LIBRO + ANEXOS NEUMOLOGÍA PEDIÁTRICA

Neumología Pediátrica. Anexos ❚ 101 b. Prognosis with therapy b. Craniofacial abnormalities with micrognathia 1. Epidemiology 2. Etiology/Genetics 3. Pathophysiology a. Pathology b. Path mechanisms and consequences 4. Diagnosis and clinical manifestations a. History 1. Recognize the risk of obstructive sleep apnea in children with micrognathia 2. Recognize that upper airway obstruction may occur in infants with severe micrognathia b. Physical examination 1. Describe the effect of positioning on breathing in children with micrognathia 2. Recognize the physical features of mandibular hypoplasia c. Other investigations 1. Recognize the role of polysomnography in evaluating the severity of the respiratory compromise associated with micrognathia that occurs during sleep d. Diagnostic criteria e. Complications 1. Recognize the difficulties associated with feeding in infants with severe micrognathia and cleft palate (Pierre Robin sequence) 2. Recognize that micrognathia may cause hypoventilation and hypoxemia in the absence of apnea 5. Prevention and therapeutic approach a. Prevention b. Therapeutic approach 1. Recognize that management of severe micrognathia includes prone positioning, placement of a nasopharyngeal airway, and ultimately a tracheostomy for persistent, severe airway obstruction c. Side effects of therapy 1. Recognize that palate repair without anterior tongue displacement is likely to cause airflow obstruction in children with micrognathia 2. Recognize that pharyngeal flap surgery may worsen upper airway obstruction during sleep in patients with micrognathia and cleft palate 6. Prognosis a. Natural history 1. Recognize that the natural history of micrognathia involves improvement associated with mandibular growth b. Prognosis with therapy 1. Recognize that resolution of airway obstruction in patients with severe micrognathia is dependent on growth