Pediatric obstructive sleep apnea in orthodontic patients – the importance of interdisciplinary approach

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Rok publikování 2022
Druh Konferenční abstrakty
Fakulta / Pracoviště MU

Lékařská fakulta

Popis Objective: The prevalence of pediatric obstructive sleep apnea (POSA) in the general population varies usually between 2 to 4%, however it appears to be severely underdiagnosed. We aimed to monitor the prevalence of POSA in orthodontic patients and to focus on the importance of interdisciplinary approach during the initial examination. Subjects: A total of 48 orthodontic patients (22 boys and 26 girls) aged 6-12 years were included in this study. Method: All patients underwent three step examination – 1) visit at the orthodontist including complex check-up, cephalogram and panoramic x-ray; 2) visit at the pediatric ENT specialist for endoscopic examination of the nose, nasopharynx and tonsils grading, and 3) a home sleep testing under the supervision of sleep specialist to determine the presence of POSA. A detailed medical history was taken from all patients, including data from questionnaire originally designed by us. Results: POSA was found in 73% children diagnosed with orthodontic anomaly – mild form (AHI=1-4) in 68.8% and moderate form (AHI=5-10) in 4.2% of children. Based on the ENT examination, the size of the palatine tonsils and the preference of mouth breathing during both day and night were positively correlated with the severity of POSA. POSA was found more often in patients diagnosed with maxillary constriction, crowding, increased overjet and ANB angle and decreased range of tongue mobility, than in children without these craniofacial dysmorphisms. Conclusion: Based on the results of our study, patients aged 6-12 years with specific craniofacial phenotype are very susceptible for the POSA development. As these risky characteristics may be easily diagnosed by orthodontist, ENT, and sleep specialist during the initial examination, interdisciplinary approach seems to be the most suitable way in the early diagnosis and later the treatment of this disease.
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