Sleep Breathing Related Disorders and Ear Nose and Throat Alterations: Clinical Manifestations, Diagnosis and Treatments

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Pulmonary and Sleep Medicine".

Deadline for manuscript submissions: closed (1 February 2024) | Viewed by 5045

Special Issue Editors

Otolaryngology-Head and Neck Surgery Unit, Department of Cardiothoracic Sciences, University of Campania “Luigi Vanvitelli”, 80100 Naples, Italy
Interests: sleep disorders; allergic rhinitis; endoscopic surgery; pediatric otolaryngology
Pulmonary Rehabilitation Division, Istituti Clinici Scientifici Maugeri IRCCS, 82037 Telese Terme, BN, Italy
Interests: pediatric rehabilitation; pediatric sleep disorders; pediatric polysomnography; pediatric headaches; pediatric epilepsy; pediatric EEG; autism
Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
Interests: pediatric rehabilitation; pediatric sleep disorders; pediatric polysomnography; pediatric headaches; pediatric epilepsy; pediatric EEG; autism
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Special Issue Information

Dear Colleagues,

Acute and chronic ear nose and throat infections in childhood represent a great proportion of clinical conditions presented both in preschool and school age. Sleep-related breathing disorders (SRBDs), which range from primary snoring to obstructive sleep apnea syndrome (OSAS), occur in 34.5% of children. OSAS is believed to be present in about 1% to 3% in children aged 2 to 18 with no gender predominance; furthermore, chronic snoring or primary snoring may be present in more than 10% of children. Neurocognitive and behavioral impairment often depends on sleep breathing disorders. Several clinical conditions of the nose, rhinopharynx, mouth and oropharynx, hypopharynx and larynx lead to SRBDs such as hypertrophy of adenoids and palatine tonsils, nasal polyposis and other chronic rhinosinusitis, rhinitis (allergic and nonallergic), anatomic alterations of nasal cavity, and laryngitis.

The aim of this Special Issue is to focus on these ear, nose and throat clinical conditions associated with SRBDs, inducing neurocognitive and behavioral alterations in preschool- and school-aged children and adolescents in order to give an appropriate treatment to improve patients’ clinical condition, as well as both patient and caregiver quality of life.

Dr. Domenico Testa
Dr. Giuseppina Marcuccio
Dr. Marco Carotenuto
Guest Editors

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Keywords

  • sleep related disorders
  • obstructive sleep apnea syndrome
  • adenoiditis
  • tonsillitis
  • adenotonsillectomy
  • otitis media with effusion
  • hearing loss
  • rhinitis
  • neurocognitive impairment
  • behavioural disorders

Published Papers (3 papers)

