DOWN SENDROMLU ÇOCUKLARDA UYKU APNE SENDROMU VE AĞIZ DİŞ SAĞLIĞI

Yıl 2016, Cilt: 26 Sayı: 3, 511 - 516, 01.12.2016

Müesser Ahu Durhan İlknur Tanboğa

https://doi.org/10.17567/ataunidfd.290432

Öz

Down Sendromu (DS) (Trizomi 21) yeni doğanın mental ve fiziksel retardasyonunu içeren yaygın kromozom anomalilerinden biridir. Down Sendrom’lu bireylerde; birçok sağlık sorunu doğrudan veya dolaylı olarak meydana gelmekte, hastanın hayat kalitesini ve yaşam süresini etkilemektedir. Bu hastalıklardan bazıları önemli boyutta medikal takip gerektirmektedir. Down Sendrom’lu çocuklarda Obstruktif Uyku Apne Sendromu önemli sağlık problemlerinden biridir. Sağlıklı çocuklarda Obstruktif Uyku Apne Sendromu görülme prevelansı % 0,7-2 arasında değişirken, Down Sendrom’lu çocuklarda bu oran % 31-75’lere kadar yükselmektedir Obstruktif Uyku Apne Sendromu tanısı koyulurken altın standart teşhis yöntemi uyku sırasında polisomnografi uygulamasıdır. Obstruktif Uyku Apne Sendromu’nun, Down Sendrom’lu pediatrik hasta grubunda ağız diş sağlığını nasıl etkilediğine yönelik derinlemesine çalışmalara ihtiyaç duyulmaktadır. Anahtar Kelimeler: Down Sendromu, Obstruktif Uyku Apnes

 Down Sendromu (DS) (Trizomi 21) yeni doğanın mental ve fiziksel retardasyonunu içeren yaygın kromozom anomalilerinden biridir. Down Sendrom’lu bireylerde; birçok sağlık sorunu doğrudan veya dolaylı olarak meydana gelmekte, hastanın hayat kalitesini ve yaşam süresini etkilemektedir. Bu hastalıklardan bazıları önemli boyutta medikal takip gerektirmektedir. Down Sendrom’lu çocuklarda Obstruktif Uyku Apne Sendromu önemli sağlık problemlerinden biridir. Sağlıklı çocuklarda Obstruktif Uyku Apne Sendromu görülme prevelansı % 0,7-2 arasında değişirken, Down Sendrom’lu çocuklarda bu oran % 31-75’lere kadar yükselmektedir Obstruktif Uyku Apne Sendromu tanısı koyulurken altın standart teşhis yöntemi uyku sırasında polisomnografi uygulamasıdır. Obstruktif Uyku Apne Sendromu’nun, Down Sendrom’lu pediatrik hasta grubunda ağız diş sağlığını nasıl etkilediğine yönelik derinlemesine çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler: Down Sendromu, Obstruktif Uyku Apnesi 

OBSTRUCTIVE SLEEP APNEA AND ORAL HEALTH IN
CHILDREN WITH DOWN SYNDROME

ABSTRACT

    Down syndrome is the most common chromosomal disorder in newborns and
causes delays in physical and intellectual development. Children with Down
syndrome are at an increased risk for health complications beyond usual
childhood illnesses and are at high risk for many disorders known to interfere
with growth requring medical follow up whole life. Obstructive Sleep Apnea is one of the major health problem in children
with Down Syndrome.
Among the general pediatric population, up to 2-4% of children experience Obstructive Sleep Apnea. Children with Down Syndrome are at an increased risk for
Obstructive Sleep Apnea when compared to children without Down
Syndrome, with reported prevalence rates of 31±75% among clinic-based samples.
The gold standard for diagnosis of Obstructive Sleep Apnea is overnight
polysomnogrphy. Furthermore studies should be done to clarify how Obstructive
Sleep Apnea
affects oral health in children with Down Syndrome.

