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Adenotonsillectomy outcomes regarding bone age and osteocalcin in treatment of obstructive sleep apnea syndrome in children

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Abstract

Background

To investigate the effect of adenotonsillectomy (AT) on bone development, quality of life and polysomnography evaluation in children with obstructive sleep apnea syndrome (OSA).

Methods

Preoperative and postoperative (6 months) physical examination, PSG, bone age (BA) and osteocalcin (OC) evaluation were performed on the selected OSA children (n=92) and the healthy children (n=87). The OSA children were also scored based on the OSA 18-item questionnaire. A two-year follow-up was conducted to evaluate BA and OC changes.

Results

After AT, 81 (88.04%) OSA children recovered completely, eight (8.70%) achieved remarkable improvements, and three (3.26%) achieved moderate improvements. In the OSA children, postoperative OSA 18-item score and the scores of the five domains were significantly higher than preoperative ones. Compared with the preoperative, body mass index (BMI), weight for age Z-sores, height for age Z-sores, weight for height Z-sores and BMI Z-score in the OSA group 6 months after the operation were significantly increased, but no significant difference was detected between the OSA and the control group. The changes of BA and chronological age in the OSA group were significantly different from those in the control group. Two years after AT, BA between the two groups was no longer significantly different. Preoperative serum OC in the OSA group was lower than that in the control group, but increased to normal levels 6 months after AT. Correlation analysis showed serum OC levels were negatively correlated with apnea hyponea index, obstructive apnea index, arousal index, and lowest oxygen saturation.

Conclusions

After AT, bone growth and development in children with OSA recovered gradually, and the serum OC levels decreased to the normal level. Therefore, preventive measures and positive treatments should be applied to minimize the negative effects of OSA in children.

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Acknowledgements

We would like to acknowledge the helpful comments on this paper received from our reviewers.

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Authors and Affiliations

  1. Department of Pediatric Internal Medicine, Linyi People’s Hospital, Linyi, China

    Qing-Biao Zhang, Yin-Feng Li, Hui-Wei Feng & **an-Liang Fan

  2. Department of Pediatric Surgery, Linyi People’s Hospital, No.27 East Jiefang Road, Linyi, 276003, China

    Ming-**u Li & Liang-Fu Jiang

  3. Department of Breast Surgery, Linyi Cancer Hospital, Linyi, China

    Ling-Yu Kong

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  1. Qing-Biao Zhang
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Correspondence to Ming-**u Li.

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Zhang, QB., Li, YF., Li, MX. et al. Adenotonsillectomy outcomes regarding bone age and osteocalcin in treatment of obstructive sleep apnea syndrome in children. World J Pediatr 13, 158–164 (2017). https://doi.org/10.1007/s12519-016-0073-3

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  • DOI: https://doi.org/10.1007/s12519-016-0073-3

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