4-YEAR-OLD GIRL WITH GOLDENHAR-SEQUENCE AND SEVERE OBSTRUCTIVE SLEEP-APNEA, SYMPTOMS, DIAGNOSIS AND THERAPY

Recently sleep related breathing disorders in children have received c onsiderable attention. Unfortunately, cardiorespiratory polygraphy is expensive and time-consuming, and up until now today only a few pediat ric hospitals have complete facilities for all-night cardiorespiratory polygraphy. Nevertheless, the prevalence of sleep related breathing d isorders in children is higher than has previously been thought. To sh ow the importance of proper diagnosis of sleep related breathing disor ders, we report a case of a 4-year-old girl with severe obstructive sl eep apnea caused by Goldenhar-sequence (facio-auriculo-vertebral dyspl asia). Despite some treatment efforts to correct the aplastic right ma ndible, the symptoms of obstructive sleep apnea were not immediately r ecognized and remained untreated. Untreated obstructive sleep apnea le d to growth and mental retardation. After polygraphic confirmation of obstructive sleep apnea and appropriate interdisciplinary treatment, t he 4-year-old girl made rapid advances in growth and mental developmen t. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.