Related Experiment Video

Updated: Dec 12, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
07:54

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

Published on: December 6, 2016

20.3K

Effect of adenoids and tonsil tissue on pediatric obstructive sleep apnea severity determined by computational fluid

Tomonori Iwasaki1, Takesi Sugiyama2,3, Ayaka Yanagisawa-Minami1

  • 1Department of Pediatric Dentistry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|August 12, 2020
PubMed

Insights

Diagnosing pediatric obstructive sleep apnea (OSA) can be improved by measuring airway cross-sectional area (CSA). When CSA is 50 mm² or less, the apnea-hypopnea index (AHI) is likely elevated, indicating a need for surgery.

Area of Science:

  • Pediatric Otolaryngology
  • Respiratory Medicine
  • Medical Imaging

Background:

  • Obstructive sleep apnea (OSA) in children is often caused by enlarged adenoids and tonsils.
  • Adenotonsillectomy is the primary treatment, but persistent OSA occurs due to challenges in evaluating tissue size.
  • Current methods for assessing airway obstruction may not accurately predict treatment outcomes.

Purpose of the Study:

  • To develop a diagnostic method for determining the need for adenoidectomy or tonsillectomy in pediatric OSA.
  • To correlate pharyngeal airway morphology with OSA severity.
  • To establish objective criteria for surgical intervention in pediatric OSA.

Main Methods:

  • Twenty-seven Japanese children with suspected OSA underwent polysomnography and computed tomography.
  • Pharyngeal airway morphology, including adenoid and tonsil size, volume, and cross-sectional area (CSA), was evaluated.
  • Computational fluid dynamics (CFD) analysis was used to assess upper airway pressure.

Main Results:

  • A strong linear association was found between the apnea-hypopnea index (AHI) and maximum negative pressure (Pmax).
  • Inversely proportional relationships were observed between minimum CSA (CSAmin) and Pmax, and between CSAmin and AHI.
  • Negative pressure significantly increased when CSA was 50 mm² or less, particularly below 30 mm².

Conclusions:

  • A minimum pharyngeal airway cross-sectional area (CSA) of 50 mm² or less is associated with elevated AHI in children.
  • This finding suggests that CSA measurement can aid in diagnosing the need for tonsillectomy or adenoidectomy.
  • Objective airway measurements may improve the evaluation and management of pediatric OSA.
Abstract

Keywords:
adenoidairway negative pressurecomputed fluid dynamicsobstructive sleep apneapediatricstonsil

More Related Videos

Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue07:38

Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue

Published on: June 14, 2020

7.9K
Evaluating Regional Pulmonary Deposition using Patient-Specific 3D Printed Lung Models07:56

Evaluating Regional Pulmonary Deposition using Patient-Specific 3D Printed Lung Models

Published on: November 11, 2020

4.6K

Related Concept Videos

Tonsillitis I: Introduction01:30

Tonsillitis I: Introduction

Tonsillitis is inflammation of the tonsils, which are two lymphoid tissue masses at the back of the throat. This condition can cause discomfort and irritation in the throat.
Etiology
Three primary contributing factors have been identified.
1.2K
Sleep Apnea01:21

Sleep Apnea

Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
364
Factors Affecting Pulmonary Ventilation01:19

Factors Affecting Pulmonary Ventilation

Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
2.5K
Chronic Pharyngitis01:23

Chronic Pharyngitis

Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
9.1K
Anatomy of Respiratory System I: Upper Respiratory Tract01:29

Anatomy of Respiratory System I: Upper Respiratory Tract

The upper respiratory tract plays a vital role in the respiratory system, comprising several structures that facilitate air intake and prepare air for the lungs. It also serves as the first line of defense against pathogens and particles. This tract includes the nose and nasal cavity, the oral cavity, the paranasal sinuses, and the pharynx, each with specific functions and features.
Nose and nasal cavity
The nose and nasal cavity represent the main external openings of the respiratory tract....
4.1K