Multidisciplinary approach in a 12-year-old patient affected by severe obstructive sleep apnea: A case-report

Abstract

A 12-year-old boy shows a restless sleep and snoring episodes declaring himself tired during the day and the school lessons. On clinical examination the patient presents a second-class profile, a retrusive jaw with a small chin and an open nasolabial angle. From the intraoral examination a tonsillar hypertrophy is denoted. The patient is sent by the ear, nose, and throat specialist (ENT) and subsequently subjected to a polysomnography (PSG). The ENT decides to subject him to a tonsillectomy and the subsequent PSG shows an improvement in the obstructive sleep apnea syndrome (OSAS) pathology with an apnea-hypopnea index (AHI) improved from 25.5 episodes/hr to 3.4 episodes/hr. Subsequently a orthodontic treatment with twin-block was start to further reduce the apnea episodes. The last PSG highlights the success of the treatment further lowering the AHI to 0.7 episodes/hr. This case report shows how a multidisciplinary approach to OSAS is fundamental also in the young patient and that the orthodontist carried out in this area a fundamental task both in diagnosis and treatment.