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- W2955552986 abstract "Le syndrome d’apnées obstructives (SAOS) de l’adolescent est beaucoup moins étudié que le SAOS de l’enfant malgré une prévalence élevée. Il peut certes être résiduel d’un SAOS de l’enfant traité par adéno-amygdalectomie mais est le plus souvent une pathologie de novo. Les facteurs physiopathologiques associent des voies aériennes supérieures étroites et facilement collabables, parfois une hypertrophie des amygdales pharyngées, palatines voire linguales et fréquemment un surpoids ou une obésité. Le bilan ORL est essentiel, tout comme le bilan orthodontique systématique. Ce dernier peut conduire à un traitement spécifique d’anomalies dento-faciales susceptibles d’aggraver le SAOS. Le traitement du SAOS de l’adolescent repose essentiellement sur la chirurgie adéno-amygdalienne, rarement complétée par la réduction des amygdales linguales et sur le traitement orthodontique. La pression positive continue est rarement nécessaire chez les adolescents indemnes de malformations et est réservée aux adolescents obèses, avec un SAOS sévère non amélioré par les autres approches thérapeutiques. Le traitement du SAOS de l’adolescent s’inscrit dans une prise en charge globale, pluridisciplinaire, prenant aussi en compte ses désordres fréquemment associés tels que l’obésité et les anomalies du rythme veille/sommeil. Although the prevalence of the obstructive sleep apnoea syndrome (OSAS) is high in adolescents, studies pertaining to adolescent OSAS are less numerous than childhood studies. Cases of adolescent OSAS may consist of residual OSAS after adenotonsillectomy, but most often are de novo cases. Major pathophysiological factors are weight excess or even high-grade obesity, and the association of upper airway narrowing and tonsillar hypertrophy (pharyngeal, palatal or even lingual). ENT and systematic orthodontic assessments are the main points. In case of predisposing factors such as dental, occlusal or dento-facial abnormalities, a specific orthodontic treatment can be discussed. First line treatment is surgical adenotonsillectomy; surgical reduction of the lingual tonsils is seldom required. CPAP treatment may be indicated in the case of severe comorbidities (craniofacial malformations, neuromuscular diseases…) or in obese adolescents with severe residual OSAS. Treatment of adolescent OSAS has to be comprehensive and multidisciplinary, taking into account the specific treatments of obesity and abnormal sleep/wake rhythms." @default.
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- W2955552986 date "2019-06-01" @default.
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- W2955552986 title "Syndrome d’apnées obstructives du sommeil de l’adolescent : particularités et prise en charge" @default.
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- W2955552986 doi "https://doi.org/10.1016/j.rmr.2018.06.011" @default.
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