Publicado jul 28, 2017



PLUMX
Almetrics
 
Dimensions
 

Google Scholar
 
Search GoogleScholar


Andrea del Carmen Caiza Rennella

Gabriela Elizabeth Sotomayor Guamán

Andrea Catalina Terreros Peralta

Eneida López

Ángela Suarez

Liliana Otero Mendoza

##plugins.themes.bootstrap3.article.details##

Resumen

RESUMEN. Antecedentes La apnea obstructiva del sueño (AOS) es un trastorno respiratorio asociado a alteraciones faciales y esqueléticas. Objetivo: Identificar las características craneofaciales asociadas a AOS en niños colombianos. Métodos: Se seleccionaron 43 niños entre 6 y 13 años de edad con estudio polisomnográfico para trastornos del sueño. Los niños seleccionados se distribuyeron en grupo caso (19 niños con AOS) y grupo control (24 sin AOS), y se les tomaron radiografías laterales. Las variables cefalométricas analizadas fueron: longitud anteroposterior del cráneo (SN), clasificación esquelética (ANB), longitud efectiva mandibular (Co-Pg) y maxilar (Co-A), posición sagital maxilar (N┴A) y mandibular (N┴Pg), ángulo del plano mandibular (FH-PM), eje de crecimiento facial de Ricketts (Ba-N / PTM-Gn), espacios faríngeo superior e inferior y posición del hueso hioides (HPM). Resultados: El 84,2 % de niños con AOS mostró una disminución de la longitud de la base de cráneo en comparación con el 58,3 % de niños sin AOS (p= 0,067, y OR=3,81 IC 0,87 -16,7). La posición superior del hueso hioides estuvo asociada a la ausencia de AOS (OR = 0,26 IC: 0,87 a 16,7.).  Conclusiones A pesar que los resultados no fueron estadísticamente significativos, los resultados de esta investigación, muestran una tendencia que sugiere una relación entre la longitud de la base de cráneo y la posición del hioides con la presencia de AOS en niños. 

ABSTRACT. Background: Obstructive sleep apnea (OSA) is a Sleep breathing disorder in children associated with facial and skeletal features. Purpose: to identify craniofacial features associated with OSA in Colombian children. Method: 43 children from 6-13 years old were selected for cephalometric measurements. All patients had been studied trough polysomnography. Cases were represented for 19 children with OSA and 24 children without OSA were grouped as controls, and lateral radiographs were taken. Cephalometric variables analyzed were: anteroposterior cranial length (SN), skeletal classification (ANB), effective mandibular and maxillary length (Co-Pg) (Co-A), sagittal position of maxillary and mandible (N┴A) (N┴Pg), mandibular plane angle (FH-PM), Ricketts growth axis angle (Ba-N/Ptm-Gn), upper and lower pharynx and hyoid Bone position (HPM). Results: 84.2 % of children with OSA showed a decrease in the length of cranial base compared with 58.3 % of children without OSA (p = 0.067; OR=3.81 95 % CI 0.87- 16.7). The superior bone hyoid position is associated with absence of OSA (OR = 0.26 95 % CI 0.87 to 16.7.) Conclusions: these results suggest trends to relation between length of cranial base and bone hyoid position e and the presence of OSA in children.

Keywords

anomalías craneofaciales, apnea obstructiva del sueño, cefalometría, anatomía craneofacial, enfermedades respiratorias, ortodonciacephalometry, child, craniofacial abnormalities, obstructive sleep apnea, craneofacial anatomy, orthodontics, respiratory diseases

