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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

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[Relationship between children's obstructive sleep apnea hypopnea syndrome and nasal diseases]

Ling Shen¹, Yang-yang Xu, Zong-tong Lin

¹Department of Otorhinolaryngology, Fuzhou Children's Hospital, Fujian Medical University Hospital, Fuzhou 350005, China (Email: shenlingfz@126.com).

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi = Chinese Journal of Otorhinolaryngology Head and Neck Surgery

|October 10, 2013

Insights

Pediatric obstructive sleep apnea hypopnea syndrome (OSAHS) is linked to nasal diseases. Nasosinusitis and narrow nasal cavities are key risk factors, worsening with OSAHS severity.

Area of Science:

Otolaryngology
Pediatric Sleep Medicine
Allergy Immunology

Background:

Pediatric obstructive sleep apnea hypopnea syndrome (OSAHS) is a significant health concern.
The association between OSAHS and upper airway conditions, particularly nasal diseases, requires further investigation.

Purpose of the Study:

To investigate the relationship between pediatric obstructive sleep apnea hypopnea syndrome (OSAHS) and various nasal diseases.
To identify specific nasal conditions that act as risk factors for pediatric OSAHS.

Main Methods:

Retrospective analysis of 338 pediatric OSAHS cases (treatment group) and 207 pediatric cases without OSAHS (control group).
Evaluation included upper respiratory tract infection frequency, IgE levels, electronic nasopharyngoscopy, and nasal sinus CT scans.
Data analyzed using SPSS 17.0, with subgroups based on obstructive apnea index (OAI) and apnea hypopnea index (AHI).

Main Results:

Children with OSAHS exhibited higher rates of upper respiratory tract infections, elevated total IgE (tIgE), nasosinusitis, and narrow nasal cavities compared to controls (P < 0.01).
Multiple regression identified nasosinusitis (OR=16.008) and narrow nasal cavity (OR=4.671) as major risk factors for pediatric OSAHS.
Prevalence of nasosinusitis and narrow nasal cavities increased significantly with OSAHS severity (P < 0.01).

Conclusions:

Infection and allergy are identified as risk factors contributing to pediatric OSAHS.
Nasosinusitis and narrow nasal cavities are significant risk factors for pediatric OSAHS.
These nasal conditions demonstrate a positive correlation with the severity of pediatric OSAHS.

Read full analysis

Abstract

Objective:

To explore the relationship between children obstructive sleep apnea hypopnea syndrome (OSAHS) and nasal diseases.

Methods:

Three hundred and thirty-eight cases of pediatric OSAHS confirmed by polysomnography (PSG) had been enrolled as the treatment group, and divided into mild subgroup, moderate subgroup and severe subgroup according to the obstructive apnea index (OAI) and apnea hypoventilation index (AHI). The other two hundred and seven pediatric vocal cord nodule cases without OSAHS had been randomly selected as the control group. The retrospective analysis of upper respiratory tract infection frequency per year, expression levels of total IgE (tIgE) and allergen-specific IgE (sIgE), results of electronic nasopharyngoscope test and nasal sinus CT scans had been performed in all the pediatric cases. The data were analyzed by SPSS 17.0.

Results:

The upper respiratory tract infection frequency per year, ratio of cases with positive results of tIgE, ratio of cases with nasosinusitis, ratio of cases with narrow nasal cavity in the experiment group were respectively 8.7 ± 5.7, 60.9%, 79.9% and 50.0%, while those in the control group were respectively 4.4 ± 2.6, 32.8%, 12.1% and 6.3%, with significant difference between groups (t = 7.578,χ(2) value was 41.943, 237.704, 110.322, all P < 0.01). The multiple regression analysis indicated that, nasosinusitis and narrow nasal cavity were the two major risk factors of pediatric OSAHS (OR1 = 16.008, OR2 = 4.671, all P < 0.01), with combined effects (OR = 113.430, P < 0.01) . The rank test analysis in term of risk factors of severity of OSAHS had indicated that, prevalence of nasosinusitis and narrow nasal cavity were increased as rising severity of OSAHS (χ1(2) = 21.571, χ2(2) = 17.304, all P < 0.01).

Conclusions:

Infection and allergy are risk factors of pediatric OSAHS. Nasosinusitis and narrow nasal cavity are two major risk factors of pediatric OSAHS, which have positive relationship with the severity of OSAHS.

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