Correlations between obstructive sleep apnea and adenotonsillar hypertrophy in children of different weight status

Wang, Jing; Zhao, Yu; Yang, Wen; Shen, Tian; Xue, Ping; Yan, Xiaohong; Chen, Danni; Qiao, Yixin; Chen, Min; Ren, Rong; Ren, Jianjun; Yang, Xu; Zheng, Yongbo; Zou, Jian; Tang, Xiangdong

doi:10.1038/s41598-019-47596-5

Cited by 29 publications

(39 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 34 The patency pharynx should be evaluated for tongue size (grades +1 [intravelic] and +2 [extravelic] are normal, while +3 [not reaching midline] and +4 [reaching midline] are enlarged), as it is commonly associated with type 1 OSA. 26 , 35 Several studies did not show any relationship between the size of the tonsils and adenoids and the presence of OSAS. 25 , 35 , 36 Generally, in the literature, there is an agreement to use history and physical examination as a screening tool to determine whether patients need extra investigation, such as a complete sleep study, but there remains some controversy regarding interventions such as adenotonsilectomy.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Children Comment 26,35 Several studies did not show any relationship between the size of the tonsils and adenoids and the presence of OSAS. 25,35,36 Generally, in the literature, there is an agreement to use history and physical examination as a screening tool to determine whether patients need extra investigation, such as a complete sleep study, but there remains some controversy regarding interventions such as adenotonsilectomy.…”

Section: Measurementmentioning

confidence: 99%

“…86 The severity of OSA paralleled the severity of obesity in an analysis that suggested for each unit increase in BMI, there was a 12% higher risk of OSA. 26 Metabolic syndrome. Metabolic syndrome is defined as a tetrad (obesity, dyslipidemia, insulin resistance, and hypertension).…”

Section: Measurementmentioning

confidence: 99%

“…When sleep commences, the neuromuscular tone decreases, resulting in a decrease in the pharyngeal luminal cross sectional area, which results in a flow limitation. 25,26 Enlarged tonsils and adenoids are clearly an important risk factor in children, and the sizes of the tonsils and adenoids increase from birth, reaching the peak of development at 2-4 years then start to subside after the age of 4 years, another surge of growth may occur in the pubertal period during growth spurt; however, a number of studies have shown that there is no absolute correlation between the size of the tonsils and adenoids and the presence of OSAS. 26 Genetic factors has an important role in the pathophysiology of OSA ( Table 1).…”

mentioning

confidence: 99%

“…25,26 Enlarged tonsils and adenoids are clearly an important risk factor in children, and the sizes of the tonsils and adenoids increase from birth, reaching the peak of development at 2-4 years then start to subside after the age of 4 years, another surge of growth may occur in the pubertal period during growth spurt; however, a number of studies have shown that there is no absolute correlation between the size of the tonsils and adenoids and the presence of OSAS. 26 Genetic factors has an important role in the pathophysiology of OSA ( Table 1). 27 Children with obesity are certainly at high risk for developing SDB, and there is direct proportional between the severity of OSA to the degree of obesity, it was reported that the risk for OSA increased by 12% for any increment in body mass index (BMI) by 1 kg/m 2 beyond the mean BMI for age and gender.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Diagnosis and management of childhood sleep-disordered breathing

Al-Shamrani

Alharbi‎

2020

SMJ

View full text Add to dashboard Cite

Sleep-disordered breathing (SDB) includes disorders of breathing that affect airway patency, which impair children's sleep and lead to negative consequences. Obstructive sleep apnea, hypoventilation and upper airway resistance syndrome are common causes of morbidity and mortality in childhood. These clinical practice guidelines, intended for use by pediatricians and primary care clinicians, provide a clear recommendation for the diagnosis and management of sleep-disordered breathing, focusing on the most serious disorder, obstructive sleep apnea syndrome (OSAS). These clinical guidelines formulate clear recommendations to identify patients with suspected OSAS. Further, the manuscript will highlight the potential consequences of SBD in children, and how to overcome such difficulties, what could be the therapeutic options, a 12 recommendations and what are the future direction for pediatric sleep medicine.

show abstract

Section: Clinical Featuresmentioning

confidence: 99%

Section: Measurementmentioning

confidence: 99%

Section: Measurementmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Diagnosis and management of childhood sleep-disordered breathing

Al-Shamrani

Alharbi‎

2020

SMJ

View full text Add to dashboard Cite

show abstract

Changes in Cone-Beam Computed Tomography Pediatric Airway Measurements After Adenotonsillectomy in Patients With OSA

