Grading adenoid utilizing flexible nasopharyngoscopy

Alammar, Ahmed; Shebib, Deena; Bokhari, Manal; Jomah, Mohammed

doi:10.5144/0256-4947.2013.265

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…Tonsil size was graded according to occupation of the oropharynx (grade 1: 0%–25%; grade 2: 26%–50%; grade 3: 51%–75%; and grade 4: 76–100%), 36 and adenoid size was graded according to the degree of obstruction of the posterior choana (grade 1: 0%–25%; grade 2: 26%–50%; grade 3: 51%–75%; and grade 4: 76–100%) 37 by two senior investigators (Li, H.-Y. and Lee, L.-A.)…”

Section: Methodsmentioning

confidence: 99%

The 3% Oxygen Desaturation Index is an Independent Risk Factor for Hypertension Among Children with Obstructive Sleep Apnea

Chuang¹,

Wang²,

Chuang³

et al. 2022

NSS

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Background Obstructive sleep apnea (OSA) and obesity are both directional risk factors of hypertension. Chronic intermittent hypoxemia (IH) is a commonly observed pathophysiological mechanism involved in multiple comorbidities of OSA. However, their interactions are not well understood in children. This study aimed to investigate the associations of IH indexes (oxygen desaturation index 3% [ODI3], mean peripheral oxygen saturation [SpO 2 ], least SpO 2 , and time with SpO 2 < 85%), apnea-hypopnea index, and weight status with hypertension in a sample of pediatric OSA patients. Methods The medical records of 365 pediatric OSA patients were retrospectively reviewed in this cross-sectional study. Demographics, anthropometrics, standard in-laboratory polysomnography, and nocturnal blood pressure were collected. Multivariate logistic regression with forward selection was used to identify independent predictors of hypertension. Results Multivariate logistic regression analysis showed that ODI3 (odds ratio [OR] = 1.02, 95% confidence interval [CI] = 1.01–1.03) and body mass index z-score (OR = 1.34, 95% CI = 1.12–1.60) were independent continuous predictors of pediatric hypertension, whilst severe OSA (OR = 2.62, 95% CI = 1.60–4.29) and overweight/obesity (OR = 2.63, 95% CI = 1.59–4.34) were independent categorical predictors. Traditional risk factors including male sex (OR = 2.33, 95% CI = 1.02–5.33), late childhood/adolescence (OR = 1.98, 95% CI = 1.01–3.88), and overweight/obesity (OR = 2.97, 95% CI = 1.56–5.67) combined with sleep hypoxemia (least SpO 2 ≤ 95%) (OR = 2.24, 95% CI = 1.16–4.04) predicted hypertension ( R 2 = 0.21) in the severe IH subgroup (n = 205), while the no/mild IH subgroup (n = 160) had an entirely different predictor, severe OSA (OR = 3.81, 95% CI = 1.49–9.74) ( R 2 = 0.07). Conclusion The close relationships among IH, overweight/obesity, and hypertension highlight the importance of reducing IH and body weight in children with OSA.

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Section: Methodsmentioning

confidence: 99%

The 3% Oxygen Desaturation Index is an Independent Risk Factor for Hypertension Among Children with Obstructive Sleep Apnea

Chuang¹,

Wang²,

Chuang³

et al. 2022

NSS

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“…19,20 To assess the possibility of adenoid size asymmetry in both nasal sides by nasopharyngoscopy. 21 The tonsillar size was graded using Friedman's classification by the physician. 22 The diagnosis of inherited metabolic diseases (Pierre Robin syndrome, Prader-Willi syndrome, spinal muscular atrophy (SMA), glycogen storage disease, epilepsy), hypothalamic syndrome, and chromosomal diseases are based on clinical manifestation, molecular genetic diagnosis, the examination of chromosomes.…”

Section: Evaluation Of Coexisting Conditionsmentioning

confidence: 99%

Exploring the Multifaceted Landscape of Pediatric Obstructive Sleep Apnea: Insights into Prevalence, Severity, and Coexisting Conditions

Yang,

Huang,

Lin

et al. 2024

NSS

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Background: Pediatric obstructive sleep apnea (OSA) is a multifaceted disorder marked by recurrent upper airway obstruction during sleep, often coexisting with various medical conditions. This study, aimed to comprehensively analyze the Multifaceted Landscape of Pediatric Insights into Prevalence, Severity, and Coexisting Conditions. With a sample of 1928 participants, our study sought to determine the prevalence, severity, and associations between OSA and diverse conditions. Methods: Conducted retrospectively from February 2019 to April 2023, the study included pediatric patients. Data were collected through electronic health records, involving clinical assessments, medical histories, and diagnostic tests to establish OSA and coexisting condition diagnoses. Relationships between sleep parameters, apnea types, and severity indices were evaluated. Results: High OSA prevalence was evident across age groups, with severity peaking between 3 to 12 years. Among the participants, coexisting conditions included allergic rhinitis (59.6%), tonsillar hypertrophy (49.7%), adenoid hypertrophy (28.4%), and obesity (15.3%). Analysis revealed intriguing relationships between different sleep parameters and apnea types. Notable associations were observed between Obstructive Apnea (OA) and Central Apnea (CA), and Mixed Apnea (MA) displayed associations with both OA and CA. Hypopnea correlated directly with the Apnea-Hypopnea Index (AHI), reflecting its role in OSA severity. Conclusion:This study provides a comprehensive understanding of the intricate dynamics between pediatric OSA and coexisting conditions. The prevalence of OSA and its coexistence with various conditions underscore the need for comprehensive evaluation and management strategies. By revealing associations between different sleep parameters and apnea types, the study emphasizes the complexity of OSA diagnosis and management. These findings hold the potential to enhance clinical approaches, ultimately leading to improved care and outcomes for affected children.

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