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European Archives of Oto-Rhino-Laryngology

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Open Access 04-04-2024 | Polysomnography | Laryngology

Nap polysomnography in infants with laryngomalacia as a tool to predict treatment strategy

Authors: Mariem Lajili, Natacha Teissier, Benjamin Dudoignon, Charlotte Benoit, Sophie Bellanger, Laureline Kahn, Thierry Van Den Abbeele, Christophe Delclaux, Plamen Bokov

Published in: European Archives of Oto-Rhino-Laryngology | Issue 6/2024

Abstract

Purpose

This study aimed to investigate the role of nap polysomnography (NPSG) in predicting treatment strategies for infants with moderate to severe laryngomalacia and to explore the association between obstructive sleep apnea (OSA) severity, weight gain, and laryngomalacia severity.

Methods

A retrospective analysis was conducted on infants diagnosed with moderate to severe laryngomalacia who underwent NPSG between January 2019 and June 2023. Clinical variables, NPSG parameters, and treatment decisions were collected. Weight gain rate and its correlation with NPSG indices were assessed. Logistic regression analyses were performed to predict treatment strategies based on NPSG findings.

Results

Of the 39 infants included (median age: 3.3 months), 77% exhibited OSA, with 69% having moderate to severe OSA [apnea–hypopnea index (AHI) > 5/h]. Weight gain rate correlated negatively with indices of OSA severity, including the hypopnea index (HI) and the AHI. In a multiple logistic regression analysis incorporating the severity of OSA (AHI), weight gain rate, and laryngomalacia severity, only AHI predicted the decision for surgical or non-invasive ventilation treatment (OR = 2.1, CI₉₅ [1.6; 2.8], p ≤ 10^–4). The weight gain rate was predicted (r² = 0.28) by the AHI and the presence of retractions of auxiliary inspiratory muscles.

Conclusion

This study underscores the importance of NPSG in assessing infants with moderate to severe laryngomalacia. The AHI from NPSG emerged as a potential predictor for treatment decisions and weight gain rate, emphasizing its clinical relevance. These findings advocate incorporating NPSG into the diagnostic and management process for infants with laryngomalacia.

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Title: Nap polysomnography in infants with laryngomalacia as a tool to predict treatment strategy
Authors: Mariem Lajili
Natacha Teissier
Benjamin Dudoignon
Charlotte Benoit
Sophie Bellanger
Laureline Kahn
Thierry Van Den Abbeele
Christophe Delclaux
Plamen Bokov
Publication date: 04-04-2024
Publisher: Springer Berlin Heidelberg
Keywords: Polysomnography
Non-Invasive Ventilation
Published in: European Archives of Oto-Rhino-Laryngology / Issue 6/2024
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-024-08623-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Nap polysomnography in infants with laryngomalacia as a tool to predict treatment strategy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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