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Article

Age and Upper Airway Obstruction: A Challenge to the Clinical Approach in Pediatric Patients

1
Division of Pediatrics, “F. Del Ponte” Hospital, University of Insubria, 21100 Varese, Italy
2
Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37134 Verona, Italy
3
Department of Otorhinolaryngology, University of Insubria and ASST Sette Laghi, Ospedale di Circolo, 21100 Varese, Italy
4
Pennington Biomedical Research Center, Baton Rouge, LA 225, USA
5
Division of Neonatology and Neonatal Intensive Care Unit, “F. Del Ponte” Hospital, 21100 Varese, Italy
*
Author to whom correspondence should be addressed.
Nosetti Luana and Marco Zaffanello contributed equally.
Int. J. Environ. Res. Public Health 2020, 17(10), 3531; https://doi.org/10.3390/ijerph17103531
Received: 28 February 2020 / Revised: 28 April 2020 / Accepted: 8 May 2020 / Published: 18 May 2020
Upper airway abnormalities increase the risk of pediatric morbidity in infants. A multidisciplinary approach to obstructive sleep apnea syndrome (OSAS) poses challenges to clinical practice. The incidence and causes of OSA are poorly studied in children under 2 years of age. To fill this gap, we performed this retrospective observational study to determine the causes of obstructive sleep apnea (OSA) in children admitted to our hospital between January 2016 and February 2018, after a brief unexplained event (BRUE) or for OSA. We reviewed the medical charts of 82 patients (39 males; BRUE n = 48; OSAS n = 34) and divided them into two age groups: < 1 year old (1–12 months; n = 59) and >1 year old (>12–24 months; n = 23). Assessment included nap polysomnography, multichannel intraluminal impedance-pH, and nasopharyngoscopy. Sleep disordered breathing was comparable between the two groups. Omega-shaped epiglottis, laryngomalacia, and nasal septum deviation were more frequent in the younger group, and nasal congestion in older group. Tonsillar and adenoidal hypertrophy was more frequent in the older group, while laryngomalacia and gastroesophageal reflux was more frequent in the younger group. Tonsil and adenoid size were associated with grade of apnea-hypopnea index severity in the older group, and laryngomalacia and gastroesophageal reflux in the younger group. The main causes of respiratory sleep disorders differ in children before or after age 1 year. Our findings have potential clinical utility for assessing the pathophysiology of obstructive sleep disordered breathing in patients less than 2 years old. View Full-Text
Keywords: brief resolved unexplained event; gastro-esophageal reflux; infants; laryngomalacia; obstructive sleep disordered breathing; polysomnography brief resolved unexplained event; gastro-esophageal reflux; infants; laryngomalacia; obstructive sleep disordered breathing; polysomnography
MDPI and ACS Style

Luana, N.; Marco, Z.; Francesca, D.B.; Giorgio, P.; Giulia, R.; Silvia, S.; Daniela, S.; Angelo, P.; Massimo, A. Age and Upper Airway Obstruction: A Challenge to the Clinical Approach in Pediatric Patients. Int. J. Environ. Res. Public Health 2020, 17, 3531. https://doi.org/10.3390/ijerph17103531

AMA Style

Luana N, Marco Z, Francesca DB, Giorgio P, Giulia R, Silvia S, Daniela S, Angelo P, Massimo A. Age and Upper Airway Obstruction: A Challenge to the Clinical Approach in Pediatric Patients. International Journal of Environmental Research and Public Health. 2020; 17(10):3531. https://doi.org/10.3390/ijerph17103531

Chicago/Turabian Style

Luana, Nosetti, Zaffanello Marco, De Bernardi Francesca, Piacentini Giorgio, Roberto Giulia, Salvatore Silvia, Simoncini Daniela, Pietrobelli Angelo, and Agosti Massimo. 2020. "Age and Upper Airway Obstruction: A Challenge to the Clinical Approach in Pediatric Patients" International Journal of Environmental Research and Public Health 17, no. 10: 3531. https://doi.org/10.3390/ijerph17103531

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