Sleep apnea syndrome in infants and children.

Obstructive sleep apnea syndrome (OSAS) is characterized by prolonged, gene rally partial, upper airway obstruction associated with hypoxemia and/or hy percapnia. Main etiological factors include hypertrophy of the tonsils and adenoids, craniofacial abnormalities with reduction in the upper airway cal iber, abnormality of neural upper airway control, or a combination of these factors. Symptoms depend an age, but they always include snoring and breat hing difficulties during sleep. Diagnosis of OSAS must be established early in order to prevent complications It is suspected on history, physical exa mination and investigative confrontation such as nasofibroscopy and imaging . Polysomnography is the gold standard for diagnosis, scoring of the obstru ction and distinction between primary snoring and obstructive breathing. Ad enotonsillectomy is an effective therapy For selected patients, craniofacia l surgery may be helpful. Same children require continuous positive airway pressure or the nasopharyngeal tube. Tracheotomy is rarely indicated (C) 20 00 Editions scientifiques et medicales Elsevier SAS.