Severe Obstructive Sleep Apnea Alleviated by Oral Appliance in a Three-Year-Old Boy

Vol. 76, No. 1, 2008

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Case Report

Severe Obstructive Sleep Apnea Alleviated by Oral Appliance in a Three-Year-Old Boy
Joachim Schessl^a, Edmund Rose^b, Rudolf Korinthenberg^a, Matthias Henschen^c

^aDepartment of Pediatrics and Adolescent Medicine, Division of Neuropediatrics and Muscular Disorders,
^bDepartment of Orthodontics, and
^cDepartment of Pediatrics and Adolescent Medicine, Pediatric Pulmonology, University Hospital Freiburg, Freiburg, Germany

Address of Corresponding Author

Respiration 2008;76:112-116 (DOI: 10.1159/000098407)

Key Words

Oral appliance
Obstructive sleep apnea
Fraenkel appliance

Abstract

This clinical report describes a 3.5-year-old boy suffering from chronic daytime fatigue, accumulated snoring and dramatically appearing apnea during sleep. Oxycardiorespirography revealed a breathing pattern similar to repetitive obstructive apnea and an oxygen saturation periodically dropping to 80%. During tidal breathing, fiberoptic bronchoscopy showed aspiration of the aryepiglottic folds and the epiglottis during inspiration. Adenotonsillar hypertrophy was excluded. Due to the acknowledged side effects from various surgical approaches and nasal continuous positive airway pressure, a removable, functional Fraenkel II oral appliance was applied during sleep. Clinical assessment demonstrated resolution of the main respiratory symptoms, and oxycardiorespirography revealed a fundamental reduction in periodic obstructive apnea and desaturation. In conclusion, we consider the use of an oral functional appliance for severe obstructive sleep apnea in children to be a valuable alternative to other treatment methods.

Author Contacts

PD Dr. Dr. Edmund Rose
Department of Orthodontics, University Hospital Freiburg
Hugstetter Strasse 55, DE-79106 Freiburg (Germany)
Tel. +49 761 270 4839, Fax +49 761 270 4852
E-Mail edmund.rose@uniklinik-freiburg.de

Article Information

Received: January 5, 2006
Accepted after revision: October 11, 2006
Published online: January 5, 2007
Number of Print Pages : 5
Number of Figures : 3, Number of Tables : 1, Number of References : 16

Medline Abstract (ID 17202808)

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