Avaliação sistemática da via aérea superior e polissonográfica de crianças obesas

• Ano de defesa: 2011
• Autor(a) principal: Martinelli, Eli Onivaldo [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Questionarios; Antropometria; Crianças; Obesidade; Polissonografia; Apnéia do sono tipo obstrutiva; Sleep apnea, obstructive; Polysomnography; Obesity; Child; Anthropometry; Questionnaires
• Link de acesso: http://repositorio.unifesp.br/handle/11600/9132

Introduction: The relationship between obstructive apnea syndrome (OSAS) and obesity in childhood is still controversial, and works with obese children, until then, do not include a systematic evaluation of the upper airway (UA). The aim was to make a systematic assessment of the UA and polysomnography in obese children. Method: The study included 44 obese children who underwent an evaluation protocol that consisted of questionnaires, physical examination, nasofibroscopy, polysomnography and laboratory tests including fasting glucose, serum immunoglobulin E and Radio Allergia Sorbent Test (RAST). Results: Twenty-two patients (50%) were female and 22 (50%) males, mean age 7.6 ± 2.5 years. OSAS was present in 19 (43%) patients. When compared to gender, the presence of snoring and RAST were detected more frequently in males (p = 0.02 and p = 0.01). When compared according to the presence of OSA, the presence of habitual snoring, witnessed pauses and headache were more frequent in OSAS group (p = 0.04, p = 0.03 and p = 0.04) and anthropometric and laboratory parameters did not showed significant differences. The Polysomnography significant findings were higher obstructive apnea index (p <0.001), higher arousal index (p = 0.004), higher percentage of REM sleep (p = 0.003) and lower minimum saturation of oxyhemoglobin (p <0.001)in OSAS group. In the evaluation of the UA, pharyngeal and palatine tonsils hypertrophy and Mallampati index Modified classes III and IV were the only parameters that showed a higher frequency in the OSAS group (p = 0.05, p <0.001 and p = 0.05), and confirmed by logistic regression as risk factors for sleep apnea in this group of children. Conclusions: The occurrence of OSAS in this obese pediatric population was high, and pharyngeal and palatine tonsils hypertrophy and the modified Mallampati index classes III and IV were the markers of OSAS in this group.