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dos Inocentes RJM, de Almeida Ribeiro A, Marzano-Rodrigues MN, Yatabe-Ioshida MS, Trindade-Suedam IK. Adults with Treacher Collins Syndrome Share Comparable 3D Upper Airway Dimensions with Nonsyndromic Individuals. Int J Dent 2024; 2024:6545790. [PMID: 38962724 PMCID: PMC11221962 DOI: 10.1155/2024/6545790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/27/2024] [Accepted: 05/09/2024] [Indexed: 07/05/2024] Open
Abstract
Purpose Sleep apnea symptoms, such as snoring and daytime somnolence, are commonly observed in individuals with Treacher Collins Syndrome (TCS) and may be related to airway obstruction due to micro- and retro-gnathia. This study aims to three-dimensionally evaluate the upper airway using cone-beam computed tomography (CBCT) exams of adolescents (TCS-ADOL) and adults (TCS-ADUL) with TCS compared to a nonsyndromic group (CON). Materials and Methods Twenty-six CBCT exams were divided into three groups: TCS-ADOL (n = 7) (13.14 ± 1.67 years): CBCT exams of TCS adolescents; TCS-ADUL (n = 10) (21.80 ± 4.39 years): CBCT exams of TCS adults; and CON (n = 9) (25.33 ± 8.57 years): CBCT exams of adult nonsyndromic individuals with Class II skeletal pattern. The variables analyzed were (1) total upper airway volume; (2) nasal cavity volume; (3) total pharyngeal volume; (4) nasopharyngeal volume; (5) oropharyngeal volume; (6) pharyngeal minimal cross-sectional area; (7) pharyngeal length; and (8) pharyngeal depth. Scans were analyzed by two examiners, and intra- and inter-rater agreement was calculated. A p-value of ≤0.05 was considered significant. Results Although not statistically significant, the TCS-ADUL group showed decreased airway volume and minimal cross-sectional areas compared to the CON group. There were also significant differences between TCS-ADOL and TCS-ADUL, with significantly lower airway volumes in the TCS-ADOL group. Strong positive correlations were found between certain airway measurements in the TCS-ADOL group, which were not observed in adults. Conclusions The upper airways of adults with TCS are dimensionally similar to those of nonsyndromic individuals, despite absolute value reductions found in the syndromic group. The reduced airway in the adolescent population suggests significant potential for growth, mainly in pharyngeal dimensions.
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Affiliation(s)
| | - Alexandre de Almeida Ribeiro
- Laboratory of PhysiologyHospital for Rehabilitation of Craniofacial AnomaliesUniversity of São Paulo, São Paulo, Brazil
| | | | | | - Ivy Kiemle Trindade-Suedam
- Laboratory of PhysiologyHospital for Rehabilitation of Craniofacial AnomaliesBauru School of DentistryUniversity of São Paulo, Rua Silvio Marchione 3-20, Bauru—SP, CEP, São Paulo 17102-900, Brazil
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Pang Y, Xiao L, Liang J, Zhang F, Yao HB, Shu Y. Role of Nasal Ventilation Function in Obstructive Sleep Apnea Syndrome in Children. EAR, NOSE & THROAT JOURNAL 2023:1455613231205991. [PMID: 37864363 DOI: 10.1177/01455613231205991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023] Open
Abstract
Background: The association between increased nasal resistance (NR) and obstructive sleep apnea syndrome (OSAS) is controversial. The purpose of this study was to examine nasal ventilation function (NVF) in children with OSAS, with a focus on its pathogenetic role. Methods: Children were recruited and divided into the OSAS group (n = 109) and control group (n = 116). The participants underwent polysomnography (PSG), measurement of NR, and acoustic rhinometry (AR). A combination of intranasal corticosteroids (ICS) and oral montelukast (OM) was administered to 90 children with mild to moderate OSAS for 12 weeks. After excluding participants who dropped out or were lost to follow-up, there were 58 children who responded to the treatment, who were divided into 2 groups-A and B. We compared the size of the tonsil adenoids, the PSG, NR, and AR before and after treatment in the 2 groups. Results: Children aged 6 to 12 years with OSAS had significantly higher NR than the control group (P < .05). The OSAS group had a smaller nasal minimal cross-sectional area (NMCA), nasal cavity volume (NCV) from 0 to 5 cm, and nasopharyngeal volume (NPV) from 6 to 8 cm than the control group, and the difference was statistically significant (P < .05 or P < .01). A total of 58 (84.1%) children responded to the 12-week ICS+OM treatment and 11 (15.9%) children did not respond to the treatment. Effective treatment was achieved in 32 children, as evidenced by a significant reduction in tonsil adenoid size and variations in NR and AR values. There were significant improvements in NR, NMCA, and NCV in the remaining 26 children who were successfully treated, but there was no change in tonsil adenoids and NPV value. Conclusion: NVF may play an important pathogenetic role in children with OSAS.
