Identification and evaluation of obstructive sleep apnea prior to adenotonsillectomy in children: a survey of practice patterns.
Identification and evaluation of obstructive sleep apnea prior to adenotonsillectomy in children: a survey of practice patterns.
复制标题
儿童腺样体扁桃体切除术前阻塞性睡眠呼吸暂停的识别和评估：实践模式调查。
DOI：
10.1016/s1389-9457(03)00100-x
复制
发表时间：
2003
期刊：
影响因子：
4.8
通讯作者：
Chervin,RonaldD
中科院分区：
文献类型：
--
作者：
Weatherly,RobertA;Mai,EvelynF;Ruzicka,DeborahL;Chervin,RonaldD
ObjectivesSome data suggest that the clinical diagnosis of obstructive sleep apnea（OSA）in a child should be confirmed by polysomnography before adenotonsiphalomy（AT），but otolaryngology literature generally does not agree and few studies have examined surgical practice patterns.MethodsWe mailed，to 603 members of two North American otolaryngology societies，调查对象为5.0-12.9岁的儿童，他们在过去的一年中进行了ATs.ResultsA共183耳鼻喉科医生估计，他们已经进行了24,000 AT。报告的主要手术适应症（不相互排斥）包括复发性咽喉感染（42%的手术）、任何类型的呼吸阻塞（59%）、OSA（39%）、学习成绩差（17%）和注意力不集中（11%）。术前评估包括93%的儿童有基于办公室的睡眠相关病史，10%的儿童有OSA的任何客观测试，5%的儿童有基于实验室的多导睡眠图。外科医生的学术背景，较高的体积AT，和儿科专业化报告的AT的百分比较低的复发性扁桃体炎，而不是其他indications.ConclusionsAs AT的常见适应症，OSA现在对手复发性咽喉感染。不超过12%的因OSA接受AT的学龄儿童在手术前进行了多导睡眠图检查。AT的适应症可能部分取决于实践环境和耳鼻喉科医生的背景。
ObjectivesSome data suggest that the clinical diagnosis of obstructive sleep apnea (OSA) in a child should be confirmed by polysomnography before adenotonsillectomy (AT), but otolaryngology literature generally does not agree and few studies have examined surgical practice patterns.MethodsWe mailed, to 603 members of two North American otolaryngology societies, surveys about children aged 5.0–12.9 years upon whom they performed ATs in the previous year.ResultsA total of 183 otolaryngologists estimated that they had performed 24,000 ATs. Reported major surgical indications, not mutually exclusive, included recurrent throat infections (for 42% of procedures), obstructed breathing of any type (59%), OSA (39%), poor school performance (17%), and poor attention (11%). Pre-operative evaluations included an office-based, sleep-related history in 93% of children, any objective testing for OSA in <10%, and laboratory-based polysomnography in <5%. Surgeons with academic affiliations, higher volumes of ATs, and pediatric specialization reported lower percentages of ATs performed for recurrent tonsillitis as opposed to other indications.ConclusionsAs a common indication for AT, OSA now rivals recurrent throat infection. No more than 12% of school-aged children who undergo AT for OSA have polysomnography prior to the procedure. Indications for AT may depend, in part, on practice settings and otolaryngologists' backgrounds.