Craniofacial syndromes and sleep-related breathing disorders

Tan, Hui-Leng; Kheirandish‐Gozal, Leila; Abel, François; Gozal, David

doi:10.1016/j.smrv.2015.05.010

Cited by 78 publications

(60 citation statements)

References 137 publications

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“…All reports were related to snoring when sleeping. Children with UCLP have a higher incidence of obstructive sleep apnea, 28 which is characterized by prolonged partial upper airway obstruction and/or an intermittent complete obstruction that disrupts both normal ventilation during sleep and normal neurophysiological sleep patterns. 29 The size of their pharyngeal airways has been shown to be smaller and their craniofacial dimensions differ from those of healthy controls.…”

Section: Discussionmentioning

confidence: 99%

Orofacial functions and quality of life in children with unilateral cleft lip and palate

et al. 2019

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This study aimed to evaluate the orofacial functions and oral health-related quality of life (OHRQoL) of children with unilateral cleft lip and palate (UCLP). This case-control study included patients with UCLP matched by sex and age with controls (children without UCLP), resulting in the inclusion of a total of 108 eight-to ten-year-old children. Orofacial functions and OHRQoL were evaluated using the Nordic Orofacial Test-Screening (NOT-S) and the Child Perceptions Questionnaire (CPQ 8-10 ), respectively. Data normality was assessed by the Kolmogorov-Smirnov test. Differences and correlations in NOT-S and CPQ 8-10 scores between and within the groups were evaluated using Mann-Whitney and Spearman´s correlation tests, respectively. The distribution of NOT-S and global ratings of CPQ 8-10 for each group were assessed by Chi-squared/Fisher's Exact tests. The UCLP group had a higher NOT-S total and examination scores than the controls. Dysfunctions related to breathing, facial symmetry/expression, and speech were more frequent in the UCLP patients than in the controls. The UCLP group had higher scores on the social well-being domain than the controls. There was a significant difference between the groups in their ratings in regards to the extent to which their oral condition affected their life overall, with controls perceiving it as somewhat better than patients. In both groups, NOT-S total and interview scores were positively correlated with CPQ 8-10 total and domain scores. The NOT-S examination score was only significantly correlated with social domain scores in the control group. The presence of UCLP was associated with clinical signs of orofacial dysfunctions related to breathing, facial symmetry/expression, and speech. Children with UCLP reported more orofacial dysfunctions and negative impacts on social well-being than controls.

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Section: Discussionmentioning

confidence: 99%

Orofacial functions and quality of life in children with unilateral cleft lip and palate

et al. 2019

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“…Mandibular hypoplasia may coexist and contribute to upper airway obstruction. Several of these infants develop OSAS during an upper respiratory tract infection or due to adenotonsillar hypertrophy, but OSAS severity improves over the first 3 years of life [44,45]. Infants with cleft lip and/or palate frequently have obstructive respiratory events during sleep [46].…”

Section: Literature Reviewmentioning

confidence: 99%

ERS statement on obstructive sleep disordered breathing in 1- to 23-month-old children

et al. 2017

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The present statement was produced by a European Respiratory Society Task Force to summarise the evidence and current practice on the diagnosis and management of obstructive sleep disordered breathing (SDB) in children aged 1-23 months. A systematic literature search was completed and 159 articles were summarised to answer clinically relevant questions. SDB is suspected when symptoms or abnormalities related to upper airway obstruction are identified. Morbidity (pulmonary hypertension, growth delay, behavioural problems) and coexisting conditions (feeding difficulties, recurrent otitis media) may be present. SDB severity is measured objectively, preferably by polysomnography, or alternatively polygraphy or nocturnal oximetry. Children with apparent upper airway obstruction during wakefulness, those with abnormal sleep study in combination with SDB symptoms ( snoring) and/or conditions predisposing to SDB ( mandibular hypoplasia) as well as children with SDB and complex conditions ( Down syndrome, Prader-Willi syndrome) will benefit from treatment. Adenotonsillectomy and continuous positive airway pressure are the most frequently used treatment measures along with interventions targeting specific conditions ( supraglottoplasty for laryngomalacia or nasopharyngeal airway for mandibular hypoplasia). Hence, obstructive SDB in children aged 1-23 months is a multifactorial disorder that requires objective assessment and treatment of all underlying abnormalities that contribute to upper airway obstruction during sleep.

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“…Adenotonsillectomy may confer some benefit, as even a small increase in the pharyngeal airway diameter can significantly alter airflow dynamics, increasing the critical closing pressure and improving the severity of OSAS. However, residual OSAS post‐adenotonsillectomy is common and patients may require further airway intervention, that is, insertion of nasopharyngeal airway, ventilatory support, or surgical intervention such as tracheostomy or midface advancement surgery …”

Section: Are There Complex Conditions Related To Upper Airway Obstrucmentioning

confidence: 99%

“…However, residual OSAS postadenotonsillectomy is common and patients may require further airway intervention, that is, insertion of nasopharyngeal airway, ventilatory support, or surgical intervention such as tracheostomy or midface advancement surgery. 123 Children with isolated or non-syndromic cleft lip/ palate or Pierre Robin sequence represent a special subgroup with high prevalence of OSAS. Glossoptosis is one of the main contributing factors to upper airway obstruction, though OSAS pathogenesis is often multifactorial and disruption of the oropharyngeal musculature by the cleft can also adversely affect maintenance of airway patency, particularly during sleep.…”

Section: Craniofacial Abnormalitiesmentioning

confidence: 99%

When and why to treat the child who snores?

Tan

Álvarez

Tsaoussoglou

et al. 2016

Pediatric Pulmonology

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Obstructive sleep-disordered breathing (SDB) can result in cardiovascular and neurocognitive morbidity as well as adversely affect behavior, growth, quality of life, and nocturnal continence. This article summarizes the latest evidence regarding the morbidity related to obstructive SDB, commenting on the impact of severity of obstruction, that is, the difference in effects seen of moderate to severe obstructive sleep apnea syndrome (OSAS) compared to those of mild OSAS or primary snoring. The impact of therapy is discussed, focusing on which children are likely to benefit from treatment interventions; namely those with moderate or severe OSAS irrespective of the presence of morbidity, children with mild OSAS with associated morbidity or predictors of SDB persistence such as obesity, and children with complex conditions accompanied by upper airway obstruction like craniosynostosis and Prader-Willi syndrome. The co-existing conditions which may improve when treatment for obstructive SDB is offered are reviewed, while the clinical parameters associated with spontaneous improvement or resolution of obstructive SDB are discussed. The intention being to enable clinicians to make informed decisions on who should be treated, when and why. Pediatr Pulmonol. 2017;52:399-412. © 2016 Wiley Periodicals, Inc.

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Craniofacial syndromes and sleep-related breathing disorders

Cited by 78 publications

References 137 publications

Orofacial functions and quality of life in children with unilateral cleft lip and palate

Orofacial functions and quality of life in children with unilateral cleft lip and palate

ERS statement on obstructive sleep disordered breathing in 1- to 23-month-old children

When and why to treat the child who snores?

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