Sleep apnoea in syndromic craniosynostosis occurs independent of hindbrain herniation

Driessen, Caroline; Joosten, Koen; Florisson, Joyce M.G.; Lequin, Maarten H.; Veelen, Marie-Lise C. van; Dammers, Rúben; Bredero-Boelhouwer, Hansje; Tasker, Robert C.; Mathijssen, Irene M.J.

doi:10.1007/s00381-012-1922-6

Cited by 16 publications

(17 citation statements)

References 24 publications

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“…Indeed, only 2 of these patients had central apneas outside the normal range (26). Similar findings have also been described in a separate study where sleep study parameters, including both the CAI and OAHI of craniosynostosis patients with hind brain herniation were similar to those without hind brain herniation (27). …”

Section: Cranosynostosis and Central Apneassupporting

confidence: 87%

Craniofacial syndromes and sleep-related breathing disorders

Tan

Kheirandish‐Gozal

Abel

et al. 2016

Sleep Medicine Reviews

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Summary Children with craniofacial syndromes are at risk of sleep disordered breathing, the most common being obstructive sleep apnea. Midface hypoplasia in children with craniosynostosis and glossoptosis in children with Pierre Robin syndrome are well recognized risk factors, but the etiology is often multifactorial and many children have multilevel airway obstruction. We examine the published evidence and explore the current management strategies in these complex patients. Some treatment modalities are similar to those used in otherwise healthy children such as as adenotonsillectomy, positive pressure ventilation and in the refractory cases, tracheostomy. However, there are some distinct approaches such as nasopharyngeal airways, tongue lip adhesion, mandibular distraction osteogenesis in children with Pierre Robin sequence, and midface advancement in children with craniosynostoses. Clinicians should have a low threshold for referral for evaluation of sleep-disordered-breathing in these patients.

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Section: Cranosynostosis and Central Apneassupporting

confidence: 87%

Craniofacial syndromes and sleep-related breathing disorders

Tan

Kheirandish‐Gozal

Abel

et al. 2016

Sleep Medicine Reviews

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“…Horizontal lines indicate the different severity levels of pediatric OSA: mild OSA AHI 1-4.9, moderate OSA AHI 5.0-9.9, and severe OSA AHI ≥ 10. morphology of the upper airway from birth, predisposing to sleep disordered breathing symptoms and OSA. [7][8][9][10][11] Nevertheless, we found that even in "mild" non-syndromic CFM where the pharyngeal airway may not be involved, such as in isolated cleft lip, the presence of symptoms was associated with a frequency of OSA greater than 90%. It has been previously reported that children with syndromes are more likely to have symptoms and undergo PSG.…”

Section: Discussionmentioning

confidence: 71%

“…[7][8][9] However, only two studies have prospectively investigated the frequency of OSA in children with CFM. The fi rst one was conducted in children with syndromic craniosynosotosis 10 and the second in 50 infants with cleft lip and/or palate prior to any surgical procedure. 11 While these previous studies support an association between CFM and pediatric OSA, available data are limited to children with a specifi c CFM or to children in a particular age range.…”

mentioning

confidence: 99%

Obstructive Sleep Apnea Pretreatment and Posttreatment in Symptomatic Children with Congenital Craniofacial Malformations

Moraleda-Cibrián

Edwards

Kasten

et al. 2015

Journal of Clinical Sleep Medicine

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“…The most widely accepted operative window is within 1 year of age to get maximum benefits in terms of IQ and cognition, with many authors favouring surgery between 6 and 12 months [4,[15][16][17]. Fifty two percentage of our cases were operated in this desirable period.…”

Section: Discussionmentioning

confidence: 93%

Syndromic Craniosynostosis: Objective and Parent-Reported Outcome Measurements after Cranio-Facial Remodelling Surgeries

et al. 2021

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Introduction: Syndromic craniosynostosis (SC) is a rare entity compared to the non-syndromic variant. Treatment involves a multidisciplinary approach towards a multitude of problems. Early intervention is known to be better for optimum results. We reviewed outcomes of children with SC who underwent reconstructive cranio-facial surgery. Materials and Methods: A retrospective study was conducted using data from hospital case files and the picture archival communication system. Objective data like the cephalic index (CI), both preoperatively and post-operatively, were compared. Subjective data for the cosmesis outcome – “Sloan and Whitaker outcome class” – following surgery were assessed. Also, parent-reported outcome measurement (PROM) was performed with various parameters to assess quality of life (QOL). Results: We had 21 operated cases of SC, with 19 needing cranio-facial remodelling. The male to female ratio was 11:10. Crouzon’s syndrome was the most common syndromic association followed by Apert’s syndrome. Nineteen patients underwent cranio-facial remodelling surgeries and 2 underwent the ventriculo-peritoneal shunt only – for raised intracranial pressure (ICP). Nine patients underwent cranial remodelling with fronto-orbital advancements, and 3 of these patients also received le-fort’s type 3 osteotomy and advancement later. Ten patients underwent fronto-orbital advancement with parieto-occipital barrel-stave osteotomies. Outcomes: Improvement in the CI was maximum at the 6-month follow-up. Six (37.5%) cases had Sloan class 1 outcome, 9 (56.25%) had class 2 outcomes, and 1 patient had a class 6 outcome. Whitaker cosmesis outcomes – 14 out of 16 cases (87.5%) had Category 1 outcomes. PROM was assessed. All parents reported at least a moderate improvement in cosmesis following surgery. Out of 15 cases, 10 (66%) reported significant improvement, while 4 (26.6%) cases reported moderate improvement with respect to eye and visual problems. Four parents reported snoring as a significant problem even after surgery. Most parents felt that the children were doing well, attending regular school, and social well-being was normal and had an overall good QOL. Conclusions: SC cases may have a multitude of other problems like raised ICP, ophthalmological problems, poor intelligence, and cognition apart from cosmetic concerns. PROMs revealed good outcomes in terms of cosmesis, cognition, and ophthalmological and oral cavity-related problems. Significant improvement in overall QOL was seen in most patients following cranio-facial remodelling surgery.

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Sleep apnoea in syndromic craniosynostosis occurs independent of hindbrain herniation

Cited by 16 publications

References 24 publications

Craniofacial syndromes and sleep-related breathing disorders

Craniofacial syndromes and sleep-related breathing disorders

Obstructive Sleep Apnea Pretreatment and Posttreatment in Symptomatic Children with Congenital Craniofacial Malformations

Syndromic Craniosynostosis: Objective and Parent-Reported Outcome Measurements after Cranio-Facial Remodelling Surgeries

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