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Evaluation of obstructive sleep apnea in pediatric patients with facio-craniostenosis: a brief communication

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Abstract

Purpose

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.

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Acknowledgments

The authors declare that they have no conflict of interest and that this study has no financial support. We respected the ethical rules and preserved the privacy and the health of the patients.

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Authors and Affiliations

  1. Maxillo Facial Surgery Unit, Complesso Integrato Columbus, Catholic University of the Sacred Heart, Via Giuseppe Moscati 31-33, 00168, Rome, Italy

    Giulio Gasparini, Gianmarco Saponaro, Tito Matteo Marianetti, Enrico Foresta, Francesca Maria Denise Rinaldo, Daniele Cervelli & Sandro Pelo

  2. Department of Paediatric Neurosurgery, Catholic University of the Sacred Heart, Largo A Gemelli, 8, 00168, Rome, Italy

    Concezio Di Rocco & Gianpiero Tamburrini

  3. Viale Umberto I, 39, Naro (AG), Italy

    Francesca Maria Denise Rinaldo

Authors
  1. Giulio Gasparini
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  2. Concezio Di Rocco
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  3. Gianmarco Saponaro
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  4. Tito Matteo Marianetti
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  5. Enrico Foresta
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  6. Francesca Maria Denise Rinaldo
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  7. Daniele Cervelli
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  8. Gianpiero Tamburrini
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  9. Sandro Pelo
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Corresponding author

Correspondence to Francesca Maria Denise Rinaldo.

Additional information

This work was performed at the U.O. MaxilloFacial Surgery, Catholic University of the Sacred Heart, Complesso Integrato Columbus—Via G. Moscati, 31-00168, Roma.

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Gasparini, G., Di Rocco, C., Saponaro, G. et al. Evaluation of obstructive sleep apnea in pediatric patients with facio-craniostenosis: a brief communication. Childs Nerv Syst 28, 1135–1140 (2012). https://doi.org/10.1007/s00381-012-1821-x

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  • DOI: https://doi.org/10.1007/s00381-012-1821-x

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