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題名 | Current Treatment for Childhood Obstructive Sleep Apnea= |
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作者 | Lee, Li-ang; Huang, Yu-shu; Wong, Kin-sun; Lin, Cheng-hui; Chen, Ning-hung; Li, Hsueh-yu; |
期刊 | Journal of Pediatric Respiratory Disease |
出版日期 | 20121200 |
卷期 | 8:4 2012.12[民101.12] |
頁次 | 頁98-111 |
分類號 | 417.53 |
語文 | eng |
關鍵詞 | Obstructive sleep apnea; Prevalence; Polysomnography; Treatment; Adenotonsillectomy; |
英文摘要 | About 5% of children are affected by obstructive sleep apnea (OSA) and it has been the most common disorders encountered at sleep centers. Snoring, mouth breathing, labored breathing, and witnessed apnea are the core symptoms and signs of OSA in children. The true mechanism of childhood OSA remains elusive and is probably multifactorial. Adenotonsillar hypertrophy, nasal obstruction, craniofacial anomaly, obesity, and neuromuscular disorder are possible reasons. An overnight polysomnography confirms the diagnosis of OSA when apnea-hypopnea index >1 episodes/h. OSA are associated with inattention, hyperactivity, learning problem, elevated blood pressure, inadequate somatic growth and nocturnal enuresis. Weight control, anti-inflammatory therapy, nasal continuous positive airway pressure, oral appliance, rapid maxillary expansion, supraglottoplasty, craniofacial reconstruction, and tracheostomy have been proven effective for the treatment of pediatric OSA; however, adenotonsillectomy continues to be the primary treatment of childhood OSA. Despite snoring and respiratory difficulty are greatly reduced by adenotonsillectomy, residual disease is common. This evidence-based article provides a systemic review of the literature regarding indications, timing, postoperative management, and complications of OSA therapy in children, and we propose a clinical guideline on the treatment for childhood OSA at a tertiary sleep center. |
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