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Medical management of severe obstructive sleep apnoea in two cases during the coronavirus disease 2019 pandemic

Part of: JLO Coronavirus Collection

Published online by Cambridge University Press:  21 March 2022

H S Gajaweera ,
C Griffiths ,
L H Everitt  and
H J Evans Open the ORCID record for H J Evans [Opens in a new window]
H S Gajaweera
Affiliation:
Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
C Griffiths
Affiliation:
Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
L H Everitt
Affiliation:
Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
H J Evans*
Affiliation:
Paediatric Respiratory Department, Southampton Children's Hospital, Southampton, UK
*
Author for correspondence: Dr H J Evans, Paediatric Respiratory Department, Southampton Children's Hospital, Southampton SO16 6YD, UK E-mail: Hazel.Evans@uhs.nhs.uk
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Abstract

Objective

Severe paediatric obstructive sleep apnoea in typically developing children with adenotonsillar hypertrophy is primarily managed surgically. Non-emergency ENT surgery was paused early in the coronavirus disease 2019 pandemic and children were offered medical management for obstructive sleep apnoea.

Methods

A service evaluation was performed to assess the impact of continuous positive airway pressure alongside medical management for severe obstructive sleep apnoea.

Results

Over 5 months during 2020, in a tertiary care setting, two children (one boy and one girl), aged 2.7 years and 4.1 years, were offered continuous positive airway pressure and medical treatments for severe obstructive sleep apnoea whilst surgery was paused during the coronavirus disease 2019 pandemic. Both children failed to establish continuous positive airway pressure therapy because of ongoing disturbed sleep on ventilation, and they proceeded to adenotonsillectomy. Sleep-Related Breathing Disorder scale scores improved following surgical intervention.

Conclusion

Continuous positive airway pressure therapy is poorly tolerated in children with severe obstructive sleep apnoea secondary to adenotonsillar hypertrophy. Surgery remains the most appropriate treatment.

Keywords

COVID-19Apnea, SleepChildTonsillectomyAdenoidectomyVentilators, MechanicalMedical Practice Management
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 5 , May 2022 , pp. 464 - 465
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr H J Evans takes responsibility for the integrity of the content of the paper

References

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