Usefulness of Adenotonsillar Size for Prediction of Severity of Obstructive Sleep Apnea and Flow Limitation

Hwang, Se Hwan; Guilleminault, Christian; Park, Chan-Soon; Kim, Tae−Won; Hong, Seung‐Chul

doi:10.1177/0194599813490892

Cited by 41 publications

(42 citation statements)

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“…In the current investigation, prevalence of severe OSA increased as the grade of tonsil size increased; however, it is important to note that prevalence of residual OSA was not different between the grades of tonsil size. The correlation between adenoid size and OSA has been reported with conflicting results . Our findings showed no difference in the prevalence of severe OSA among the grades of adenoid size.…”

Section: Discussioncontrasting

confidence: 63%

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Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children

Imanguli

Ulualp

2016

The Laryngoscope

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Section: Discussioncontrasting

confidence: 63%

“…The correlation between adenoid size and OSA has been reported with conflicting results. 34,35 Our findings showed no difference in the prevalence of severe OSA among the grades of adenoid size. The prevalence of residual OSA increased as the grade of adenoid size decreased.…”

Section: Discussioncontrasting

confidence: 48%

Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children

Imanguli

Ulualp

2016

The Laryngoscope

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“…6,13 Hypertrophied tonsils may represent one of the several possible etiolo- be aware of the limitations of using these grading scales and must consider parental reports of nighttime snoring and presence of other associated obstructive symptoms in order to diagnose OSA in children. A potential limitation is our intraobserver reliability methodology.…”

Section: Discussionmentioning

confidence: 99%

The Reliability of Clinical Tonsil Size Grading in Children

Kumar

Valenzuela

Kozak

et al. 2014

JAMA Otolaryngol Head Neck Surg

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“…Another major reason is the lack of availability of sleep labs with the ability and desire to test. 22,23 By contrast, it has been reported that clinical history and physical examination are not reliable for diagnosing OSA and that questionnaires alone do not provide a good diagnostic prediction for OSA in children. 23 Consequently, many researchers have tried to find a screening tool for the presence and severity of OSA in children.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Salivary Alpha Amylase Level and Adenotonsillar Hypertrophy with Sleep Disordered Breathing in Pediatric Subjects

Park

Guilleminault

Park

et al. 2014

Journal of Clinical Sleep Medicine

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Recently, salivary proteins have gained become of interest in diagnosing a variety of diseases, and several salivary proteins have been suggested as biomarkers to predict a variety of diseases. Among them, salivary cortisol may indicate a chronically stressed HPA axis and be a useful biomarker for OSAS. 10Salivary protein α-amylase (sAA) regulated by the sympathetic nervous system has been suggested as a biomarker for sympathetic activity because sAA activity is a readily accessible, noninvasive parameter that refl ects human responses to physiological and psychological stress. [11][12][13] For example, sAA activity can be used with moderate sensitivity and specifi city to detect acute myocardial infarction in patients with acute chest pain.14 A few studies have been published on α-amylase (AA) related to Study Objectives: Obstructive sleep apnea syndrome (OSAS) and sleep disordered breathing (SDB) can affect the sympathetic adrenomedullary system (SAM). As a biomarker of SAM activity, salivary α-amylase (sAA) in pediatric subjects was evaluated whether it has any correlation with polysomnographic (PSG) parameters related to SDB. Methods: Sixty-seven children who attended our clinic during 1 year were enrolled prospectively and underwent clinical examinations and in-lab polysomnography. The sAA was measured at 2 points-at night before PSG and in the early morning after PSG Results: Subjects were divided into control (n = 26, apneahypopnea index [AHI] < 1) and OSAS (n = 41, AHI ≥ 1) groups. The OSAS group was subdivided according to AHI (mild-moderate, 1 ≤ AHI < 10; severe, AHI ≥ 10). The sAA subtraction and ratio (p = 0.014 and p < 0.001, respectively) were signifi cantly higher in severe OSAS than in the mildmoderate and control groups. Although oxygen desaturation index (ODI) and AHI were signifi cantly associated with sAA, sAA in the OSAS group was not related to lowest oxygen saturation or adenotonsillar hypertrophy. Conclusion: sAA was well related to polysomnographic (PSG) parameters related to SDB, such as AHI and ODI. Therefore, screening test for sAA in children suspected to have SBD may help to identify OSAS patients from control. S C I E N T I F I C I N V E S T I G A T I O N SO bstructive sleep apnea (OSA) is a relatively common disorder, with an estimated frequency of 2% to 3% in children. Sleep disordered breathing (SDB) has a wide spectrum of respiratory abnormalities from primary snoring to OSA, and its prevalence is estimated to be from 0.9% to 13% in children. Reduced airfl ow (fl ow limitation, hypopnea), increased respiratory effort, and repetitive cessation of airfl ow (apnea) are usually observed in subjects with SDB. As a result, SDB can cause intermittent hypoxia and hypercapnia followed by successive restoration of normo-oxygenation after arousals, which can activate stress responses mediated by the hypothalamic-pituitary-adrenocortical (HPA) axis and the autonomic nervous system (ANS). 2-5It is well known that ANS parasympathetic tone is elevated by apnea and hypopnea, and sympathetic t...

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Usefulness of Adenotonsillar Size for Prediction of Severity of Obstructive Sleep Apnea and Flow Limitation

Cited by 41 publications

References 24 publications

Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children

Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children

The Reliability of Clinical Tonsil Size Grading in Children

Correlation of Salivary Alpha Amylase Level and Adenotonsillar Hypertrophy with Sleep Disordered Breathing in Pediatric Subjects

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