: There was a high resolution rate after surgery for OSA in this group of young children, with significant improvements in both the OAHI measured with PSG and parent-reported symptoms. The only clinical predictor of residual OSA after surgery was higher preoperative OAHI.