Key Words: Down’s Syndrome,
Obstructive Sleep Apnea

i

Anahtar Kelimeler

Down Sendromu

Kaynakça

• ndersson EM, Axelsson S, Austeng ME, Overland B, Valen IE, Jensen TA, et al. Bilateral hypodontia is more common than unilateral hypodontia in children with Down syndrome: a prospective popu- lation-based study. Eur J Orthod. 2014;36:414-8.
• 2. Acikbas I, Tomatir AG, Akdag B, Koksal A. Retrospective analysis of live birth prevalence of children with Down syndrome in Denizli, Turkey. Genet Mol Res. 2012;11:4640-5.
• 3. Weijerman ME, de Winter JP. Clinical practice. The care of children with Down syndrome. Eur J Pediatr. 2010;169:1445-52.
• 4. Ocak Z, Ozlu T, Yazicioglu HF, Ozyurt O, Aygun M. Clinical and cytogenetic results of a large series of amniocentesis cases from Turkey: report of 6124 cases. J Obstet Gynaecol Res. 2014;40:139-46.
• 5. Danisman N, Kahyaoglu S, Celen S, Kahyaoglu I, Candemir Z, Yesilyurt A, et al. A retrospective analysis of amniocenteses performed for advanced maternal age and various other indications in Turkish women. J Matern Fetal Neonatal Med. 2013;26:242-5.
• 6. Weijerman ME, van Furth AM, Vonk Noordegraaf A, van Wouwe JP, Broers CJ, Gemke RJ. Prevalence, neonatal characteristics, and first-year mortality of Down syndrome: a national study. J Pediatr. 2008;152:15-9.
• 7. Ahmad NE, Sanders AE, Sheats R, Brame JL, Essick GK. Obstructive sleep apnea in association with periodontitis: a case-control study. J Dent Hyg. 2013;87:188-99.
• 8. Lal C, White DR, Joseph JE, van Bakergem K, LaRosa A. Sleep-disordered breathing in Down syndrome. Chest. 2015;147:570-9.
• 9. Shott SR, Amin R, Chini B, Heubi C, Hotze S, Akers R. Obstructive sleep apnea: Should all children with Down syndrome be tested? Arch Otolaryngol Head Neck Surg. 2006;132:432-6.
• 10. Trois MS, Capone GT, Lutz JA, Melendres MC, Schwartz AR, Collop NA, et al. Obstructive sleep apnea in adults with Down syndrome. J Clin Sleep Med. 2009;5:317-23.
• 11. Balbani AP, Weber SA, Montovani JC. Update in obstructive sleep apnea syndrome in children. Braz J Otorhinolaryngol. 2005;71:74-80.
• 12. Cote V, Ruiz AG, Perkins J, Sillau S, Friedman NR. Characteristics of children under 2 years of age undergoing tonsillectomy for upper airway obstruc- tion. Int J Pediatr Otorhinolaryngol 2015;79:903-8.
• 13. Goffinski A, Stanley MA, Shepherd N, Duvall N, Jenkinson SB, Davis C, et al. Obstructive sleep apnea in young infants with Down syndrome evaluated in a Down syndrome specialty clinic. Am J Med Genet A. 2015;167:324-30.
• 14. Guimaraes CV, Donnelly LF, Shott SR, Amin RS, Kalra M. Relative rather than absolute macroglossia in patients with Down syndrome: implications for treatment of obstructive sleep apnea. Pediatr Radiol. 2008;38:1062-7.
• 15. Uong EC, McDonough JM, Tayag-Kier CE, Zhao H, Haselgrove J, Mahboubi S, et al. Magnetic resonance imaging of the upper airway in children with Down syndrome. Am J Respir Crit Care Med. 2001;163:731-6.
• 16. Dyken ME, Lin-Dyken DC, Poulton S, Zimmerman MB, Sedars E. Prospective polysomnographic analysis of obstructive sleep apnea in down syndrome. Arch Pediatr Adolesc Med. 2003; 157:655-60.
• 17. Shott SR. Down syndrome: common otolaryngologic manifestations. Am J Med Genet C Semin Med Genet. 2006;142:131-40.
• 18. Macchini F, Leva E, Torricelli M, Valade A. Treating acid reflux disease in patients with Down syndrome: pharmacological and physiological approaches. Clin Exp Gastroenterol. 2011;4:19-22.
• 19. May JG, Shah P, Lemonnier L, Bhatti G, Koscica J, Coticchia JM. Systematic review of endoscopic airway findings in children with gastroesophageal reflux disease. Ann Otol Rhinol Laryngol. 2011; 120: 116-22.
• 20. Attal P, Chanson P. Endocrine aspects of obstructive sleep apnea. J Clin Endocrinol Metab. 2010; 95:483-95.
• 31. Gunaratnam K, Taylor B, Curtis B, Cistulli P. Obstructive sleep apnoea and periodontitis: a novel association? Sleep Breath. 2009;13:233-9.
• 32. Al-Hammad NS, Hakeem LA, Salama FS. Oral health status of children with obstructive sleep apnea and snoring. Pediatr Dent. 2015;37:35-9.
• 33. Austeng ME, Overland B, Kvaerner KJ, Andersson EM, Axelsson S, Abdelnoor M, et al. Obstructive sleep apnea in younger school children with Down syndrome. Int J Pediatr Otorhinolaryngol. 2014;78:1026-9.
• 34. Breslin J, Spano G, Bootzin R, Anand P, Nadel L, Edgin J. Obstructive sleep apnea syndrome and cognition in Down syndrome. Dev Med Child Neurol. 2014;56:657-64.
• 35. Jheeta S, McGowan M, Hadjikoumi I. Is oximetry an effective screening tool for obstructive sleep apnoea in children with Down syndrome? Arch Dis Child 2013;98:164.
• 36. Shires CB, Anold SL, Schoumacher RA, Dehoff GW, Donepudi SK, Stocks RM. Body mass index as an indicator of obstructive sleep apnea in pediatric Down syndrome. Int J Pediatr Otorhinolaryngol. 2010;74:768-72.
• 37. Shete MM, Stocks RM, Sebelik ME, Schoumacher RA. Effects of adeno-tonsillectomy on polysomnography patterns in Down syndrome children with obstructive sleep apnea: a comparative study with children without Down syndrome. Int J Pediatr Otorhinolaryngol. 2010;74:241-4.
• 38. de Moura CP, Andrade D, Cunha LM, Tavares MJ, Cunha MJ, Vaz P, et al. Down syndrome: otolaryngological effects of rapid maxillary expansion. J Laryngol Otol. 2008;122:1318-24.
• 39. Donnelly LF, Shott SR, LaRose CR, Chini BA, Amin RS. Causes of persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy in children with down syndrome as depicted on static and dynamic cine MRI. AJR Am J Roentgenol. 2004;183:175-81.