ObjectiveTo investigate the contributions of adenoid and tonsil size to childhood obstructive sleep apnea (OSA) and the interactions between adenotonsillar hypertrophy, age, and obesity in children with OSA.MethodsIn total, 495 symptomatic patients were recruited. The patients were assigned to four groups according to age：toddler (age 1-3, n=42), preschool (age 3-6, n=164), school (age 6-12, n=200), and adolescence (age 12-18, n=89). All subjects had tonsil size graded by otolaryngologists, adenoid size determined on lateral radiographs (Fujioka method), and a full-night polysomnography. The apnea-hypopnea index (AHI), adenoid size, and tonsil size were compared in obese and non-obese children in the four age groups. Adjusted odds ratios (ORs) and 95% confidence interval (CI) of adenotonsillar hypertrophy and OSA risk were estimated by multi-logistic regression.ResultsThe AHI was positively related to tonsil grade (r=0.33, p <0.001) and adenoid size (r=0.24, p <0.01) in all patients. Tonsil grade was positively related to AHI in all four age groups. Adenoid size was positively related to AHI in the toddler, preschool, school groups, but not in the adolescent group (r=0.11, p=0.37). Tonsil grade and adenoid size were both positively related to AHI in obese and non-obese children. In the regression model, obesity (OR=2.89; 95% CI 1.47-5.68), tonsillar hypertrophy (OR=3.15; 95% CI 2.04-4.88), and adenoidal hypertrophy (OR=1.89; 95% CI 1.19-3.00) significantly increased OSA risk.ConclusionsAdenotonsillar hypertrophy and obesity are the major determinants of OSA in children. However, the influence of adenoid size decreases in adolescence.

OBJECTIVE:The relationship between weight status, adenotonsillar hypertrophy and obstructive sleep apnea (OSA) in children has not yet been well studied. As the sleep parameters may show a disparity in different weight statuses, this study examined the relationship between the data of over-night polysomnography and different weight statuses, as well as the impact of adenotonsillar hypertrophy on children with OSA. METHODS: Children with sleep disturbances were recruited from our clinics. Standard physical examinations, history taking, lateral neck roentgenography, and full-night polysomnography were obtained. Children were divided into four groups based on the age-and gender-corrected body mass index (BMI): underweight, normal weight, overweight and obese. An adenoidal/ nasopharyngeal ratio of more than 0.67 was considered adenoidal hypertrophy. Tonsillar hypertrophy was defined as having Grade III tonsils or above. RESULTS: From July 2006 to January 2009, 197 children were included in this study. Obese children had a significantly higher apnea --hypopnea index (AHI), obstructive apnea index and lower minimum oxygen saturation (MinSaO 2 ) than those of the other groups. Underweight children had the second highest AHI. A negative correlation was also found between BMI z scores and MinSaO 2 (r ¼ À0.194; P ¼ 0.007). Children with tonsillar hypertrophy (P ¼ 0.001) were associated with a higher risk of having OSA. The risk of having OSA was significantly higher in obese children (P ¼ 0.001) and underweight children (P ¼ 0.043) than in those with a normal weight. CONCLUSION: Obesity, underweight status and tonsillar hypertrophy are associated with children having OSA, and obese children have a significantly higher risk than children with underweight status.

Although sleep parameters improved in all weight statuses, obese children had a higher incidence of residual OSA postoperatively. About half of the underweight children shifted to normal weight status after T&A.

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The traditional Chinese version of OSA-18 demonstrated high reliability and good validity in our study. The domain of caregiver concern is the major element in Taiwanese children with sleep-disordered breathing.

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In children with SDB, younger ones have a significantly higher CAI than older ones. Additionally, obese children had a lower CAI than non-obese ones.

To investigate whether the saccule exhibits temporary or permanent functional loss resembling threshold shifts in auditory brainstem response (ABR) of guinea pigs following noise exposure.Design: Randomly bred guinea pigs were divided into 3 groups: A (short-term noise exposure, 30 minutes, n=15), B (long-term noise exposure, 40 hours, n=9), and C (no noise exposure, n = 5).Setting: University hospital. Main Outcome Measures: All animals underwent vestibular-evoked myogenic potential (VEMP) and ABR tests. Chronological changes of VEMP and ABR responses following noise exposure were analyzed and compared. After audiovestibular function testing, animals were killed for morphological study with light and electron microscopy. Results: In group A, temporary VEMP loss and ABR METHODS ANIMAL PREPARATIONRandomly bred Hartley-strain guinea pigs weighing 250 to 300 g were housed at a mean