PT  - JOURNAL ARTICLE
AU  - Rajesh Srikantaiah
AU  - Hiroshi Nishikawa
AU  - Guirish Solanki
AU  - Steve Dover
AU  - Priti Kenia
AU  - Satish Rao
TI  - Outcome of sleep assessment (SA) in children with cranio-facial anomalies (CFA): Experience of supra-regional centre
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P4031
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P4031.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P4031.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - IntroductionIt is recognised that CFA patients can develop sleep disordered breathing (SDB). SA includes clinical history, examination and investigations e.g. polysomnography. In this study, we sought to determine the use of SA and its impact on clinical management in symptomatic CFA patients at a Supra-regional Centre.MethodRetrospective analysis of patients with syndromic and non–syndromic CFA who reported symptoms of SDB was undertaken at Birmingham Children’s Hospital (BCH), UK. Demographic features, clinical signs, symptoms, results of multichannel sleep study and clinical outcome following SA were collected over 2 year period (January 2011-December 2012).Results14 patients with CFA and SDB symptoms were referred for SA [age (range): 2-16 years]. 11 (80%) had a diagnosis of specific syndromic (e.g. Apert’s) and 3 (20%) had non-syndromic craniosynostosis. SA showed features of SDB in 13 (90%) [mild obstructive sleep disordered breathing (OSDB) in 5 (38%), moderate OSDB 4 (30%) and severe OSDB 3 (23%)]. 1 patient had no evidence of OSDB and 1 patient had central SDB. Based on the SA results, 5 (35%) children were managed conservatively, 3 (21%) started on non-invasive ventilation (NIV), 6 (44%) had surgery (2-facial advancement and 4-adeno-tonsillectomy).ConclusionSA assessment allowed non-surgical management in significant proportion of symptomatic CFA patients including NIV. In those who required surgery, it informed optimum timing, further investigations and the type of surgery. These findings suggest that SA should be performed in all symptomatic CFA patients. Further research is required to ascertain role of SA in asymptomatic patients.