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Tracheostomy for paediatric obstructive sleep apnoea: A systematic review

Published online by Cambridge University Press:  03 August 2018

S Fray
Affiliation:
School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
A Biello
Affiliation:
School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
J Kwan
Affiliation:
School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
Y A Kram
Affiliation:
Department of Surgery, Division of Otolaryngology, Tripler Army Medical Center, Hawaii, USA
K Lu
Affiliation:
Department of Surgery, Division of Otolaryngology, San Antonio Military Medical Center, Texas, USA
M Camacho*
Affiliation:
Department of Surgery, Division of Otolaryngology, Tripler Army Medical Center, Hawaii, USA
*
Author for correspondence: Dr Macario Camacho, Department of Surgery, Division of Otolaryngology, Tripler Army Medical Center, 1 Jarrett White Rd, HI 96859, USA E-mail: drcamachoent@yahoo.com

Abstract

Objective

To search the international literature (any language) for publications reporting outcomes of tracheostomy performed to treat obstructive sleep apnoea in children.

Method

Data sources included: Google Scholar, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, and PubMed/Medline. Four authors searched systematically through to 20 January 2018.

Results

A total of 597 studies were screened; 64 were downloaded and 11 met criteria. A total of 196 patients underwent tracheostomy (mean age, 4.2 years; range, newborn to 18 years); 40 had detailed qualitative data and 6 had detailed quantitative data. Apnoea/hypopnoea index showed a 97 per cent reduction (n = 2) and apnoea index showed a 98 per cent reduction (n = 3). Lowest oxygen saturation showed a 34 oxygen saturation point improvement (n = 3). Several patients demonstrated significant improvement in breathing. All identified patients were syndromic, had significant co-morbidities or had severe obstructive sleep apnoea.

Conclusion

Based on reports of children who have undergone a tracheostomy, for whom there are pre- and post-operative data, tracheostomy appears to be a successful treatment for obstructive sleep apnoea. However, additional research is recommended given the small number of patients in the literature.

Type
Review Articles
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr M Camacho takes responsibility for the integrity of the content of the paper

References

1Camacho, M, Teixeira, J, Abdullatif, J, Acevedo, JL, Certal, V, Capasso, R et al. Maxillomandibular advancement and tracheostomy for morbidly obese obstructive sleep apnea: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 2015;152:619–30Google Scholar
2Camacho, M, Certal, V, Brietzke, SE, Holty, JE, Guilleminault, C, Capasso, R. Tracheostomy as treatment for adult obstructive sleep apnea: a systematic review and meta-analysis. Laryngoscope 2014;124:803–11Google Scholar
3Brietzke, SE, Gallagher, D. The effectiveness of tonsillectomy and adenoidectomy in the treatment of pediatric obstructive sleep apnea/hypopnea syndrome: a meta-analysis. Otolaryngol Head Neck Surg 2006;134:979–84Google Scholar
4Camacho, M, Certal, V, Abdullatif, J, Zaghi, S, Ruoff, CM, Capasso, R et al. Myofunctional therapy to treat obstructive sleep apnea: a systematic review and meta-analysis. Sleep 2015;38:669–75Google Scholar
5Tapia, IE, Marcus, CL. Newer treatment modalities for pediatric obstructive sleep apnea. Paediatr Respir Rev 2013;14:199203Google Scholar
6Bannink, N, Nout, E, Wolvius, EB, Hoeve, HL, Joosten, KF, Mathijssen, IM. Obstructive sleep apnea in children with syndromic craniosynostosis: long-term respiratory outcome of midface advancement. Int J Oral Maxillofac Surg 2010;39:115–21Google Scholar
7Burstein, FD, Cohen, SR, Scott, PH, Teague, GR, Montgomery, GL, Kattos, AV. Surgical therapy for severe refractory sleep apnea in infants and children: application of the airway zone concept. Plast Reconstr Surg 1995;961:3441Google Scholar
8Cohen, SR, Suzman, K, Simms, C, Burstein, FD, Riski, J, Montgomery, G. Sleep apnea surgery versus tracheostomy in children: an exploratory study of the comparative effects on quality of life. Plast Reconstr Surg 1998;102:1855–64Google Scholar
9Cook, BJ, Berkowitz, RG. Tracheostomy in children with nemaline core myopathy. Int J Pediatr Otorhinolaryngol 2005;69:263–6Google Scholar
10Gozal, D, Torres, JE, Menendez, AA. Longitudinal assessment of hypercapnic ventilatory drive after tracheotomy in a patient with the Prader-Willi syndrome. Eur Respir J 1996;9:1565–8Google Scholar
11Guilleminault, C, Eldridge, FL, Simmons, FB, Dement, WC. Sleep apnea in eight children. Pediatrics 1976;58:2330Google Scholar
12Handford, HA, Cadieux, RJ, Kales, A, Ballard, JO, Potter, CR. Tracheostomy for sleep apnea in a hemophilic child. Am J Pediatr Hematol Oncol 1984;6:346–9Google Scholar
13Imataka, G, Nakajima, I, Goto, K, Konno, W, Hirabayashi, H, Arisaka, O. Drop episodes improved after tracheotomy: a case of Coffin-Lowry syndrome associated with obstructive sleep apnea syndrome. Eur Rev Med Pharmacol Sci 2016;20:498501Google Scholar
14Kasow, KA, Stocks, RM, Kaste, SC, Donepudi, S, Tottenham, D, Schoumacher, RA et al. Airway evaluation and management in 7 children with malignant infantile osteopetrosis before hematopoietic stem cell transplantation. J Pediatr Hematol Oncol 2008;30:225–9Google Scholar
15Perks, WH, Cooper, RA, Bradbury, S, Horrocks, P, Baldock, N, Allen, A et al. Sleep apnoea in Scheie's syndrome. Thorax 1980;35:8591Google Scholar
16Rizzi, CJ, Amin, JD, Isaiah, A, Valdez, TA, Jeyakumar, A, Smart, SE et al. Tracheostomy for severe pediatric obstructive sleep apnea: indications and outcomes. Otolaryngol Head Neck Surg 2017:157:309–13Google Scholar
17Camacho, M, Zaghi, S, Chang, ET, Song, SA, Szelestey, B, Certal, V. Mini tracheostomy for obstructive sleep apnea: an evidence based proposal. Int J Otolaryngol 2016;2016:7195349Google Scholar