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Title
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Predicting the effect of treatment in paediatric OSA by clinical examination and functional respiratory imaging
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Author
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Abstract
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| OBJECTIVEThe aim of this study was to investigate whether functional respiratory imaging (FRI) or clinical examination could predict treatment outcome for obstructive sleep apnea (OSA) in normal-weight, non-syndromic children. METHODSNormal weight children diagnosed with OSA by polysomnography were prospectively included. All children got a thorough evaluation and an ultra-low dose computed tomography scan of the upper airway (UA). A 3-D reconstruction was built combined with computational fluid dynamics for FRI. Decisions on the need and type of surgery were based upon findings during drug-induced sleep endoscopy. A second polysomnography was performed 3-12 months after surgery. RESULTSNinety-one children were included: 62 boys, 5.02.7 years, and BMI z-score of -0.1 +/- 1.2. Children with more severe OSA had a smaller volume of the overlap region between the adenoids and tonsils. Nineteen out of 60 patients had persistent OSA (oAHI >2/h). A lower conductance in the UA and a higher tonsil score predicted successful treatment. CONCLUSIONSA less constricted airway, as characterized by both FRI and a lower tonsil score, was associated with a less favorable response to (adeno) tonsillectomy. Further studies after treatment using FRI and DISE are warranted to further characterize the UA of these subjects. |
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Language
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English
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Source (journal)
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Pediatric pulmonology. - Philadelphia, Pa
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Publication
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Philadelphia, Pa
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2017
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ISSN
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8755-6863
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DOI
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10.1002/PPUL.23684
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Volume/pages
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52
:6
(2017)
, p. 799-805
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ISI
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000401729800014
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Pubmed ID
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28267299
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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