Mechanisms of obstructive sleep apnea syndrome in infants with micrognathia

项目摘要/摘要 我是一名儿科肺科医生，接受过睡眠医学方面的团契培训，并具有临床和 儿童阻塞性睡眠呼吸暂停综合征的翻译研究。我的研究主要集中在 患有颅面部疾病的儿童阻塞性睡眠呼吸暂停综合征的病理生理学、后果和治疗。建议数 该项目旨在确定患有小颌症的婴儿OSAS的机制，这是一组患有 下颌骨发育不全。阻塞性睡眠呼吸暂停综合征在儿童中很常见，并与生长发育障碍和各种 认知和心血管后遗症。患有小颌症的婴儿是OSAS的高危人群之一， 但OSAS在这一人群中的机制、OSAS对生长的影响以及结局的差异性 手术后对OSAS的治疗知之甚少。在目标1中，我们将评估结构性贡献 上呼吸道MRI对小颌畸形婴儿OSAS的影响及神经运动对OSAS的影响 评价动态压力-流量关系。AIM 2将使用各种增长评估，包括 静息能量消耗评估和双能x射线吸收法，以评估不良的原因 成长。目的3将确定手术治疗阻塞性睡眠呼吸暂停综合征对颅面结构的影响， 小颌畸形婴儿的神经运动功能和生长发育。 我的长期目标是成为一名独立的临床/翻译医生兼科学家，在 儿童颅面部疾病OSAS的评估与处理计划中的职业 发展奖通过让我在以下方面获得进一步的培训和经验来促进这一职业目标 影像数据分析和成长评估。这门课还有生物统计学的课程作业和 中华儿科医院优秀科研环境下的临床研究设计与管理 费城和宾夕法尼亚大学。我已经召集了一支杰出的多学科导师队伍 一队。我的主要导师卡罗尔·马库斯医生是国际公认的儿科临床研究人员。 具有杰出的指导记录的OSAS。我的另一位导师理查德·施瓦布博士是厄普的先驱。 阻塞性睡眠呼吸暂停综合征的呼吸道成像。这些导师，以及一个多学科咨询委员会，包括 放射学、整形外科、营养学和生物统计学方面的研究人员将帮助指导我的职业发展 并将提供内容方面的专门知识，以确保拟议研究的成功。拟议的项目，以及 通过构成我的职业发展计划的结构化指导、课程作业和培训，Will 为我提供必要的技能和经验，以确保他作为一名独立调查员取得成功 更好地了解小颌畸形儿童OSAS的评估和治疗的独特技能 以及其他头面部疾病。

PROJECT SUMMARY/ABSTRACT I am a pediatric pulmonologist with fellowship training in sleep medicine and a background in clinical and translational research in pediatric obstructive sleep apnea syndrome (OSAS). My research is focused on the pathophysiology, consequences, and treatment of OSAS in children with craniofacial conditions. The proposed project seeks to determine the mechanisms of OSAS in infants with micrognathia, a group of children with mandibular hypoplasia. OSAS is common in children and is associated with growth failure and a variety of cognitive and cardiovascular sequelae. Infants with micrognathia are one of the highest-risk groups for OSAS, but the mechanisms of OSAS in this population, the effect of OSAS on growth, and the variability in outcomes after surgical intervention for OSAS are poorly understood. In Aim 1, we will assess the structural contributions to OSAS in infants with micrognathia using upper airway MRI and the neuromotor contributions to OSAS by evaluating dynamic pressure-flow relationships. Aim 2 will use a variety of growth assessments, including resting energy expenditure assessment and dual-energy x-ray absorptiometry, to evaluate the causes of poor growth. Aim 3 will determine the impact of surgical treatment for OSAS on the craniofacial structure, neuromotor function, and growth in infants with micrognathia. My long-term goal is to become an independent clinical/translation physician-scientist with unique expertise in the evaluation and management of OSAS in children with craniofacial conditions. The proposed career development award facilitates this career goal by allowing me to obtain further training and experience in imaging data analysis and growth assessment. This is complemented with coursework in biostatistics and clinical study design and management in the outstanding research environment of Children’s Hospital of Philadelphia and the University of Pennsylvania. I have assembled an exceptional multidisciplinary mentorship team. My primary mentor, Dr. Carole Marcus, is an internationally-recognized clinical researcher in pediatric OSAS with an outstanding record of mentorship. My co-mentor, Dr. Richard Schwab, is a pioneer in upper airway imaging in OSAS. These mentors, along with a multidisciplinary Advisory Committee that includes investigators in radiology, plastic surgery, nutrition, and biostatistics, will help guide my career development and will provide content expertise to ensure success of the proposed research. The proposed project, along with the structured mentoring, coursework, and training that comprise the my career development plan, will provide me with the skill and experience necessary to ensure his success as an independent investigator with a unique skill set in better understanding the evaluation and treatment of OSAS in children with micrognathia and other craniofacial conditions.