The effects of posterior fossa decompressive surgery in adult patients with Chiari malformation and sleep apnea Clinical article

The effects of posterior fossa decompressive surgery in adult patients with Chiari malformation and sleep apnea Clinical article

Autor Botelho, Ricardo Vieira Autor UNIFESP Google Scholar
Azeredo Bittencourt, Lia Rita Autor UNIFESP Google Scholar
Rotta, Jose Marcus Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Instituição Hosp Servidor Publ Estado
Universidade Federal de São Paulo (UNIFESP)
Resumo Object. One of the feared consequences of craniovertebral junction diseases is apnea. Although several cases of patients with central apnea have been described, obstructive sleep apnea has been identified as the most frequent manifestation of sleep respiratory disorder. Neuronal involvement may be responsible for both central and obstructive apneas. the objective of this work was to study the effect of posterior fossa decompressive surgery on respiratory parameters during sleep in patients with craniovertebral junction malformations and breathing-related sleep disorders.Methods. in this study, prospectively enrolled consecutive symptomatic adult patients were monitored with full-night polysomnography before and after surgical decompression of the cranial posterior fossa.Results. of the 25 patients who were evaluated, 68% received a diagnosis of sleep apnea. After surgery, the mean number of respiratory events decreased from 180.70 to 69.29 (p = 0.005); the mean number of obstructive events decreased from 107.37 to 60.58 (p = 0.01); and the mean number of central events decreased from 38.45 to 8.05 (p = 0.01). the mean preoperative apnea/hypopnea index decreased from 26.68 to 12.98 (p = 0.06), and the mean central apnea index decreased from 13.81 to 1.68 (p = 0.01).Conclusions. Decompressive surgery in patients with craniovertebral junction malformations resulted in decreased respiratory events during sleep, lowered sleep fragmentation, and enhanced the sleep apnea index in a significant number of patients. the effect was more pronounced in patients with central apnea. (DOI: 10.3171/2009.7.JNS09174)
Palavra-chave Chiari malformation
basilar invagination
sleep apnea
surgery
Idioma Inglês
Data de publicação 2010-04-01
Publicado em Journal of Neurosurgery. Rolling Meadows: Amer Assoc Neurological Surgeons, v. 112, n. 4, p. 800-807, 2010.
ISSN 0022-3085 (Sherpa/Romeo, fator de impacto)
Publicador Amer Assoc Neurological Surgeons
Extensão 800-807
Fonte http://dx.doi.org/10.3171/2009.7.JNS09174
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000276033200022
Endereço permanente http://repositorio.unifesp.br/handle/11600/32465

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