Liu

Kang

Yao

et al. 2022

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

IMPORTANCEEarly intervention using cone-beam computed tomography (CBCT) and adenotonsillectomy for children with obstructive sleep apnea (OSA) may prevent impaired growth, adverse cardiovascular consequences, learning deficits, and poor quality of life.OBJECTIVE To assess changes in CBCT airway measurements and polysomnography (PSG) parameters that occur after adenotonsillectomy in children with OSA and to determine whether CBCT changes are correlated with apnea-hypopnea index (AHI) reduction. DESIGN, SETTING, AND PARTICIPANTSThis prospective cohort study was conducted at a tertiary medical center from 2013 to 2016. Children aged 7 to 13 years with PSG-confirmed OSA (ie, AHI Ն1) were recruited. Data analysis was performed from March to July 2021.EXPOSURES All participants underwent CBCT and PSG before and after adenotonsillectomy. MAIN OUTCOMES AND MEASURESChanges in PSG and CBCT parameters after adenotonsillectomy were analyzed.RESULTS A total of 49 children (mean [SD] age, 9.5 [1.8] years; 34 boys [69.4%]) were recruited. Eighteen participants (36.7%) had obesity. After adenotonsillectomy, AHI significantly decreased from 11.4 to 1.2 events per hour (mean difference, −10.24 events per hour; 95% CI, −13.84 to −6.64 events per hour). The following CBCT parameters significantly increased: total airway volume (from 11 265 to 15 161 mm 3 ; mean difference, 3896.6 mm 3 ; 95% CI, 2788.0 to 5005.2 mm 3 ), nasopharyngeal volume (from 2366 to 3826 mm 3 ; mean difference, 1459.7 mm 3 ; 95% CI, 1122.9 to 1796.5 mm 3 ), minimal nasopharyngeal airway area (from 128 to 191 mm 2 ; mean difference, 63.1 mm 2 ; 95% CI, 47.4 to 78.8 mm 2 ), mean nasopharyngeal airway area (from 144 to 231 mm 2 ; mean difference, 86.8 mm 2 ; 95% CI, 67.0 to 106.5 mm 2 ), oropharyngeal volume (from 8898 to 11 335 mm 3 ; mean difference, 2436.9 mm 3 ; 95% CI, 1477.0 to 3396.8 mm 3 ), minimal oropharyngeal airway area (from 82 to 158 mm 2 ; mean difference, 76.2 mm 2 ; 95% CI, 57.0 to 95.4 mm 2 ), and mean oropharyngeal airway area (from 182 to 234 mm 2 ; mean difference, 52.5 mm 2 ; 95% CI, 33.6 to 71.4 mm 2 ). Among all parameters, only body mass index percentile showed large effect size between the group with residual OSA (postoperative AHI Ն1) and the group with resolved disease, with the residual OSA group having a higher body mass index percentile (87.8 vs 61.4; mean difference, 26.33; 95% CI, 10.00 to 42.66). A quantile regression model revealed that total airway volume and minimal oropharyngeal airway area were significantly correlated with reductions in AHI.CONCLUSIONS AND RELEVANCE These findings suggest that in children undergoing adenotonsillectomy, improvements in total airway volume and oropharyngeal minimal airway area were correlated with reduction of AHI. Future studies are needed to assess whether CBCT has a role in the evaluation of children with OSA who are being considered for adenotonsillectomy.

show abstract

High Prevalence of Obstructive Sleep‐Disordered Breathing in Pediatric Patients With Turner Syndrome

Pham,

Davis,

Tong

et al. 2023

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

ObjectiveGirls with Turner syndrome (TS) often have features that have been associated with obstructive sleep‐disordered breathing (oSDB). However, little is known about oSDB in TS. Herein, we aimed to characterize oSDB in young patients with TS and identify associated risk factors.Study DesignRetrospective cross‐sectional study.SettingTertiary care pediatric hospital.MethodsWe reviewed medical records for patients diagnosed with TS seen at our institution between October 1, 2007 and December 31, 2019 with the first outpatient visit before age 6 years. The prevalence of oSDB was compared to the general pediatric population with 1‐sample binomial proportion tests. Clinical characteristics were compared between those diagnosed with oSDB and those without oSDB, and risk factors for oSDB were identified.ResultsOf 151 patients with TS, 73 (48%) were diagnosed with oSDB which is 4‐fold higher than the general pediatric population (12%, P < 0.0001). In the multivariable model, adenoid, tonsillar, and inferior turbinate hypertrophy, birthweight, failure to thrive, and older age at the last clinic visit were all associated with increased odds for oSDB.ConclusionYoung children with TS have a high prevalence of oSDB and thus should be screened for oSDB. Polysomnography should be performed in those with associated risk factors and symptoms oSDB. Treatment of oSDB is imperative as individuals with TS are already at increased risk of behavioral problems, neurocognitive deficits, and growth impairment that may be worsened with oSDB.

show abstract

Correlations between obstructive sleep apnea and adenotonsillar hypertrophy in children of different weight status

Cited by 29 publications

References 38 publications

Diagnosis and management of childhood sleep-disordered breathing

Diagnosis and management of childhood sleep-disordered breathing

Changes in Cone-Beam Computed Tomography Pediatric Airway Measurements After Adenotonsillectomy in Patients With OSA

High Prevalence of Obstructive Sleep‐Disordered Breathing in Pediatric Patients With Turner Syndrome

Contact Info

Product

Resources

About