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Upper airway findings in children with Down syndrome on sleep nasopharyngoscopy: case-control study

Elaine Fung1, Manisha Witmans, Monty Ghosh

  • 1Division of Otolaryngology, Dalhousie University, Halifax, NS.

Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'Oto-Rhino-Laryngologie Et De Chirurgie Cervico-Faciale
|May 10, 2012
PubMed

Insights

Children with Down syndrome (DS) and sleep-disordered breathing (SDB) show more pharyngeal collapse. Adenoidal obstruction is less common in DS children compared to controls.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Genetics

Background:

  • Sleep-disordered breathing (SDB) is a common concern in children.
  • Down syndrome (DS) is associated with an increased risk of SDB.
  • Upper airway obstruction patterns in DS children with SDB require detailed characterization.

Purpose of the Study:

  • To delineate the specific patterns of upper airway endoscopic findings in children with Down syndrome (DS) experiencing sleep-disordered breathing (SDB).
  • To compare these findings with a matched control group of children with SDB.

Main Methods:

  • Retrospective case-control study at a tertiary pediatric center.
  • 23 DS children with SDB undergoing sleep nasopharyngoscopy (SNP) were identified and matched with 23 controls.
  • Video recordings of SNPs were reviewed to compare obstruction patterns (Obstruction, Collapse, Mixed).

Main Results:

  • DS children demonstrated significantly more pharyngeal collapses (15 vs 10) and lingual collapses (11 vs 4) compared to controls.
  • Adenoidal obstruction was significantly less prevalent in DS children (p < .05).
  • Tonsillar obstruction was similar between groups.

Conclusions:

  • Generalized pharyngeal collapse is the predominant upper airway obstruction pattern in DS children with SDB.
  • This pattern is independent of age, gender, and BMI.
  • Adenoidal hypertrophy is less frequently the cause of obstruction in DS children with SDB than in controls.
Abstract

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