References
1. Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome. American Academy of Pediatrics. Clinical practice guideline: diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2002; 109: 704-12.
2. Cielo C, Brooks L. Therapies for Children with Obstructive Sleep Apnea. Sleep Medicine Clin. 2013; 8(4): 483-93.
3. Borrego Abello C. Síndrome de apnea del sueño (SAS). Iatreia. 1994; 7(3): 135.
4. Diez C. Apnea obstructiva del sueño. CES Odontol. 2002; 15(1): 51-6.
5. Trosman I. Childhood Obstructive Sleep Apnea Syndrome: A Review of the 2012 American Academy of Pediatrics Guidelines. Pediatr Ann. 2013; 42: e205-e209
6. Carter KA, Hathaway NE, Lettieri CF. Common Sleep Disorders in Children. Am Family Physician. 2014 Mar 1; 89(5): 368-77.
7. Carra MC, Bruni O, Huynh N. Topical Review: Sleep Bruxism, Headaches, and Sleep-Disordered Breathing in Children and Adolescents. J Orofac Pain. 2012 Fall; 26(4): 267-76.
8. Dayyat E, Kheirandish-Gozal L, Gozal D. Childhood Obstructive Sleep Apnea: One or Two Distinct Disease Entities? Sleep Medicine Clin. 2007 Sep; 2(3): 433-44.
9. Escobar X, Espinosa E. Factores clínicos y epidemiológicos de los trastornos del sueño en la edad pediátrica. Actualizaciones Pediátr. 1994; 4: 21-4.
10. Major MP, Flores-Mir C, and Major PW. Assessment of lateral cephalometric diagnosis of adenoid hypertrophy and posterior upper airway obstruction: A systematic review. Am J Orthod Dentofac Orthop. 2006; 130: 700-8.
11. Villafranca C, Cobo J, Mondragón F. Cefalometría de las vías aéreas superiores (VAS). RCOE 2002 Ago; 7(4): 407-14.
12. Verma S, Maheshwari S, Sharma N, Prabhat K. Role of oral health professional in pediatric obstructive sleep apnea. Natl J Maxillofac Surg. 2010; 1(1): 35-40.
13. Verrillo E, Cilveti Portillo R, Estivill Sancho E. Síndrome de apnea obstructiva del sueño en el niño: una responsabilidad del pediatra. Anuales de Pediatría 2002; 57: 540-6.
14. Lavezzi AM, Casale V, Oneda R, Gioventù S, Matturri L, Farronato G. Obstructive sleep apnea syndrome (OSAS) in children with Class III malocclusion: involvement of the PHOX2B gene. Sleep and Breathing. 2013; 17(4): 1275-80.
15. Rivero Millán P, Domínguez Reyes A. La apnea del sueño en el niño. Vox Paediatrica. 2011; XVIII: 77-85.
16. Maltrana-García JA, Uali-Abeida ME, Pérez- Delgado L, Adiego-Leza I, Vicente González EA, Ortiz- García A. Síndrome de apnea obstructiva en niños. Acta Otorrinolaringol Española. 2009; 60(3): 202-7.
17. Carvalho FR, Lentini-Oliveira D, Machado MAC, Saconato H, Prado GF, Prado LBF. Oral appliances and functional orthopaedic appliances for obstructive sleep apnoea in children. Cochrane Database Syst Rev. 2008.
18. Schechter M. Technical Report: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome. Pediatrics. 2002 Apr; 109(4).
19. McNamara J. A method cephalometric evaluation. Am J Orthod. 1989 Dec; 86(6).
20. Katyal V, Pamula Y, Daynes C, Martin J. Craniofacial and upper airway morphology in pediatric sleep-disordered breathing and changes in quality of life with rapid maxillary expansión. Am J Orthod Dentofacial Orthop. 2013; 144: 860-71.
21. Flores-Mir C, Korayem M, Heo C, Witmans M, Major MP, Major PW. Craniofacial morphological characteristics in children with obstructive sleep apnea syndrome. J Am dent Assoc. 2013 Mar; 144(3): 269-77.
22. Deng J, Gao X. A case–control study of craniofacial features of children with obstructed sleep apnea. Sleep Breath. 2012; 16: 1219-27.
23. Ozdemir H, Altin R, Söğüt A, Cinar F, Mahmutyazicioğlu K, Kart L, Uzun L, Davşanci H, Gündoğdu S, Tomaç N. Craniofacial differences according to AHI scores of children with obstructive sleep apnea syndrome: cephalometric study in 39 patients. Pediatr Radiol 2004; 34(5): 393-9.
24. Vieira B, Itikawa C, Almeida L, Sander H, Fernandes R. Cephalometric evaluation of facial pattern and hyoid bone position in children with obstructive sleep apnea syndrome. Int J Pediatric Otorhinolaryngol. 2011; 75: 383-6.
25. Zettergren-Wijk L, Forsberg C, Linder-Aronson S. Changes in dentofacial morphology after adeno-/tonsillectomy in young children with obstructive sleep apnea-a 5-year follow-up study. Eur J Orthod. 2006 Aug; 28(4): 319-26.
26. Chiang PY, Lin CM, Powell N, Chiang YC, Tsai YJ. Systematic analysis of cephalometry in obstructive sleep apnea in Asian children. Laryngoscope. 2012; 122(8): 1867-72.
27. Bergamo AZN, Itikawa CE, de Almeida LA, Sander HH, Fernandes RMF, Anselmo-Lima WT, Valera FCP, Matsumoto MAN. Adenoid hypertrophy, craniofacial morphology in apneic children. Pediatric Dental J. 2014; 24(2): 71-7.
28. Katyal V, Pamula Y, Martin AJ, Daynes CN, Kennedy JD, Sampson WJ. Craniofacial and upper airway morphology in pediatric sleep-disordered breathing: systematic review and metanalysis. Am J Orthod Dentofacial Orthop. 2013; 143: 20-30.
29. Villaneuva ATC, Buchanan PR, Yee BJ, Grunstein RR. Ethnicity and obstructive sleep apnoea. Sleep Medicine Reviews. 2005 12; 9(6): 419-36.
30. Kawashima S, Niikuni N, Chia-hung L, Takahasi Y, Kohno M, Nakajima I, Akasaka M, Sakata H, Akashi S. Cephalometric comparisons of craniofacial and upper airway structures in young children with obstructive sleep apnea syndrome. Ear Nose Throat J. 2000 Jul; 79(7): 499-502, 505-6.
31. Di Francesco R, Monteiro R, Paulo ML, Buranello F, Imamura R. Craniofacial morphology and sleep apnea in children with obstructed upper airways: differences between genders. Sleep Med. 2012; 13(6): 616-20.
32. Guilleminault C, Huang Y, Glamann C, Li K, Chan C. Adenotonsillectomy and obstructive sleep apnea in children: A prospective survey. Otolaryngol Head Neck Surg. 2007; 136: 169-75.
33. Pirilä-Parkkinen K, Löppönen H, Nieminen P, Tolonen U, Pirttiniemi P. Cephalometric evaluation of children with nocturnal sleep-disordered breathing. Eur J Orthod. 2010; 32: 662- 71.
34. Zhong Z, Tang Z, Gao X, Zeng XL. A Comparison study of upper airway among different skeletal craniofacial patterns in nonsnoring Chinese children. Angle Orthod. 2010 Mar; 80(2): 267-74.
Cómo citar
Caiza Rennella, A. del C., Sotomayor Guamán, G. E., Terreros Peralta, A. C., López, E., Suarez, Ángela, & Otero Mendoza, L. (2017). Morfología craneofacial en niños con apnea obstructiva del sueño / Craneofacial Morphology in Children with Obstructive Sleep Apnea. Universitas Odontologica, 36(76). https://doi.org/10.11144/Javeriana.uo36-76.mcna
Sección
Práctica Clínica