Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 6/2019

01-06-2019 | Sleep Apnea | Review Article

Adenotonsillectomy in children with syndromic craniosynostosis: a systematic review and meta-analysis

Authors: Petcharat Saengthong, Busarakum Chaitusaney, Prakobkiat Hirunwiwatkul, Natamon Charakorn

Published in: European Archives of Oto-Rhino-Laryngology | Issue 6/2019

Login to get access

Abstract

Objective

To conduct a systematic review and meta-analysis in children with syndromic craniosynostosis, to evaluate the effect of adenotonsillectomy for the treatment of obstructive sleep apnea (OSA).

Study design

A systematic review and meta-analysis.

Search methods

Data sources: a comprehensive search of PubMed, SCOPUS, Ovid Medline, and Web of science databases was performed through June 22nd, 2018. Manual searches and subject matter expert input were also obtained. This article includes studies assessing the effectiveness of adenotonsillectomy in syndromic craniosynostosis children, in which apnea–hypopnea index (AHI) or oxygen desaturation index (ODI) was reported.

Results

A total of 3 retrospective studies (24 patients) met the inclusion criteria. Pooled random effect analysis did not identify a statistically significant difference between preoperative and postoperative AHI. But there was an overall reduction of AHI of 5.00 events per hour [95% confidence interval (CI) (– 17.79, 7.79); P = 0.44]. However, the fixed effect model demonstrated a statistically significant difference between preoperative and postoperative ODI with an overall reduction of 8.5 per hour [95% CI (– 15.01, – 1.99); P = 0.01].

Conclusion

Adenotonsillectomy showed benefits for the treatment of OSA in syndromic craniosynostosis children, in terms of AHI and ODI. However, only ODI, but not AHI, reached statistical significance. Data were based on meta-analysis of retrospective reviews. Further studies that are conducted at multiple centers are needed to confirm the benefits of adenotonsillectomy for the treatment of OSA in syndromic craniosynostosis children.
Literature
1.
go back to reference Jones KL, Jones MC, Campo Md (2013) Craniosynostosis syndromes. In: Smith's recognizable patterns of human malformation, 7th edn. Saunders, US, pp 530–559 Jones KL, Jones MC, Campo Md (2013) Craniosynostosis syndromes. In: Smith's recognizable patterns of human malformation, 7th edn. Saunders, US, pp 530–559
2.
go back to reference Mixter RC, David DJ, Perloff WH, Green CG, Pauli RM, Popic PM (1990) Obstructive sleep apnea in Apert's and Pfeiffer's syndromes: more than a craniofacial abnormality. Plast Reconstr Surg 86(3):457–463CrossRefPubMed Mixter RC, David DJ, Perloff WH, Green CG, Pauli RM, Popic PM (1990) Obstructive sleep apnea in Apert's and Pfeiffer's syndromes: more than a craniofacial abnormality. Plast Reconstr Surg 86(3):457–463CrossRefPubMed
17.
go back to reference Sculerati N, Gottlieb MD, Zimbler MS, Chibbaro PD, McCarthy JG (1998) Airway management in children with major craniofacial anomalies. Laryngoscope 108(12):1806–1812CrossRefPubMed Sculerati N, Gottlieb MD, Zimbler MS, Chibbaro PD, McCarthy JG (1998) Airway management in children with major craniofacial anomalies. Laryngoscope 108(12):1806–1812CrossRefPubMed
18.
go back to reference Edwards TJ, David DJ, Martin J (1992) Aggressive surgical management of sleep apnea syndrome in the syndromal craniosynostoses. J Craniofac Surg 3(1):8–10 (discussion 11) CrossRefPubMed Edwards TJ, David DJ, Martin J (1992) Aggressive surgical management of sleep apnea syndrome in the syndromal craniosynostoses. J Craniofac Surg 3(1):8–10 (discussion 11) CrossRefPubMed
19.
go back to reference National Institute for Health and Clinical Excellence: Guidance (2003) Preoperative tests: the use of routine preoperative tests for elective surgery. National Institute for Health and Clinical Excellence: Guidance, London National Institute for Health and Clinical Excellence: Guidance (2003) Preoperative tests: the use of routine preoperative tests for elective surgery. National Institute for Health and Clinical Excellence: Guidance, London
22.
go back to reference Iber C, Ancoli-Israel S, Chesson AL, Quan S (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications Iber C, Ancoli-Israel S, Chesson AL, Quan S (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications
23.
go back to reference Aurora RN, Zak RS, Karippot A, Lamm CI, Morgenthaler TI, Auerbach SH, Bista SR, Casey KR, Chowdhuri S, Kristo DA, Ramar K, American Academy of Sleep M (2011) Practice parameters for the respiratory indications for polysomnography in children. Sleep 34(3):379–388CrossRefPubMedPubMedCentral Aurora RN, Zak RS, Karippot A, Lamm CI, Morgenthaler TI, Auerbach SH, Bista SR, Casey KR, Chowdhuri S, Kristo DA, Ramar K, American Academy of Sleep M (2011) Practice parameters for the respiratory indications for polysomnography in children. Sleep 34(3):379–388CrossRefPubMedPubMedCentral
24.
26.
go back to reference American Academy of Sleep Medicine Task Force (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force (1999). Sleep 22(5):667–689CrossRef American Academy of Sleep Medicine Task Force (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force (1999). Sleep 22(5):667–689CrossRef
29.
go back to reference Brouillette RT, Morielli A, Leimanis A, Waters KA, Luciano R, Ducharme FM (2000) Nocturnal pulse oximetry as an abbreviated testing modality for pediatric obstructive sleep apnea. Pediatrics 105(2):405–412CrossRefPubMed Brouillette RT, Morielli A, Leimanis A, Waters KA, Luciano R, Ducharme FM (2000) Nocturnal pulse oximetry as an abbreviated testing modality for pediatric obstructive sleep apnea. Pediatrics 105(2):405–412CrossRefPubMed
31.
go back to reference Blumenfeld J (2000) Racial identification in the skull and teeth. Totem Univ West Ont J Anthropol 8(1):20–33 Blumenfeld J (2000) Racial identification in the skull and teeth. Totem Univ West Ont J Anthropol 8(1):20–33
Metadata
Title
Adenotonsillectomy in children with syndromic craniosynostosis: a systematic review and meta-analysis
Authors
Petcharat Saengthong
Busarakum Chaitusaney
Prakobkiat Hirunwiwatkul
Natamon Charakorn
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 6/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-019-05427-3

Other articles of this Issue 6/2019

European Archives of Oto-Rhino-Laryngology 6/2019 Go to the issue