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12 pages, 727 KiB  
Article
Clinical Application of Pediatric Sleep Endoscopy: An International Survey
by Giannicola Iannella, Giuseppe Magliulo, Antonio Greco, Armando De Virgilio, Antonino Maniaci, Jerome R. Lechien, Christian Calvo-Henriquez, Ahmed Yassin Bahgat, Manuele Casale, Rodolfo Lugo, Peter Baptista, Fabrizio Salamanca, Aurelio D’Ecclesia, Tiziano Perrone, Federico Leone, Angelo Cannavicci, Giovanni Cammaroto, Claudio Vicini and Annalisa Pace
Children 2024, 11(1), 94; https://doi.org/10.3390/children11010094 - 12 Jan 2024
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Abstract
Objectives: To investigate through an international survey the actual clinical application of drug-induced sleep endoscopy (DISE) in pediatric patients with obstructive sleep apnea (OSA) and to clarify the use, application, clinical indications, and protocol of pediatric DISE. Methods: A specific survey about pediatric [...] Read more.
Objectives: To investigate through an international survey the actual clinical application of drug-induced sleep endoscopy (DISE) in pediatric patients with obstructive sleep apnea (OSA) and to clarify the use, application, clinical indications, and protocol of pediatric DISE. Methods: A specific survey about pediatric DISE was initially developed by five international otolaryngologists with expertise in pediatric sleep apnea and drug-induced sleep endoscopy and was later spread to experts in the field of sleep apnea, members of different OSA-related associations. Results: A total of 101 participants who answered all the survey questions were considered in the study. Sixty-four sleep apnea experts, equivalent to 63.4% of interviewed experts, declared they would perform DISE in pediatric OSA patients. A total of 81.9% of responders agreed to consider the DISE as the first diagnostic step in children with persistent OSA after adenotonsillectomy surgery, whereas 55.4% disagreed with performing DISE at the same time of scheduled adenotonsillectomy surgery to identify other possible sites of collapse. In the case of young patients with residual OSA and only pharyngeal collapse during DISE, 51.8% of experts agreed with performing a velopharyngeal surgery. In this case, 27.7% disagreed and 21.4% were neutral. Conclusion: Pediatric DISE is internationally considered to be a safe and effective procedure for identifying sites of obstruction and collapse after adenotonsillectomy in children with residual OSA. This is also useful in cases of patients with craniofacial malformations, small tonsils, laryngomalacia or Down syndrome to identify the actual site(s) of collapse. Despite this evidence, our survey highlighted that pediatric DISE is not used in different sleep centers. Full article
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14 pages, 1466 KiB  
Article
Sleep-Disordered Breathing and Its Association with Nocturnal Enuresis at the Primary Schools in Saudi Arabia: A Cross-Sectional Study
by Ali Abdullah Alshehri, Mohamed Soliman Hassan Zaki, Sameh Osama Nour, Wala H. Gadi, Basem A. Zogel, Samar M. Alfaifi, Enas M. Masmali, Amani B. Aburasain and Mohamed Osama Nour
Children 2023, 10(6), 1074; https://doi.org/10.3390/children10061074 - 18 Jun 2023
Cited by 1 | Viewed by 1442
Abstract
The correlation between nocturnal enuresis (NE) and sleep-disordered breathing (SDB) was reported. We aim to determine whether there is an association between NE and SDB in children and to assess the prevalence of SDB and NE in primary school children aged 6–12 years [...] Read more.
The correlation between nocturnal enuresis (NE) and sleep-disordered breathing (SDB) was reported. We aim to determine whether there is an association between NE and SDB in children and to assess the prevalence of SDB and NE in primary school children aged 6–12 years in Saudi Arabia. A cross-sectional observational study was conducted among the caregivers of children aged 6–12 years in all Saudi Arabia regions. The data were gathered through a self-administered online questionnaire. It included demographic information, weight and height, and associated comorbidities, in addition to the weekly frequencies of snoring symptoms and of enuresis, as well as of unrefreshing sleep using Likert-type response scales. Counts and percentages, the mean ± standard deviation, chi-square test, independent samples t-test, and regression analysis were used in the statistical analysis using R v 3.6.3. The questionnaire was completed by 686 respondents. Most respondents did not report any comorbidities in their children (77.1%). Asthma and adenotonsillar hypertrophy were reported in 16.2% and 15.6% of children, respectively. Unrefreshing sleep, mouth breathing at night, snoring, chronic nasal obstruction, and difficulty breathing while asleep were reported once or twice per week in 38%, 34%, 28%, 18%, and 18% of children, respectively. The prevalence of NE was 22.3%, with about 36.6% of children having NE two or more times per week. Significantly, NE was reported in 26.6% of children who slept before 10 PM compared to 19% of children who slept after 10 PM; in 28.6% of children who snored or loudly snored (57.1%) three times or more per week; and in 51.2% and 27.5% of children with difficulty breathing while asleep and who breathed through their mouth at night for one or two nights per week, respectively. A multivariable regression analysis showed that male gender (OR = 1.52, p = 0.010), obesity (OR = 1.24, p = 0.028), early sleeping time (OR = 1.40, p = 0.048), loud snoring for three or more nights per week (OR = 1.54, p = 0.001), difficulty breathing for one or two nights per week (OR = 1.85, p = 0.010), and mouth breathing at night for one or two nights per week (OR = 1.55, p = 0.049) were associated with higher odds of NE. Our study revealed that 22.3% of primary school children reported suffering from NE. SDB is a common problem among children with NE. The exact mechanism that links SDB to the increase in the risk of NE is unknown. Male gender, obesity, early sleeping time, loud snoring, difficulty breathing, and mouth breathing at night are potential independent risk factors of NE in school-age children. Full article
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7 pages, 538 KiB  
Case Report
Ankyloglossia in Children, a Cause of Obstructive Sleep Apnoea: Case Report of Paediatric Ankyloglossia and Sleep Apnoea: DISE Resolves the Mystery
by Johanna Ximena Valderrama-Penagos, Laura Rodríguez Alcalá, Guillermo Plaza, Peter Baptista, Maria Teresa Garcia Iriarte, Eduardo J. Correa and Carlos O’Connor-Reina
Children 2024, 11(2), 218; https://doi.org/10.3390/children11020218 - 08 Feb 2024
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Abstract
Tongue mobility is an obstructive sleep apnoea (OSA) marker and myofunctional therapy (MFT) target. For this reason, all paediatric patients with sleep-disordered breathing should require a combined functional assessment from an ear, nose, and throat (ENT) specialist and a phonoaudiologist to confirm or [...] Read more.
Tongue mobility is an obstructive sleep apnoea (OSA) marker and myofunctional therapy (MFT) target. For this reason, all paediatric patients with sleep-disordered breathing should require a combined functional assessment from an ear, nose, and throat (ENT) specialist and a phonoaudiologist to confirm or rule out the presence of ankyloglossia. To our knowledge, this is the first case of a 13-year-old girl diagnosed with severe OSA and a significant decrease of 94% in her apnoea index (AI), requiring frenotomy with an immediate postoperative change in the tongue position. A drug-induced sleep endoscopy (DISE) was performed before and immediately postfrenotomy, and the anatomical changes provoked by this surgery during sleep were confirmed for the first time. Full article
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