폐쇄성 수면무호흡이 있는 다운증후군 소아에서의 편도 및 아데노이드 절제술 1예
A Case of Tonsillectomy and Adenoidectomy in Child With Down Syndrome With Obstructive Sleep Apnea
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Children with obstructive sleep apnea (OSA) show symptoms such as snoring, sleep apnea,and oral breathing. The diagnosis of the disease can be made through polysomnography andas the most common causes are tonsillar and adenoid hypertrophy, tonsillectomy and adenoidectomy(T et A) are considered as initial treatment. OSA is an increasingly recognized problemin children with Down syndrome, who are more prone to facial hypoplasia, hypoplasia ofthe mandible, and have a large tongue. In OSA Down syndrome patients, T et A can be performedif tonsillar hypertrophy is present. However, because these patients have underlyingdiseases (atlatoaxial unstability, airway problem, heart problem, endocrine problem), generalanesthesia may be difficult and cervical extension may be limited during the operation. Wedescribe a case of 10-year-old child with Down syndrome and OSA, who underwent T et Aunder general anesthesia through multidisciplinary care.
Abstract
Children with obstructive sleep apnea (OSA) show symptoms such as snoring, sleep apnea,and oral breathing. The diagnosis of the disease can be made through polysomnography andas the most common causes are tonsillar and adenoid hypertrophy, tonsillectomy and adenoidectomy(T et A) are considered as initial treatment. OSA is an increasingly recognized problemin children with Down syndrome, who are more prone to facial hypoplasia, hypoplasia ofthe mandible, and have a large tongue. In OSA Down syndrome patients, T et A can be performedif tonsillar hypertrophy is present. However, because these patients have underlyingdiseases (atlatoaxial unstability, airway problem, heart problem, endocrine problem), generalanesthesia may be difficult and cervical extension may be limited during the operation. Wedescribe a case of 10-year-old child with Down syndrome and OSA, who underwent T et Aunder general anesthesia through multidisciplinary care.
참고문헌 (15)
- Marcus CL, "Sleep-disordered breathing in children", Curr Opin Pediatr, 12(3), pp.208~212 (2000)
- Marcus CL, "Diagnosis and management of childhood obstructive sleep apnea syndrome", Pediatrics, 130(3), pp.576~584 (2012)
- Goldstein NA, "Child behavior and quality of life before and after tonsillectomy and adenoidectomy", Arch Otolaryngol Head Neck Surg, 128(7), pp.770~775 (2002)
- Shott SR, "Obstructive sleep apnea : Should all children with Down syndrome be tested?", Arch Otolaryngol Head Neck Surg, 132(4), pp.432~436 (2006)
- Meitzner MC, "Anesthetic considerations for patients with Down syndrome", AANA J, 73(2), pp.103~107 (2005)
- Li Z, "Pediatric sleep apnea syndrome : An update", J Allergy Clin Immunol Pract, 4(5), pp.852~861 (2016)
- Muzumdar HV, "Changes in heart rate variability after adenotonsillectomy in children with obstructive sleep apnea", Chest, 139(5), pp.1050~1059 (2011)
- Malinzak EB, "Perioperative care of adults with Down syndrome : A narrative review", Can J Anaesth, 68(10), pp.1549~1561 (2021)
- Pueschel SM, "Atlantoaxial instability in individuals with Down syndrome: Epidemiologic, radiographic, and clinical studies", Pediatrics, 80(4), pp.555~560 (1987)
- Nakazawa K, "A case of difficult airway due to lingual tonsillar hypertrophy in a patient with Down’s syndrome", Anesth Analg, 97(3), pp.704~705 (2003)
- Bhattarai B, "Anesthetic consideration in downs syndrome--a review", Nepal Med Coll J, 10(3), pp.199~203 (2008)
- Santamaria LB, "Preanesthetic evaluation and assessment of children with Down’s syndrome", ScientificWorldJournal, 7, pp.242~251 (2007)
- Goldstein NA, "Postoperative complications after tonsillectomy and adenoidectomy in children with Down syndrome", Arch Otolaryngol Head Neck Surg, 124(2), pp.171~176 (1998)
- Mitic S, "A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis", Clin Otolaryngol, 32(4), pp.261~267 (2007)
- Strome M, "Obstructive sleep apnea in Down syndrome children : A surgical approach", Laryngoscope, 96(12), pp.1340~1342 (1986)