Division of Otorhinolaryngology, Chiba Children's Hospital Obstructive sleep apnea syndrome (OSAS) in children caused by ad enotonsillar hypertrophy is sometimes associated with severe sequelae. Adenotonsillectomy is the first-line treatment for OSAS, but careful pre- and post-operative management are important in severe cases. We report three cases of nasal airway application for OSAS in children. An obese 5-year-old-boy w, ho had shown snoring and narcoleptic traits, was admitted to our hospital in coma. By insertion of a nasal airway, he recovered from unconsciousness on the first night of admission. Nasal airway and sequential adenotonsillectomy relieved him of severe OSAS. A 1-year-old-boy complicated with Dandy-Walker syndrome, who had shown severe snoring and an unstable sleeping pattern, was examined by polysomnography (PSG) with a nasal airway. While conventional PSG showed a severe OSA pattern, PSG under insertion of a nasal airway showed no OSA pattern. From the result of PSG we judged that adenotonsillectomy was the first-line treatment for his condition. A 6-year-old-girl with cerebral palsy, who had been diagnosed as a mixed type of sleep apnea syndrome by former PSG, was relieved of sleep apnea by the insertion of a nasal airway. We instructed the staff and family to use a nasal airway as a home management option. In conclusion, a nasal airway is useful for the management and diagnosis of OSAS in children.
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