Oropharyngeal obstruction and respiratory system compliance are linked to ventilatory control parameters in pediatric obstructive sleep apnea syndrome

Bokov, Plamen; Boujemla, Imene; Matrot, Boris; Spruyt, Karen; Gallego, Jorge; Delclaux, Christophe

doi:10.1038/s41598-022-22236-7

Cited by 3 publications

(1 citation statement)

References 43 publications

(58 reference statements)

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“…The size of the tonsils and adenoids was recorded prior to surgery. Tonsils were graded as follows: 10 Grade I, tonsil confined to tonsillar fossa; Grade II, tonsils extending just outside the anterior pillars; Grade III, tonsils extending outside the posterior pillars but not meeting in the midline; and Grade IV, tonsils meeting in the midline and almost completely obstructing the airway. Size of the adenoids was graded based on the percentage of adenoid tissue occupying the rhinopharyngeal cavity: grade 1 (<25%); grade 2 (<50%); grade 3 (<75%); and grade 4 (>75%).…”

Section: Methodsmentioning

confidence: 99%

Analysis of Risk Factors for Otitis Media with Effusion in Children with Adenoid Hypertrophy

Yang¹,

Jv²,

Zhang³

et al. 2023

RMHP

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Objective This study aimed to explore whether children with AH have a higher obesity prevalence and analyze the risk factors for otitis media with effusion(OME) in AH children. Methods AH patients aged 3–12 years old that were hospitalized in our hospital for adenoidectomy from June 2020 to September 2022 were included in this study. Height and weight were measured to calculate the body mass index, weight for height and weight z-score to evaluate the development of AH children. Propensity score matching was applied to minimize patient selection bias and adjust for confounding factors to analyze the risk factors for OME in children with AH. Results A total of 887 children with AH were enrolled in this study. The prevalence of overweight or obesity was higher in children with AH than the control group. The size of adenoids is significantly different between AH children with and without OME. For children aged over 5, there are significantly higher counts of white blood cells, neutrophils, and monocytes in the AH children with OME than those without OME. More individuals represent to be atopic in children with OME than those without OME. Conclusion The obstruction of the Eustachian tube is the most important factor of OME in AH children. It seems that there is no apparent correlation between OME and atopic conditions in AH children. In addition to surgical resection of adenoids, active control of infection and inflammation are also important to prevent OME for AH children aged over 5.

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Section: Methodsmentioning

confidence: 99%

Analysis of Risk Factors for Otitis Media with Effusion in Children with Adenoid Hypertrophy

Yang¹,

Jv²,

Zhang³

et al. 2023

RMHP

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The role of atypical deglutition in children and adolescents with moderate to severe obstructive sleep apnea syndrome

Bokov,

Dahan,

Boujemla

et al. 2024

Journal of Sleep Research

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SummaryThis cross‐sectional study aimed to assess the prevalence of atypical deglutition (tongue thrust) in children diagnosed with moderate to severe obstructive sleep apnea syndrome (OSAS) and to explore its associations, particularly in relation to the type of dentition (mixed or permanent). The study was conducted over a 5 year period at a paediatric hospital in Paris, France. Children aged 6–18 years with moderate to severe OSAS (apnea–hypopnea index ≥5/h) underwent a comprehensive evaluation, including the recording of demographic data, symptoms of snoring and breathing issues, and otolaryngology examination. The swallowing pattern was assessed and orthodontic evaluations were performed. Cephalometric radiography and pharyngometry tests (pharyngeal collapsibility was computed) were conducted. The study found a high prevalence of atypical deglutition in children with mixed 74% [56–87] or permanent 38% [25–51] dentition. In children with mixed dentition and atypical deglutition, the pharyngeal compliance and lower facial dimensions were increased. In children with permanent dentition, atypical deglutition was associated with more severe OSAS and a lower hyoid bone position. Independent of the type of dentition, atypical deglutition was associated with an increase in the apnea–hypopnea index, an increase in the lower facial dimension, increased pharyngeal compliance, and a more caudal hyoid bone position. Atypical deglutition was strongly associated with increased pharyngeal collapsibility, more severe OSAS and altered facial measurements in children. The findings suggest that identifying atypical deglutition in children with OSAS could help to guide a personalised therapeutic approach, including myofunctional therapy.

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Central CO₂ chemosensitivity and CO₂ controller gain independently contribute to daytime Pco₂ in young subjects with congenital central hypoventilation syndrome

Bokov

Dudoignon

Patout

et al. 2023

Journal of Applied Physiology

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Whether peripheral chemoreceptor response is altered in congenital central hypoventilation syndrome (CCHS) remains debated. Our aim was to prospectively evaluate both peripheral and central CO2 chemosensitivity and to evaluate their correlations with daytime PCO2 and arterial desaturation during exercise in CCHS. To this end, tidal breathing was recorded in CCHS patients allowing the calculation of loop gain and its components (steady-state controller [assumed to mainly be peripheral chemosensitivity] and plant gains using a bivariate [PETCO2 and ventilation] constrained model), a hyperoxic, hypercapnic ventilatory response test (central chemosensitivity), and a six-minute walk test (arterial desaturation). The results of loop gain were compared to those previously obtained in a healthy group of similar age. The study prospectively included 23 subjects with CCHS, without daytime ventilatory support; the subjects had a median age of 10 (5.6 to 27.4) years (15 females) with moderate polyalanine repeat mutation (PARM: 20/25, 20/26, n=11), severe PARM (20/27, 20/33, n=8), or non-PARM (n=4). As compared to 23 healthy subjects (4.9 to 27.0 years), the subjects with CCHS had a decreased controller gain and an increased plant gain. Mean daytime PETCO2 level of subjects with CCHS correlated negatively to both Log(controller gain) and the slope of CO2 response. Genotype was not related to chemosensitivity. Arterial desaturation on exercise correlated negatively with Log(controller) gain but not with the slope of the CO2 response. In conclusion, we demonstrate that peripheral CO2 chemosensitivity is altered in some patients with CCHS and that the daytime PETCO2 depends on central and peripheral chemoreceptor responses.

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Oropharyngeal obstruction and respiratory system compliance are linked to ventilatory control parameters in pediatric obstructive sleep apnea syndrome

Cited by 3 publications

References 43 publications

Analysis of Risk Factors for Otitis Media with Effusion in Children with Adenoid Hypertrophy

Analysis of Risk Factors for Otitis Media with Effusion in Children with Adenoid Hypertrophy

The role of atypical deglutition in children and adolescents with moderate to severe obstructive sleep apnea syndrome

Central CO₂ chemosensitivity and CO₂ controller gain independently contribute to daytime Pco₂ in young subjects with congenital central hypoventilation syndrome

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Oropharyngeal obstruction and respiratory system compliance are linked to ventilatory control parameters in pediatric obstructive sleep apnea syndrome

Cited by 3 publications

References 43 publications

Analysis of Risk Factors for Otitis Media with Effusion in Children with Adenoid Hypertrophy

Analysis of Risk Factors for Otitis Media with Effusion in Children with Adenoid Hypertrophy

The role of atypical deglutition in children and adolescents with moderate to severe obstructive sleep apnea syndrome

Central CO2 chemosensitivity and CO2 controller gain independently contribute to daytime Pco2 in young subjects with congenital central hypoventilation syndrome

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Central CO₂ chemosensitivity and CO₂ controller gain independently contribute to daytime Pco₂ in young subjects with congenital central hypoventilation syndrome