(16) Are patients with Treacher Collins Syndrome at greater risk for obstructive sleep apnea than those with non-syndromic mandibular Hypoplasia?

Thursday, September 15, 2022

1:30 PM – 3:00 PM CDT

Presenting Author(s)

Michael Baron, DMD

Resident
Mount Sinai Health System
New York, New York, United States

Co-Author(s)

Dani Stanbouly, BS

Dental Student
Columbia University College of Dental Medicine
New York, New York, United States
SC

Sung-Kiang Chuang, MD, DMD, DMSc

Clinical Professor
University of Pennsylvania
Brockton, Massachusetts, United States
RK

Reha Kisnisci, DDS, PhD

Chair & Professor
Department of Oral and Maxillofacial Surgery at Lokman Hekim University
Ankara, Ankara, Turkey
Cory M. Resnick, MD, DMD

Program Director, Pediatric Cleft and Craniofacial Fellowship
Department of Plastic and Oral Surgery Boston Children’s Hospital
Boston, Massachusetts, United States

Disclosure(s):

Michael Baron, DMD: No financial relationships to disclose

Sung-Kiang Chuang, MD, DMD, DMSc: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Reha Kisnisci, DDS, PhD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Cory M. Resnick, MD, DMD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Abstract: Problem: Mandibular hypoplasia associated with Treacher Collins Syndrome (TCS) may cause glossoptosis and obstructive sleep apnea (OSA). A recent comparison of subjects with non-syndromic mandibular hypoplasia (NMH) and those with TCS, however, did not find significant differences in pharyngeal volume or minimal cross-sectional area of the oropharynx between the two groups [1]. The purpose of this study was to determine if children with TCS have a higher incidence of OSA compared to those with NMH.

Methods: This is a retrospective cohort study using the 2016 and 2019 Kids’ Inpatient Database (KID) [2]. ICD-10 codes were used to identify patients in the database with TCS (Q75.4) and NMH (M26.04). Patients in the NMH group that also had a craniofacial syndrome or other malformations of the skull and facial bones were then excluded. The primary predictor variable was study group (TCS vs. NMH). The primary outcome variable was diagnosis of OSA. Univariate analysis (chi square and ANOVA) was conducted to determine associations between the predictor and outcome variables. Multivariate logistic regression was used to determine independent risk factors for OSA. A p value < 0.05 was deemed statistically significant.

Results: The final study sample included 1,894 patients: TCS, n=544 (28.7%) and NMH, n=1,350 (71.3%). Patients in the TCS group were significantly more likely to have OSA than subjects in the NMH group (22.1 vs. 9.8%, OR 1.7, p < 0.05). Younger patients were at increased risk for OSA compared to those older than 16 years: age 0-5 years (OR 1.8, p < 0.05), age 6-10 years (OR 3.4, p < 0.01), and age 11-15 years (OR 2.3, p < 0.01). Laryngomalacia (OR 3.9, p < 0.01), gastroesophageal reflux disease (GERD) (OR 2.2, p < 0.01), and obesity (OR 3.2, p < 0.05) were each independent risk factors for OSA.

Conclusion: Children with TCS are more likely to have OSA than those with NMH, and youngest patients are at most risk. Comorbidities including laryngomalacia, GERD, and obesity further augment the OSA risk.