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Article Type

Original Study

Abstract

Background Obstructive sleep apnea (OSA) is not an uncommon finding in the pediatric age group patients with cerebral palsy (CP). Objective We aimed to evaluate the frequency of occurrence of OSA in children with CP and the most appropriate surgical procedures used in these patients. Study design A prospective study was carried out on 67 children with OSA, 36 of whom suffer from CP. The data included the presenting complaint, any coexisting illnesses, preoperative and postoperative polysomnography results, the primary surgical procedure performed, age at the time of surgery, number of postoperative hospitalization days in the ICU, and presence of postoperative respiratory disorders. Results In all, 40 (59.7%) children underwent adenotonsillectomy for initial treatment of OSA. Our results reported that the clinical manifestations were more significant in the CP-affected children. We documented a significant decrease in the mean value of the apnea hypoxia index in all included children postoperatively. However, there was no significant difference in apnea hypoxia index postoperatively among children in both groups. Nine (17.4%) children had an adenoidectomy alone and 18 (26.86%) children had tonsillectomy alone as their initial procedure. Neither uvulopalatopharyngoplasty nor tracheostomy was performed as an initial procedure. The mean follow-up was set for 24 months. Eighty-six percent of these children have not required any further surgery. Of the six children who have undergone further surgery, one required a revision adenoidectomy, and two underwent a tonsillectomy and uvulectomy 2 months after the initial adenoidectomy. Four CP children later required a tracheotomy for severe hypoxia. Conclusion OSA is a more frequent occurrence in CP children as compared with their healthy counterparts. They ultimately had significant improvement in their clinical presentations postoperatively, thus improving their quality of life.

Keywords

Adenoidectomy, cerebral palsy, obstructive sleep apnea

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