The role of nasal CPAP in obstructive sleep apnoea syndrome due to mandibular hypoplasia.

Hdl Handle:
http://hdl.handle.net/10147/207635
Title:
The role of nasal CPAP in obstructive sleep apnoea syndrome due to mandibular hypoplasia.
Authors:
Miller, Stanley D W; Glynn, Senan F; Kiely, John L; McNicholas, Walter T
Affiliation:
Department of Respiratory Medicine, St. Vincent's University Hospital, Dublin,, Ireland. stanley.miller@leedsth.nhs.uk
Citation:
Respirology. 2010 Feb;15(2):377-9.
Journal:
Respirology (Carlton, Vic.)
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207635
DOI:
10.1111/j.1440-1843.2009.01681.x
PubMed ID:
20199649
Abstract:
Melnick Needles syndrome (MNS), Treacher Collins syndrome (TCS) and Pierre Robin syndrome (PRS) are congenital abnormalities with characteristic facial appearances that include micrognathia. A 20-year-old girl with MNS, a 16-year-old boy with TCS and a 12-year-old girl with PRS attended the sleep apnoea clinic at our institution at different times. Diagnostic sleep studies were initially performed on all three patients to confirm the diagnosis of obstructive sleep apnoea syndrome (OSAS). They subsequently commenced nasal CPAP (nCPAP) treatment and their progress was followed. A limited sleep study on the patient with MNS demonstrated moderate/severe OSAS with an AHI of 33 events/h. Commencement of nCPAP resulted in symptomatic improvement. Overnight oximetry in the patient with TCS showed repeated desaturation to SpO2<90%. Subsequent treatment by nCPAP almost completely abolished the desaturation events. Overnight polysomnography in the patient with PRS demonstrated severe OSAS with an AHI of 49 events/h. After 3 years of nCPAP therapy, this patient requested discontinuation of treatment. Subsequent polysomnography without nCPAP revealed an AHI of <5 events/h. The use of nCPAP in the patients with MNS and TCS resulted in effective control of their sleep abnormalities. Mandibular growth and enlargement of the posterior airway space led to resolution of OSAS in the patient with PRS. There is a definite role for nCPAP therapy in patients with congenital micrognathia and OSAS. The use of nCPAP may obviate the need for more invasive corrective surgery for OSAS and is not necessarily a life-long requirement.
Language:
eng
MeSH:
Adolescent; Child; *Continuous Positive Airway Pressure; Female; Humans; Male; Mandible/*abnormalities; Mandibulofacial Dysostosis/complications; Micrognathism/*complications/etiology; Osteochondrodysplasias/complications; Pierre Robin Syndrome/complications; Polysomnography; Sleep Apnea, Obstructive/*etiology/*therapy; Treatment Outcome; Young Adult
ISSN:
1440-1843 (Electronic); 1323-7799 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMiller, Stanley D Wen_GB
dc.contributor.authorGlynn, Senan Fen_GB
dc.contributor.authorKiely, John Len_GB
dc.contributor.authorMcNicholas, Walter Ten_GB
dc.date.accessioned2012-02-01T10:33:31Z-
dc.date.available2012-02-01T10:33:31Z-
dc.date.issued2012-02-01T10:33:31Z-
dc.identifier.citationRespirology. 2010 Feb;15(2):377-9.en_GB
dc.identifier.issn1440-1843 (Electronic)en_GB
dc.identifier.issn1323-7799 (Linking)en_GB
dc.identifier.pmid20199649en_GB
dc.identifier.doi10.1111/j.1440-1843.2009.01681.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/207635-
dc.description.abstractMelnick Needles syndrome (MNS), Treacher Collins syndrome (TCS) and Pierre Robin syndrome (PRS) are congenital abnormalities with characteristic facial appearances that include micrognathia. A 20-year-old girl with MNS, a 16-year-old boy with TCS and a 12-year-old girl with PRS attended the sleep apnoea clinic at our institution at different times. Diagnostic sleep studies were initially performed on all three patients to confirm the diagnosis of obstructive sleep apnoea syndrome (OSAS). They subsequently commenced nasal CPAP (nCPAP) treatment and their progress was followed. A limited sleep study on the patient with MNS demonstrated moderate/severe OSAS with an AHI of 33 events/h. Commencement of nCPAP resulted in symptomatic improvement. Overnight oximetry in the patient with TCS showed repeated desaturation to SpO2<90%. Subsequent treatment by nCPAP almost completely abolished the desaturation events. Overnight polysomnography in the patient with PRS demonstrated severe OSAS with an AHI of 49 events/h. After 3 years of nCPAP therapy, this patient requested discontinuation of treatment. Subsequent polysomnography without nCPAP revealed an AHI of <5 events/h. The use of nCPAP in the patients with MNS and TCS resulted in effective control of their sleep abnormalities. Mandibular growth and enlargement of the posterior airway space led to resolution of OSAS in the patient with PRS. There is a definite role for nCPAP therapy in patients with congenital micrognathia and OSAS. The use of nCPAP may obviate the need for more invasive corrective surgery for OSAS and is not necessarily a life-long requirement.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshChilden_GB
dc.subject.mesh*Continuous Positive Airway Pressureen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMandible/*abnormalitiesen_GB
dc.subject.meshMandibulofacial Dysostosis/complicationsen_GB
dc.subject.meshMicrognathism/*complications/etiologyen_GB
dc.subject.meshOsteochondrodysplasias/complicationsen_GB
dc.subject.meshPierre Robin Syndrome/complicationsen_GB
dc.subject.meshPolysomnographyen_GB
dc.subject.meshSleep Apnea, Obstructive/*etiology/*therapyen_GB
dc.subject.meshTreatment Outcomeen_GB
dc.subject.meshYoung Adulten_GB
dc.titleThe role of nasal CPAP in obstructive sleep apnoea syndrome due to mandibular hypoplasia.en_GB
dc.contributor.departmentDepartment of Respiratory Medicine, St. Vincent's University Hospital, Dublin,, Ireland. stanley.miller@leedsth.nhs.uken_GB
dc.identifier.journalRespirology (Carlton, Vic.)en_GB
dc.description.provinceLeinster-

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