Chest
Volume 117, Issue 3, March 2000, Pages 916-918
Journal home page for Chest

Selected Reports
An Unreported Risk in the Use of Home Nasal Continuous Positive Airway Pressure and Home Nasal Ventilation in Children

https://doi.org/10.1378/chest.117.3.916Get rights and content

We report the case of a 15-year-old boy with obstructive sleep apnea and obesity who was treated since the age of 5 with nasal continuous positive airway pressure. Due to the long-term use of a nasal mask, the child developed a mid-face hypoplasia. Chronic use of a nasal mask for home ventilation in children should always be associated with regular evaluations of maxillomandibular growth.

Section snippets

Case Report

A 15-year-old African-American boy with obstructive sleep apnea (OSA) and morbid obesity was referred for evaluation to assess the present CPAP level. The patient was the product of a normal birth without evidence of any craniofacial or developmental anomalies. He has had a history of significant weight gain since 3 years of age. At age five, obesity and OSA at polygraphic recording were diagnosed. At that time, his height was normal for his age and he had normal craniofacial features. He had a

Discussion

To the best of our knowledge, this is the first reported case of mid-face hypoplasia secondary to prolonged nasal CPAP therapy by face mask. It is well known that craniofacial development occurs primarily during the prepubertal years. By 4 years of age, about 60% of the adult face is developed. At age five, when nasal CPAP treatment was initiated in this child, facial development was normal. Due to the positive pressure exerted by the face mask, a counteracting force with a headgear is

References (13)

There are more references available in the full text version of this article.

Cited by (136)

  • Children Dependent on Respiratory Technology

    2019, Kendig's Disorders of the Respiratory Tract in Children
  • The impact of positive airway pressure on midface growth: a literature review

    2020, Brazilian Journal of Otorhinolaryngology
    Citation Excerpt :

    In some cases there were syndromic patients in control groups, that are other risk factors for alterations on middle-face growth. The two case reports showed alterations after treatment, but did not describe baseline characteristics.19,20 All studies involved PAP use of more than 1 year, and most showed good PAP compliance.

View all citing articles on Scopus
View full text