Correlation between adenoidal nasopharyngeal ratio andobstructive sleep apnea in children with adenoidal hypertrophy
Keywords:
Nasopharyngeal ratio, obstructive sleep apnea, adenoidal hypertrophyAbstract
Adenoid hypertrophy is one of the most common health problems affecting the pediatric population. This retrospective study aimed to correlate adenoidal nasopharyngeal ratio (ANR) with obstructive sleep apnea in children with adenoidal hypertrophy at Udon Thani hospital, Thailand. Adenoidal Nasopharyngeal Ratio (ANR) was determined by dividing adenoidal depth with nasopharyngeal depth on the Lateral X-ray of the nasopharynx, devided to 3 groups : mild obstruction (ANR < 0.7), moderate obstruction (ANR 0.7-1.1) and severe obstruction (ANR > 1.1). Descriptive statistic and Chi-square test had used for analyse correlations.
Results: Total of 131 children, 2-8 years old, who diagnosed adenotonsillar hypertrophy were recruited for the study. Male were 80 (61.1%) with male: female ratio was 1.56:1. The mean age was 4.8 years old (S.D.=1.7) with age group 2-5 years old was the most affected group (64.1%). All the patients presented with snoring (100%). 61.1% had sleep apnea and 55.7% had nasaldischarge. Nosignificant association between sex, age, ANR and obstructive sleep apnea (p=0.494, p=0.116and, p=0.352, respectively).
Conclusion: Lateral X-ray of the nasopharynx is an effective tool to evaluate children with suspected adenoid hypertrophy, especially in a resource-limited environment. It provides objective measures of adenoid hypertrophy from ANR ratio as well as useful information that may help to decide the need for surgery. Although in this study shows no significant association between the age, sex, ANR and obstructive sleep apnea.
References
Peter JR. The adenoid and adenoidectomy. In: Michael G, George GB, Martin JB, Ray C, John H, Nicholas SJ.et al., editors. Scott-Brown's Otolaryngology. 7thed., Vol. 1. London: Hodder Arnold; 2008. p. 1095-101.
Ourenço EA, Lopes KC, Pontes A, Oliveira MH, Umemura A, Vargas A. Comparison between radiological and nasopharyngolaryngoscopic assessment of adenoid tissue volume in mouth breathing children. Rev Bras Otorrinolaringol2005; 71: 23-8.
Jaw TS, Sheu RS, Liu GC, Lin WC. Development of adenoids: A study by measurement with MR images. Kaohsiung J Med Sci 1999; 15:12-8.
Görür K, Döven O, Unal M, Akkus N, Ozcan C. Preoperative and postoperative cardiac and clinical findings of patients with adenotonsillar hypertrophy. Int J PediatrOtorhinolaryngol2001;59:41-6.
Muzumdar H, Arens R. Diagnostic issues in pediatric obstructive sleep apnea. Proc Am ThoracSoc2008;5:263-73.
Chervin RD, Ruzicka DL, Giordani BJ, Weatherly RA, Dillon JE, Hodges EK, Marcus CL, Guire KE. Sleep-disordered breathing, behavior, and cognition in children before and after adenotonsillectomy. Pediatrics 2006; 117:e769-e778.
Gozal D. Sleep-disordered breathing and school performance in children. Pediatrics 1998;102:616-620.
Paulussen C, Claes J, Claes G, Jorissen M. Adenoids and tonsils, indications for surgery and immunological consequences of surgery. Acta OtorhinolaryngolBelg2000;54:403-8.
Mlynarek A, Tewfik MA, Hagr A, Manoukian JJ, Schloss MD, Tewfik TL,etal.Lateral neck radiography versus direct video rhinoscopy in assessing adenoid size. J Otolaryngol2004;33:360-5.
Oluwole M, Mills RP. Methods of selection for adenoidectomy in childhood otitis media with effusion. Int J PediatrOtorhinolaryngol1995;32:129-35.
Orji FT, Ezeanolue BC. Evaluation of adenoidal obstruction in children: Clinical symptoms compared with roentgenographic assessment. J LaryngolOtol 2008; 122: 1201-5.
Kolo ES, Ahmed AO, Kazeem MJ, Nwaorgu OG. Plain radiographic evaluation of children with obstructive adenoids. Eur J Radiol 2011;79:e38-41.
Kurien M, Lepcha A, Mathew J, Ali A, Jeyaseelan L. X-rays in the evaluation of adenoid hypertrophy: It's role in the endoscopic era. Indian J Otolaryngol Head Neck Surg 2005; 57: 45-7.
Feres MF, Hermann JS, Sallum AC, Pignatari SS. Radiographic adenoid evaluation - Suggestion of referral parameters. J Pediatr (Rio J) 2014; 90: 279-85.
Kolo ES, Salisu AD, Tabari AM, Dahilo EA, Aluko AA. Plain radiographic evaluation of the nasopharynx: Do raters agree? Int J PediatrOtorhinolaryngol 2010; 74: 532-4.
Cohen LM, Koltai PJ, Scott JR. Lateral cervical radiographs and adenoid size: Do they correlate? Ear Nose Throat J 1992; 71: 638-42.
Wang Jing, Zhoa Yu, Yang Wen, ShenTian, Xue Pei, Yan Xiaohong, et al. Correlations between obstructive sleep apnea and adenotonsillar hypertrophy in children of different weight status. Scientifc Reports. Nature research 2019; 9: 11455.
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