Arch Otolaryngol
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To assess polysomnogram (PSG) results and global and disease-specific quality of life (QOL) in children with obstructive sleep apnea (OSA), before and after adenotonsillectomy, and to assess the association between PSG findings and QOL. ⋯ Children with OSA and sleep-disordered breathing have significantly worse QOL than healthy children. However, the association between PSG findings and QOL was only moderate. Children with OSA treated with adenotonsillectomy demonstrated large improvements in disease-specific and global QOL as well as PSG parameters.
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To determine the incidence and character of clinically significant laryngotracheal anomalies in pediatric patients undergoing surgical repair of congenital cardiac defects at a tertiary care center. ⋯ Pediatric patients with congenital cardiac disease are predisposed to laryngeal anomalies owing to (1) frequent intubation, (2) prolonged ventilatory support, and (3) recurrent laryngeal nerve injury. In our patients, subglottic stenosis was the most common laryngeal abnormality. When recognized early, in the eschar phase, most of these cases can be managed with sequential endoscopic debridement, which is conceptually similar to debridement that is performed after functional endoscopic sinus surgery. Established stenosis requires more vigorous intervention, the invasive degree of which depends on the length and circumference of the narrowing. Unilateral vocal paralysis tends to be a self-limited problem, while an elegant solution to bilateral paralysis remains elusive.
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To assess behavior and quality of life in children with obstructive sleep apnea (OSA) undergoing tonsillectomy and adenoidectomy compared with control children. ⋯ Behavioral and emotional difficulties are found in children with documented OSA compared with control children, and they improve after treatment. Large improvements in disease-specific quality of life are also found. Scores on a standardized measure of behavior assessment demonstrated significant correlation with scores on a validated quality-of-life instrument.