EN
TÜRKÇE
Poster - 25
Sleep-disordered breathing and dysphagia in children with esophageal atresia and/or tracheoesophageal fistula
T Krishnananthan*, A O'Connor**, J Hughes***, G Thambipillay*, A Teng*, U Krishnan****
*Department of Sleep Medicine, Sydney Children's Hospital, Randwick, Australia
**Department of Respiratory and Sleep Medicine, Women's and Children's Hospital Adelaide, Australia
***Department of Speech Pathology, Sydney Children’s Hospital, Randwick, NSW, Australia
****Department of Paediatric Gastroenterology, Sydney Children’s Hospital, Sydney, NSW, Australia, School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
Background
Esophageal atresia–tracheoesophageal fistula (EA-TEF) occurs in 1 in 2,400-4,500 births worldwide. A significant number of children with repaired EA-TEF suffer from dysphagia related to esophageal dysfunction. Esophageal dysphagia occurs secondary to abnormal esophageal motility and oropharyngeal dysphagia. Impaired oropharyngeal muscle function may contribute to oropharyngeal dysphagia and is also important in sleep-disordered breathing, particularly obstructive sleep apnoea (OSA). At present, there is no literature regarding children with repaired EA-TEF and sleep-disordered breathing. Given the role of oropharyngeal muscle dysfunction in both dysphagia and OSA, determining if an association exists would allow for timely sleep assessments, early intervention and overall improvement in quality of life.
Methods
Single centre retrospective study of children with repaired EA-TEF who underwent polysomnography between 2011-2024. Data includes demographic parameters, patient symptoms (including dysphagia, aspiration) and polysomnography (PSG).
Results
A total of 29 children with repaired EA-TEF were identified (Median age 4.5 years, IQR 2.5, 7.5). The cohort included 86.5% Type C (n=25), 10.3% Type A (n=3) and 3.4% Type D (n=1). Statistical analysis was performed using the Fisher Exact test. Ten children had confirmed OSA on PSG. Seven children with OSA also had dysphagia (OR 3.208, 95% CI 0.67-13.65; p=0.245). Two children (n=3) at risk of aspiration were diagnosed with OSA (OR 4.5, 95% CI 0.45-68.13; p=0.267). Nine children (n=19) with strictures had OSA (OR 8.10, 95% CI 0.98-97.32; p 0.098). These results highlight patients with dysphagia, aspiration and strictures may be at higher risk of OSA. This study is limited by its small cohort size and retrospective nature.
Conclusion
There is a high incidence of dysphagia and sleep-disordered breathing in children with repaired EA-TEF. Our results suggest further studies in a larger cohort is required to evaluate the relationship between dysphagia and sleep-disordered breathing in this at-risk patient group.