{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:53:22Z","timestamp":1786978402485,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diagnosis and treatment of obstructive sleep apnea (OSA) in infants and young children is challenging because of its clinical heterogeneity and lack of age\u2010specific guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We report the management and treatment outcome of OSA in children below 2 years of age. Treatment decisions were based upon the pattern of upper airway (UA) obstruction, clinical presentation and OSA severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective, non\u2010randomized observational cohort study at a tertiary center. Children with OSA who underwent an UA evaluation (drug\u2010induced sleep endoscopy or direct laryngoscopy) were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We studied 100 patients, 57 boys and 43 girls, age 0.72 years (0.0\u20132.0) and OSA confirmed by polysomnography. Multilevel UA collapse was present in 26%, (adeno)tonsillar hypertrophy in 31% and 21% had laryngomalacia. Laryngomalacia was more common in children below 6 months of age and adenotonsillar hypertrophy was observed mainly in children &gt;1.5 year of age. Surgical and nonsurgical treatment guided by UA findings, improved OSA severity at group level with a significant reduction (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) in obstructive apnea\/hypopnea index from 10.8\/h (2.1\u201399.1) to 1.7\/h (0.0\u201373.0), an improvement in mean oxygen saturation from 96.9% (88.9\u201398.4) to 97.4% (92.3\u201399.0), in minimal oxygen saturation from 85.4% (37.0\u201396.0) to 88.8% (51.0\u201395.5) and oxygen desaturation index from 5.1\/h (0.2\u201352.0) to 1.3\/h (0.0\u201347.8).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multidisciplinary management of young children with OSA guided by the pattern of UA obstruction and OSA severity, reduces OSA severity. The pattern of UA obstruction changes in the first 2 years of life from a dynamic collapse to structural abnormalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.26979","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T07:30:27Z","timestamp":1711092627000},"page":"1716-1723","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Role of upper airway evaluation in the multidisciplinary management of obstructive sleep apnea in children below two years of age"],"prefix":"10.1002","volume":"59","author":[{"given":"Hanne","family":"Blancke","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Antwerp Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Platteau","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Antwerp Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Slosse","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Antwerp Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1922-9716","authenticated-orcid":false,"given":"Stijn","family":"Verhulst","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Antwerp University Hospital Edegem Belgium"},{"name":"Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences University of Antwerp Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Install\u00e9","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Antwerp University Hospital Edegem Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Jouret","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Antwerp University Hospital Edegem Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Van Hoorenbeeck","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Antwerp University Hospital Edegem Belgium"},{"name":"Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences University of Antwerp Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6918-0674","authenticated-orcid":false,"given":"An","family":"Boudewyns","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Antwerp University Hospital Edegem Belgium"},{"name":"Faculty of Medicine and Translational Neurosciences University of Antwerp Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00985-2017"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201108-1455CI"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818801757"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax-2022-219582"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/children9040523"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2023.101785"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820985000"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.2172"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00385-2015"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(16)36806-7"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2014.06.016"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2020.12.028"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29536"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20230"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23685"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-017-4481-3"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110351"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26979","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T09:33:16Z","timestamp":1737106396000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.26979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,22]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/ppul.26979"],"URL":"https:\/\/doi.org\/10.1002\/ppul.26979","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,22]]},"assertion":[{"value":"2023-11-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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