Your browser doesn't support javascript.
loading
Impact of adenotonsillectomy and palatal expansion on the apnea-hypopnea index and minimum oxygen saturation in nonobese pediatric obstructive sleep apnea with balanced maxillomandibular relationship: A cross-over randomized controlled trial.
Magalhães, Maria Cecilia; Normando, David; Soares, Carlos José; Araujo, Eustaquio; Novaes, Ricardo Maurício O; Teodoro, Vinicius Vasconcelos; Flores-Mir, Carlos; Kim, Ki Beom; Almeida, Guilherme A.
Afiliación
  • Magalhães MC; Department of Pediatric Dentistry and Orthodontics, Federal University of Uberlândia, Uberlândia, Brazil.
  • Normando D; Department of Orthodontics, Federal University of Para, Belem, Brazil.
  • Soares CJ; Department of Dental Materials, School of Dentistry, Federal University of Uberlândia Uberlândia, Brazil.
  • Araujo E; Department of Orthodontics, Center for Advanced Dental School (CADE), Saint Louis University, Saint Louis, Missouri, USA.
  • Novaes RMO; Department of Otorhinolaryngology, Federal University of Uberlandia, Uberlandia, Brazil.
  • Teodoro VV; Department of Neurology, Federal University of Uberlandia, Uberlandia, Brazil.
  • Flores-Mir C; Department of Dentistry and Dental Hygiene, University of Alberta, Edmonton, Alberta, Canada.
  • Kim KB; Department of Orthodontics, Center for Advanced Dental School (CADE), Saint Louis University, Saint Louis, Missouri, USA.
  • Almeida GA; Department of Pediatric Dentistry and Orthodontics, Federal University of Uberlândia, Uberlândia, Brazil.
Pediatr Pulmonol ; 2024 Sep 06.
Article en En | MEDLINE | ID: mdl-39239911
ABSTRACT

OBJECTIVE:

To determine the impact and best management sequence between adenotonsillectomy (AT) and rapid palatal expansion (RPE) on the apnea-hypopnea index (AHI) and minimum oxygen saturation (MinSaO2) in nonobese pediatric obstructive sleep apnea (OSA) patients presenting balanced maxillomandibular relationship. STUDY DESIGN/

METHODS:

Thirty-two nonobese children with balanced maxillomandibular relationship and a mean age of 8.8 years, with a graded III/IV tonsillar hypertrophy and maxillary constriction, participated in a cross-over randomized controlled trial. As the first intervention, one group underwent AT while the other underwent RPE. After 6 months, interventions were switched in those groups, but only to participants with an AHI > 1 after the first intervention. OSA medical diagnosis with the support of Polysomnography (PSG) was conducted before (T0), 6 months after the first (T1) and the second (T2) intervention. The influence of sex, adenotonsillar hypertrophy degree, initial AHI and MinSaO2 severity, and intervention sequence were evaluated using linear regression analysis. Intra- and intergroup comparisons for AHI and MinSaO2 were performed using ANOVA and Tukey's test.

RESULTS:

The initial AHI severity and intervention sequence (AT first) explained 94.9% of AHI improvement. The initial MinSaO2 severity accounted for 83.1% of MinSaO2 improvement changes. Most AHI reductions and MinSaO2 improvements were due to AT.

CONCLUSIONS:

Initial AHI severity and AT as the first intervention accounted for most of the AHI improvement. The initial MinSaO2 severity alone accounted for the most changes in MinSaO2 increase. In most cases, RPE had a marginal effect on AHI and MinSaO2 when adjusted for confounders.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pediatr Pulmonol Asunto de la revista: PEDIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pediatr Pulmonol Asunto de la revista: PEDIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos