Videonasopharyngoscopy is useful for identifying children with Pierre Robin sequence and severe obstructive steep apnea

Introduction: Obstructive steep apnea syndrome (OSAS) commonly appears in patients with Pierre Robin sequence (PR). Polysomnography (PS) is the gold standard for the diagnosis of OSAS. Videonasopharyngoscopy (VNP) is the best diagnostic tool for visualizing the vocal tract and detecting structural abnormalities which can be associated with OSAS. Objective: The purpose of this paper is to study whether VNP can be useful for identifying severe OSAS in a population of children with PR. Materials and methods: Fifty-two children with PR who were present with sleep-disordered breathing were studied. All the parents completed a questionnaire concerning the children's sleeping habits and steep complaints before consultation. Each child underwent a general pediatric examination and an evaluation of craniofacial features and upper airway permeability. In all children, a PS was performed. Also, all children underwent a VNP. Results: The diagnosis of OSAS was confirmed by PS in 31 patients. VNP showed 87% sensitivity and 100% specificity for the detection of OSAS. VNP findings showed a significant correlation with apnea-hypopnea index, arousal index.. snoring time. percentage of steep time spent at saturation of oxygen <90% and a significant inverse correlation with total steep time, steep efficiency and the mean saturation of oxygen during steep. Conclusion: This study shows that in children with PR, airway obstruction as detected by VNP seems to be a risk factor for OSAS. VNP appears to be a safe and reliable toot for the evaluation of steep-disordered breathing in children with PR. (C) 2004 Elsevier Ireland Ltd. All rights reserved.