Title

Changes in Transcranial Ultrasound Velocities in Children with Sickle Cell Disease Undergoing Adenotonsillectomy

Document Type

Article

Abstract

Objectives: (1) To assess for changes in cerebral blood flow velocity in children with sickle cell disease and obstructive sleep apnea (OSA) following adenotonsillectomy. (2) To determine if clinical factors such as OSA severity affect cerebral blood flow velocity values. Study Design: Case series with chart review over 10 years. Settings: Two tertiary children’s hospitals. Subjects and Methods: Children aged 2 to 18 years with a history of sickle cell disease and OSA, as defined by an apnea hypopnea index (AHI) >1 on polysomnography, were eligible for inclusion. Transcranial Doppler ultrasonography was used to assess cerebral blood flow velocity before and after adenotonsillectomy. Results: Fifteen patients met inclusion criteria; 73% (n = 11) were female. The mean preoperative AHI was 8.9 (range, 1.2-22.2). Six (40%) patients had severe OSA (AHI >10). Following adenotonsillectomy, there was a significant reduction in mean (95% CI) cerebral blood flow velocities of the left terminal internal cerebral artery, 91.2 (79.4-103.1) to 75.7 (61.7-89.8; P =.018), and the right middle cerebral artery, 134.3 (119.2-149.3) to 116.5 (106.5-126.5; P =.003). There was not a significant correlation between baseline AHI and change in cerebral blood flow velocities. Conclusion: Adenotonsillectomy may result in a reduction in some cerebral blood flow velocities. Further research is needed to determine if changes in cerebral velocities as assessed by transcranial Doppler ultrasonography translate into a reduced risk of stroke for children with sickle cell disease and OSA.

Publication Date

5-1-2018

Publication Title

Otolaryngology - Head and Neck Surgery (United States)

ISSN

01945998

E-ISSN

10976817

Volume

158

Issue

5

First Page

942

Last Page

946

PubMed ID

29405840

Digital Object Identifier (DOI)

10.1177/0194599818756271

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