Related Experiment Videos
Sleep apnea syndrome in children--secondary to adenotonsillar hypertrophy?
E Laurikainen1, K Aitasalo, M Erkinjuntti
1Department of Otorhinolaryngology, University Central Hospital of Turku, Finland.
Insights
In children with obstructive sleep apnea syndrome (OSAS), right ventricular hypertrophy (RVH) was common, but not directly linked to adenotonsillar size. Treatment improved cardiac function, suggesting other factors influence airway obstruction.
Area of Science:
- Pediatrics
- Cardiology
- Otolaryngology
Background:
- Obstructive sleep apnea syndrome (OSAS) is a common condition in children.
- Enlarged adenoids and tonsils are frequently implicated as the cause of OSAS.
- The cardiac implications of OSAS, specifically right ventricular hypertrophy (RVH), require further investigation in pediatric populations.
Purpose of the Study:
- To investigate the relationship between adenotonsillar size and the presence of obstructive sleep apnea syndrome (OSAS) in children.
- To assess the prevalence of right ventricular hypertrophy (RVH) in children with OSAS.
- To evaluate the impact of adenoidectomy and/or tonsillectomy on cardiac function in these patients.
Main Methods:
- Nineteen children aged 3-7 years with suspected OSAS underwent clinical examination, ECG, VCG, echocardiogram, and static charge sensitive bed (SCSB) monitoring.
- Adenotonsillar volume was measured post-operatively after adenoidectomy and/or tonsillectomy.
- Cardiac parameters (VCG, EC) and RVH were assessed before and 6 months after surgery.
Main Results:
- Right ventricular hypertrophy (RVH) was detected in 21% of the children studied.
- RVH findings showed a strong correlation with the number of apneas but not with adenotonsillar size.
- Cardiac changes associated with RVH normalized within 6 months following surgical intervention.
Conclusions:
- Right ventricular hypertrophy (RVH) is more prevalent in children with upper airway obstruction than previously thought.
- Adenotonsillar size alone may not be the sole determinant of upper airway obstruction severity or its cardiac sequelae.
- Surgical management of adenotonsillar hypertrophy can lead to the normalization of cardiac function in children with OSAS.
Abstract:
In this study we investigated the relationship between the size of adenoids and/or tonsils and obstructive sleep apnea syndrome (OSAS) in 19 children aged 3 to 7 years. After clinical examination by an ENT specialist, electrocardiogram (ECG), vectorcardiogram (VCG) and echocardiogram (EC) were performed while the patients were awake, and static charge sensitive bed (SCSB) method recording (noninvasive monitoring of ballistocardiogram, respiration and body movements) while asleep. After adenoidectomy and/or tonsillectomy, the volume of the tonsils and the adenoids was determined. RVH was found in 4 out of 19 children (21%). RVH findings correlated highly with the number of apneas but, surprisingly, not with measured adenotonsillar size in those children. However, at 6 months of follow-up, the VCG and EC changes had returned to normal. These results suggest that RVH is more common in children suffering from upper airway obstruction than previously believed, and that factors other than adenotonsillar size also have an influence on upper airway obstruction.