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Chapter-27 Snoring Child with Possible Sleep Apnea

BOOK TITLE: Symptom Oriented Otolaryngology—Head & Neck Surgery: Otology and Pediatrics (Volume 3)

Author
1. Walker Paul
ISBN
9789385891854
DOI
10.5005/jp/books/12951_28
Edition
1/e
Publishing Year
2017
Pages
12
Author Affiliations
1. Loma Linda University Medical Center, Loma Linda, California, USA, University of Newcastle; John Hunter Children’s Hospital, Newcastle, UK
Chapter keywords
Snoring, sleep-disordered breathing, SDB, sleep apnea, obstructive sleep apnea, OSA, noisy breathing, vocal resonance, hypernasality, submucous cleft palate

Abstract

There is a clinical spectrum of sleep-disordered breathing (SDB) ranging from snoring, at the mild end of the spectrum, through an irregular gasping and choking sleep pattern, to obstructive sleep apnea (OSA) at the severe end of the spectrum. Apnea is the cessation of airflow through the nose and mouth. Sleep apnea may be characterized as central, obstructive, or mixed. Central sleep apnea is apnea, with cessation of thoracic and abdominal wall motion. Snoring or stertor is the term applied to noisy breathing due to airflow turbulence resulting from partial obstruction. This is thought to arise predominantly in the nasal cavity, nasopharynx, or oropharynx. Adenotonsillar hyperplasia is the most common cause of OSA in children. Clinical assessment, symptoms and physical signs of the snoring child are discussed in this chapter. Resonance is the perceived tone or timbre of the voice and is a vibratory response of an air-filled cavity. The resonating chambers in children include the nasopharynx and nasal cavity itself. A detailed description on submucous cleft palate, significance of SDB in a child, further investigations, techniques of operative intervention, tertiary referral and postoperative management, and postoperative follow-up and failure to cure OSA are also provided in this chapter.

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