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94 OBSTRUCTIVE SLEEP APNEA SYNDROME (OSAS) IN CHILDREN WITH CRANIOFACIAL ANOMALIES

Introduction: In children craniofacial anomalies may cause airway narrowing and lead to obstructive sleep apnea. The children show nocturnal symptoms like sleep disturbances, enuresis, excessive sweating during sleep, nocturnal snoring. The daytime symptoms are ranging from daytime sleepiness, hyperactivity up to pathological shyness and social withdrawal. OSAS may have negative effects on cardiac function and growth. An evaluation to determine the extent of the OSAS is necessary.Method: We use an nocturnal polygraphic recording (PR) that includes the recording of respiration and nasal airflow monitoring. Furthermore an electrocardiogram and heart rate are determined. Moreover an actigraph reflects movement of the wrist or the legs depending on the sensor's placement. Any intrathoracic pressure changes and transcutaneous oxygen saturation are measured by specific sensors.Results: 17 children with craniofacial anomalies were examined. 10 of these patients got maxillofacial corrective surgery. In 4 of the 10 cases the patients had PR before and after surgery. After surgery 3 of the 4 children demonstrated significant reduction of sleep disturbances and apneas during sleep (mean sleep apnea index (AI) before surgery: 6,7 - vs. AI after surgery: 3,6 ). There exists a PR only after surgery in 6 patients. One in these 6 patients showed an AI > 10 after surgery (mean AI: 5,8). 70 percent of the children with PR before maxillofacial surgery demonstrated major sleep disturbances (mean AI: 16).Conclusion: The results show the positive effects of maxillofacial surgery if maxillofacial abnormalities are reason for OSAS in children. In such cases surgery may be considered. In order to bridge the time till undergoing maxillofacial surgery, we recommend to use nasal continuous positive airway pressure to children who require orthodontic preparation.