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Affiliation(s)
- Ying Pang
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Ling Xiao
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Jia Liang
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Feng Zhang
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Hong-Bing Yao
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yan Shu
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
- Chongqing Key Laboratory of Pediatrics, Chongqing, China
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Banhara FL, Trindade IEK, Trindade-Suedam IK, Fernandes MDBL, Trindade SHK. Respiratory sleep disorders, nasal obstruction and enuresis in children with non-syndromic Pierre Robin sequence. Braz J Otorhinolaryngol 2022; 88 Suppl 1:S133-S141. [PMID: 34092522 PMCID: PMC9734268 DOI: 10.1016/j.bjorl.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/01/2021] [Accepted: 05/03/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Obstructive sleep apnea is highly prevalent in non-syndromic Pierre Robin sequence patients. Studies have found a probable relationship between obstructive sleep apnea and nasal obstruction and between obstructive sleep apnea and enuresis. Assessment of the relationship between these variables in non-syndromic Pierre Robin sequence patients is scarce. OBJECTIVE The present study aims to evaluate the relationship between symptoms of obstructive sleep apnea, nasal obstruction and enuresis, determining the prevalence of symptoms suggestive of these conditions, in schoolchildren with non-syndromic Pierre Robin sequence, and describe the prevalence of excessive daytime sleepiness habitual snoring and voiding dysfunction symptoms associated with enuresis. METHODS This was a prospective analytical cross-sectional study developed at a reference center. Anthropometric measurements and a structured clinical interview were carried out in a sample of 48 patients. The instruments "sleep disorders scale in children" "nasal congestion index questionnaire" (CQ-5), and the "voiding dysfunction symptom score questionnaire" were used. Statistical analysis was performed for p < 0.05. RESULTS Positive "sleep disorders scale in children" scores for obstructive sleep apnea and CQ-5 for nasal obstruction were observed in 38.78% and 16.33%, respectively. Enuresis was reported in 16.33% of children, being characterized as primary in 71.43% and polysymptomatic in 55.55%; according to the "voiding dysfunction symptom score questionnaire". There was a significant relationship between nasal obstruction and obstructive sleep apnea symptoms (p < 0.05), but no significance was found between obstructive sleep apnea symptoms and enuresis, and between nasal obstruction and enuresis. The prevalence of excessive daytime sleepiness was 12.24% and of habitual snoring, 48.98%. A family history of enuresis, younger age in years and a positive "voiding dysfunction symptom score questionnaire" score were associated with a higher prevalence of enuresis (p < 0.05). CONCLUSION Children with non-syndromic Pierre Robin sequence are at high risk for obstructive sleep apnea symptoms and habitual snoring, with a correlation being observed between nasal obstruction and obstructive sleep apnea symptoms. In addition, the study showed that non-syndromic Pierre Robin sequence, obstructive sleep apnea and nasal obstruction symptoms were not risk factors for enuresis in these patients.
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Affiliation(s)
- Fábio Luiz Banhara
- Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil.
| | - Inge Elly Kiemle Trindade
- Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil; Universidade de São Paulo (USP), Faculdade de Odontologia de Bauru, Bauru, SP, Brazil
| | - Ivy Kiemle Trindade-Suedam
- Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil; Universidade de São Paulo (USP), Faculdade de Odontologia de Bauru, Bauru, SP, Brazil
| | - Marilyse de Bragança Lopes Fernandes
- Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil
| | - Sergio Henrique Kiemle Trindade
- Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Unidade de Estudos do Sono do Laboratório de Fisiologia, Bauru, SP, Brazil; Universidade de São Paulo (USP), Faculdade de Odontologia de Bauru, Bauru, SP, Brazil; Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais (HRAC), Seção de Otorrinolaringologia, Bauru, SP, Brazil; Universidade Nove de Julho, Curso de Medicina, Bauru, SP, Brazil
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