Polisomnographic findings on children with laryngopathies

Abstract

Polysomnography is the goldstandard exam for child OSAS. When possible, polysomnography clearly distinguishes between those with isolated primary snoring and patients with sleep apnea (obstructive, central and mixed). The most common cause of OSAS in childhood is adenotonsillar hypertrophy. Laryngomalacia is the most common cause of stridor in childhood, though its physiopathology remains unknown. Among the most prominent theories are immaturity of the cartilaginous framework of the larynx and/or neuromuscular immaturity.

Objective: Our proposal was to describe polysomnographic findings in children with laryngomalacia or other isolated laryngeal alterations, that is, without other alterations in the upper airways.

Methods: The sample included 29 children with exclusively laryngeal alterations. All of them underwent an otorhinolaryngological exam, nasofibrolaryngoscopy and polysomnography. Information was recorded concerning age, nasofibrolaryngoscopy and polysomnography. For analysis, the children were divided into two groups: those with laryngomalacia and those with other laryngeal diseases.

Results: Among the 18 children with a diagnosis of laryngomalacia, 18 had central breathing events, knowing that the majority had showed desaturation of oxihemoglobin and bradycardia. In this same group, 3 children had obstructive events. On the other hand, 11 children with other laryngeal alterations showed no predominance of one type or another of apnea. Of these, 4 had central type breathing events and 2 obstructive type.

Conclusion: The majority of patients with laryngomalacia showed a central type apnea. Patients with various laryngeal diseases did not present a predominant type of apnea.