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Apneia obstrutiva do sono na criança
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A Síndrome da Apneia/Hipopneia Obstrutiva do Sono Pediátrica (SAHOS) é um problema de saúde pública, que afeta cerca de 1% a 5% de todas as crianças. É uma doença caraterizada por episódios recorrentes, de períodos prolongados de obstrução parcial das vias aéreas superiores, ou intermitentes com completa ou parcial obstrução, que perturba a ventilação normal durante o sono e padrões normais de sono, e que se pode localizar em diferentes níveis, envolvendo diferentes estruturas anatómicas. Carateriza-se por sintomas como roncopatia, despertares noturnos frequentes, sonolência diurna, irritabilidade, mau desempenho escolar, entre outros. Quando não tratada, pode ter consequências graves para a criança, potenciando complicações cardiovasculares, neuro-cognitivas, metabólicas e ainda atraso no crescimento.
O risco de complicações implica a necessidade de diagnosticar e tratar o mais precocemente possível, de forma a assegurar o mínimo de complicações para o desenvolvimento da criança. A Polissonografia é considerado o teste gold-standard de diagnóstico nesta patologia, no entanto, existe a necessidade de recorrer a outras técnicas de terapêutica, devido à limitada disponibilidade de material e infraestrutura, e ainda alguma intolerância por parte de algumas crianças. A Adenoamigdalectomia constitui o tratamento de eleição nas crianças, no entanto, verificam-se algumas raras complicações pós-operatórias, e ainda o aparecimento de doença residual após a cirurgia, tornando-se necessário conhecer outras opções terapêuticas, que possam ser mais indicados em algumas crianças.
Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a public health problem, that affects 1% to 5% of all children. It is a disease characterized by recurrent episodes, of prolonged periods of partial obstruction of the upper airways, or intermittent with complete or partial obstruction, which disrupts normal ventilation during sleep and normal sleep patterns, which may be located at different levels involving different anatomic structures. It is characterized by symptoms such as snoring, frequent nocturnal awakenings, daytime sleepiness, irritability, poor school performance, among others. When untreated can have serious consequences for the child, potentiating cardiovascular complications, neuro-cognitive, metabolic and still growth retardation. The risk of complications implies the need to diagnose and treat as early as possible, in order to ensure the minimum of complications for the development of the child. Polysomnography is considered the gold standard diagnostic test in this pathology, however, there is a need to resort to other therapeutic techniques due to the limited availability of material and infrastructure, as well as some intolerance on the part of some children. Adenotonsillectomy is the treatment of choice in children, however, there are some rare postoperative complications, as well as the appearance of residual disease after surgery, making it necessary to know other therapeutic options that may be more indicated in some children.
Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a public health problem, that affects 1% to 5% of all children. It is a disease characterized by recurrent episodes, of prolonged periods of partial obstruction of the upper airways, or intermittent with complete or partial obstruction, which disrupts normal ventilation during sleep and normal sleep patterns, which may be located at different levels involving different anatomic structures. It is characterized by symptoms such as snoring, frequent nocturnal awakenings, daytime sleepiness, irritability, poor school performance, among others. When untreated can have serious consequences for the child, potentiating cardiovascular complications, neuro-cognitive, metabolic and still growth retardation. The risk of complications implies the need to diagnose and treat as early as possible, in order to ensure the minimum of complications for the development of the child. Polysomnography is considered the gold standard diagnostic test in this pathology, however, there is a need to resort to other therapeutic techniques due to the limited availability of material and infrastructure, as well as some intolerance on the part of some children. Adenotonsillectomy is the treatment of choice in children, however, there are some rare postoperative complications, as well as the appearance of residual disease after surgery, making it necessary to know other therapeutic options that may be more indicated in some children.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019
Palavras-chave
Hipertrofia de adenoides e amígdalas Polissonografia Adenoamigdalectomia Síndrome da apneia Hipopneia obstrutiva do sono Otorrinolaringologia