Abstract
Purpose
Pediatric patients with Crouzon syndrome have great possibilities of suffering from obstructive sleep apnea (OSA), which is mainly due to midfacial hypoplasia and facial deformities. For most patients, a multidisciplinary and sequential treatment plan is necessary to make for Crouzon syndrome often has different phenotypes of different severity in OSA and facial deformities. Typical patients were selected in this paper to illustrate the necessity of individualized therapy for treating OSA.
Methods
In this paper, we have introduced four Crouzon syndrome children of different severity in suffering from OSA and maxillofacial deformities. Detailed information was given including clinical manifestations, radiological findings, and polysomnography detections. Based on the above findings, different but effective treatment options for these children’s OSA problems were adopted, either by surgeries including distraction osteogenesis and craniomaxillofacial surgeries with or without tonsillectomy or by noninvasive continuous positive airway pressure (CPAP) therapy.
Results
Follow-up studies for more than 1 year showed problems of OSA and nocturnal hypoxia of those four patients were all alleviated greatly, as well as maxillofacial deformities. Combined with pre-operative and post-operative orthodontics, one patient also got optimal results in better facial profile and dental occlusion.
Conclusion
Thus, based on adequate clinical evaluations and patients’ conditions including age, disease severity, and esthetic considerations, individualized therapy should be made and performed carefully to obtain optimized results in treating OSA for pediatric Crouzon syndrome patients.
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Acknowledgments
We gratefully acknowledge financial supports from the National Natural Science Foundation of China (Grant number 81470786) and Science and Technology Commission Foundation of Shanghai Municipality (Grant number 10140904300). The authors acknowledge Jiande He (Shanghai Stomatological Disease Center, Shanghai, China) and Lei Xu (Jinan Stomatological Hospital, Shandong Province, China) for their help in data collection. Sincere thanks are also given to Qixun Cai and Silong Wei (Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine) for their support in writing assistance.
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Yu, W., Wang, M., Yao, K. et al. Individualized therapy for treating obstructive sleep apnea in pediatric Crouzon syndrome patients. Sleep Breath 20, 1119–1129 (2016). https://doi.org/10.1007/s11325-016-1378-0
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DOI: https://doi.org/10.1007/s11325-016-1378-0