Abstract
Knowledge of the clinical significance, diagnosis and therapy of sleep apnea in children is still incomplete. We have seen three children, 2, 5 and 6 years of age, with obstructive sleep apnea documented by polygraphic recording who required tracheostomy for relief of incapacitating and life threatening obstructive sleep apnea. These children did not improve on passage of a nasopharyngeal tube as do those with nasopharyngeal airway obstruction associated with enlarged tonsils and adenoids. On fiberoptic endoscopy under light anestheisa the site of obstruction was noted not to be in the nasopharynx, but in the oro and hypopharynx. In one patient airway obstruction was related to glossoptosis. In two patients a sphincter like closing of the lower pharyngeal walls was observed that was synchronous with inspiration. We will show a motion picture that demonstrates this phenomenon both aurally and visually. These patients represent 10% of all children referred for sleep apnea during the past 1½ years. This lower pharyngeal site of airway obstruction has also been noted in adults with obstructive sleep apnea who also respond well to tracheostomy. Although tracheostomy may seem an extreme measure for this still obscure and poorly understood entity we think it is indicated for selected patients at this time.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
