Evidence map›Paper›PMID 39365303›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2024

Posterior fossa decompression in patients with Chiari malformation type 1: effect on sleep apnea and follow-up outcomes.

Bernard K Okai, Vinay Jaikumar, Hendrick B Francois, Matthew J Recker, Renée M Reynolds

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Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Bernard K OkaiJacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.ORCID 0009-0005-9890-8272
Vinay JaikumarDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.ORCID 0000-0002-6677-1858
Hendrick B FrancoisJacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.ORCID 0009-0005-0045-5384
Matthew J ReckerDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.ORCID 0000-0002-4442-3465
Renée M ReynoldsDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. rreynolds@ubns.com.ORCID 0000-0002-3680-1593

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSleep apnea, posing significant health risks, is frequently associated with Chiari malformation (CM), characterized by cerebellar tonsil herniation through the foramen magnum. Central sleep apnea (CSA) in CM results from impaired brain-to-muscle signaling and requires treatment. Conversely, obstructive sleep apnea (OSA), arising from throat muscle relaxation, typically unrelated to CM, often coexists. This study evaluates the effectiveness of posterior fossa decompression (PFD) on sleep apnea.

methodsA retrospective chart review was conducted of pediatric patients with CM-1 and sleep apnea who underwent PFD between April 1, 2004, and September 30, 2022. Data collected included demographics, clinical characteristics, adenotonsillectomy status, PFD details, and sleep study parameters like the apnea-hypopnea index and respiratory disturbance index. Statistical analysis assessed the surgery's impact on sleep apnea severity.

resultsThe study included eleven patients, predominantly male (63.6%). All had OSA (100%), with 63.6% also having CSA. Preoperative sleep studies classified OSA severity as 36.4% mild, 18.2% moderate, and 45.5% severe, with no change post-surgery. CSA severity initially included seven mild cases, which became three mild, one moderate, and three resolved cases post-surgery. Among seven patients who had adenotonsillectomy before decompression, five showed no improvement in OSA severity post-surgery.

conclusionThis study elucidates the complex relationship between CM-1, sleep apnea, and PFD. The findings show the persistence of sleep apnea in some patients and highlight the need for continuous monitoring of these patients in order to optimize their care after surgery.

Indexed as

Arnold-Chiari MalformationDecompression, SurgicalSleep Apnea SyndromesAdolescentChildChild, PreschoolCranial Fossa, PosteriorFemaleFollow-Up StudiesHumansMaleRetrospective StudiesSleep Apnea, ObstructiveTreatment OutcomeCentral sleep apneaChiari malformationObstructive sleep apneaPosterior decompression

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.