Hi there LNers: As some of you know, I'm active in the APHA (American
Public Health Association) and I thought I'd share something from their
automatic profiling system (they send me free weekly updates with articles
that match my interests). This one on nasal obstructions and anatomical
differences is particularly interesting for Lactnetters.
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THIS WEEK'S JOURNAL LITERATURE
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Of the 8899 articles added to MEDLINEŽ this week , 2221 matched your
profile.
The <Public Health> MEDLINEŽ citation of the week -- Anatomical basis of
sleep-related breathing abnormalities in children with nasal obstruction.
Finkelstein Y, Wexler D, Berger G, Nachmany A, Shapiro-Feinberg M, Ophir D
Palate Surgery Unit' Meir Hospital' Sapir Medical Center' Kfar Saba' Israel.
[log in to unmask]; Arch Otolaryngol Head Neck Surg; 2000 May;
126(5):593-600
PURPOSE: OBJECTIVE: To define' in a group of children with nasal
obstruction' the anatomical differences that differentiate those with quiet'
unobstructed nocturnal respiration from those with obstructive sleep-related
breathing abnormalities (snoring and obstructive sleep apnea). DESIGN: Case
series. PATIENTS: Fifty-nine children aged 3 to 13 years (35 boys and 24
girls) with nasal obstruction and without tonsillar hypertrophy' known
craniofacial syndromes' or neuromuscular diseases were included in the
study. MAIN OUTCOME MEASURES: Each patient was categorized as to severity of
nocturnal obstructive breathing symptoms. Angular and linear cephalometric
measurements were used for assessment of craniofacial features. Clinical
symptom scores were correlated with the cephalometric measurements. RESULTS:
Significant craniofacial abnormalities were identified in patients prone to
obstructive breathing patterns: increased flexure of the cranial base and
bony nasopharynx' opening of !
the gonial angle' shortened mandibular length' dorsocaudal location of the
hyoid' reduced posterior airway space' and increased velar thickness.
CONCLUSIONS: A number of anatomical abnormalities may contribute to
sleep-related abnormal breathing in otherwise normal children with nasal
obstruction. Our results suggest that symptomatic children show some of the
same skeletal and soft-tissue configurations that are found in adults with
obstructive sleep apnea. While adenoidectomy is generally an effective
treatment in children with obstructive sleep-related breathing
abnormalities' the underlying craniofacial variances that remain after
adenoidectomy may predispose these patients to redevelopment of obstructive
breathing abnormalities in adulthood.
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.
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