Obstructive Sleep Apnea Syndrome in Children

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Causes of persistent obstructive sleep apnea despite previous T&A in children with Down syndrome as depicted on static and dynamic cine MRI (Donnelly LF, Shott SR, LaRose CR, Chini BA, Amin RS Am J Roentgenol July, 2004) 27 patients – Mean age 9.9 years • Macroglossia 74% • Glossoptosis 63% • Recurrent adenoids 63% • Enlarged lingual tonsils 30% • Hypopharyngeal collapse 22%
Case 1 • 12 yr old F with DS • T&A at age 4 • Parents reported no sleep problems, but patient fell asleep in my office • Obstructive AHI= 4.1 • Desats to upper 80’s • Arousal index = 20.6
Page 1 and 2:
Obstructive Sleep Apnea (OSA) in Ch
Page 3 and 4:
Obstructive Sleep Apnea Syndrome (O
Page 5 and 6:
OSA • More difficult to diagnosis
Page 7 and 8:
• Not diagnostic of OSA Diagnosis
Page 9 and 10: Diagnosis of OSA Sleep patterns •
Page 11: Higher incidence of OSAS in: • Ob
Page 14 and 15: Down Syndrome • 50% also have an
Page 16 and 17: Before 1980’s • Despite 50% of
Page 18 and 19: Child Abuse Amendments 1984 • All
Page 20 and 21: Parents Of Children With DS Underes
Page 22 and 23: Behavior Changes with OSAS • Dayt
Page 24 and 25: Children who snore vs those who do
Page 26 and 27: OSAS and Growth • T&A hypertrophy
Page 28 and 29: • What is the incidence of OSA in
Page 30 and 31: Dyken et al (2003) • Prospective
Page 32 and 33: Shott et al 2006 • Prospective st
Page 34 and 35: Objective diagnosis of OSAS • Sle
Page 36 and 37: Sleep studies in children with deve
Page 38 and 39: Definitions of Sleep Abnormalities
Page 40 and 41: Obstructive Index Apnea-Hypopnea in
Page 42 and 43: Hypoventilation Syndrome • You br
Page 44 and 45: Repetitive Arousals and Sleep Fragm
Page 46 and 47: Treatment of OSA • Removal of ton
Page 49 and 50: Persistent OSA after T&A Current tr
Page 51 and 52: Treatment of OSA • Removal of ton
Page 53 and 54: Treatment is dependent upon appropr
Page 55 and 56: Lateral neck xray White arrow = lin
Page 57 and 58: Cine MRI • High resolution, dynam
Page 59: Results of cine MRI used to: • Pl
Page 63 and 64: Case 1 - Treatment and results •
Page 65 and 66: Case 2 - Cine MRI • Adenoid regro
Page 67 and 68: Case 3 • 8 year old male with DS
Page 69 and 70: Case 3 • Lingual tonsillectomy do
Page 71: Medical options for persistent OSA
Page 75 and 76: Oral splints and dental appliances
Page 77 and 78: Medical and Surgical Treatment afte
Page 79 and 80: DYMOSA Dynamic Computational Modeli
Page 81 and 82: Division of Pulmonary Medicine, Cin
Page 83 and 84: Computational Fluid Dynamics (CFD)
Page 85 and 86: Flow Structure Interaction modeling
Page 87 and 88: FSI and LES • LES can predict are
Page 89 and 90: Structure and Compliance Baseline M
Page 91 and 92: ROADMAP :: FSI MODELING :: 3D Case
Page 93 and 94: DYMOSA Aims • Aim 1: Collect data
Page 95 and 96: Long Term Goal Improve surgical out
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Obstructive Sleep Apnea Syndrome in Children

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