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The effects of posterior fossa decompressive surgery in adult patients with Chiari malformation and sleep apnea.
J Neurosurg. 2010 Apr; 112(4):800-7.JN

Abstract

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.

Authors+Show Affiliations

Neurosurgical Service, Hospital do Servidor publico do Estado de São Paulo, São Paulo, Brazil. bitbot@uol.com.brNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

19663555

Citation

Botelho, Ricardo Vieira, et al. "The Effects of Posterior Fossa Decompressive Surgery in Adult Patients With Chiari Malformation and Sleep Apnea." Journal of Neurosurgery, vol. 112, no. 4, 2010, pp. 800-7.
Botelho RV, Bittencourt LR, Rotta JM, et al. The effects of posterior fossa decompressive surgery in adult patients with Chiari malformation and sleep apnea. J Neurosurg. 2010;112(4):800-7.
Botelho, R. V., Bittencourt, L. R., Rotta, J. M., & Tufik, S. (2010). The effects of posterior fossa decompressive surgery in adult patients with Chiari malformation and sleep apnea. Journal of Neurosurgery, 112(4), 800-7. https://doi.org/10.3171/2009.7.JNS09174
Botelho RV, et al. The Effects of Posterior Fossa Decompressive Surgery in Adult Patients With Chiari Malformation and Sleep Apnea. J Neurosurg. 2010;112(4):800-7. PubMed PMID: 19663555.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of posterior fossa decompressive surgery in adult patients with Chiari malformation and sleep apnea. AU - Botelho,Ricardo Vieira, AU - Bittencourt,Lia Rita Azeredo, AU - Rotta,José Marcus, AU - Tufik,Sérgio, PY - 2009/8/12/entrez PY - 2009/8/12/pubmed PY - 2010/4/23/medline SP - 800 EP - 7 JF - Journal of neurosurgery JO - J Neurosurg VL - 112 IS - 4 N2 - 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. SN - 1933-0693 UR - https://www.unboundmedicine.com/medline/citation/19663555/The_effects_of_posterior_fossa_decompressive_surgery_in_adult_patients_with_Chiari_malformation_and_sleep_apnea_ L2 - https://thejns.org/doi/10.3171/2009.7.JNS09174 DB - PRIME DP - Unbound Medicine ER -