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Published on: December 6, 2016
[The relationship between obstructive sleep apnea hypopnea syndrome and adenoid size as well as tonsil size in
Insights
Enlarged adenoids and tonsils are significant risk factors for obstructive sleep apnea hypopnea syndrome (OSAHS) in children. Increased size of these tissues correlates with a higher risk and severity of OSAHS.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Respiratory Disorders
Background:
- Obstructive sleep apnea hypopnea syndrome (OSAHS) in children is a significant health concern.
- Identifying anatomical risk factors is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the association between adenoid and tonsil size and OSAHS in pediatric patients.
- To determine if adenoid and tonsil hypertrophy are risk factors for pediatric OSAHS.
Main Methods:
- Retrospective analysis of 545 children (338 with OSAHS, 207 controls).
- Oropharyngeal and electron-nasopharyngolaryngoscopy examinations were reviewed.
- Patients were categorized by OSAHS severity based on polysomnography (PSG) findings.
Main Results:
- Significantly higher rates of grade III-V adenoids (89.7%) and grade III-IV tonsils (68.4%) were observed in OSAHS patients compared to controls (30.9% and 13.5%, respectively).
- Larger adenoid and tonsil sizes (grade IV) were associated with a higher risk of OSAHS.
- The severity of adenoid and tonsil hypertrophy positively correlated with the severity of OSAHS.
Conclusions:
- Adenoidal and tonsil hypertrophy are confirmed risk factors for pediatric OSAHS.
- The degree of airway obstruction severity is positively associated with the extent of adenoid and tonsil enlargement.
- Electron-nasopharyngolaryngoscopy is a valuable tool for diagnosing pediatric OSAHS and assessing tonsil size.
Objective:
To investigate the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and adenoid size as well as tonsil size in Children.
Method:
A total of 545 patients, 338 OSAHS patients (treated group) diagnosed by PSG and 207 patients with vocal cord nodules but symptoms of upper airway obstruction (control group), were enrolled from inpatient and outpatient between June, 2008 and October, 2010. The oropharynx and electron-nasopharyngolaryngoscopy examination records of the two groups were retrospectively analyzed. The patients in the treated group were also divided into mild group, moderate group and severe group according to obstructive apnea index (OAI) or AHI. SPSS 17.0 was used for statistical analysis.
Result:
In the treated group, 89.7% had grade III-V adenoid and 68.4% had grade III-IV tonsil, compared with 30.9% (adenoid) and 13.5% (tonsil) in the control group. The significant differences were found (all P < 0.01). The comparison between patients with different grades of adenoidal size and tonsil size in the treated group had indicated that patients with grade IV adenoid or grade IV tonsil have a higher risk of OSAHS than patients with grade III adenoid or grade III tonsil. In the treated group, the ratio of patients with different severity of adenoid or tonsil had increased with the severity of OSAHS (P < 0.01). This retrospective study had also found that most of the grading results from Electron-nasopharyngolaryngoscopy examination were consistent with that from oropharynx examination. 13 (37.1%) of 35 patients with grade I or II tonsil diagnosed by Oropharynx examination were considered as grade III by Electron-nasopharyngolaryngoscopy examination.
Conclusion:
Adenoidal hypertrophy and tonsil hypertrophy are the risk factors for OSAHS in children. The risk of OSAHS and the severity of OSAHS are positively associated with the severity of adenoid and tonsil. The electron-nasopharyngolaryngoscopy examination is an important examination method for diagnosing OSAHS in children, as well as determination of tonsil size.
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