내시경적 아데노이드 등급과 소아 폐쇄성 수면무호흡증 중증도의 상관관계
Correlation between Endoscopic Adenoid Grading and Obstructive Sleep Apnea Severity in Pediatric Patients
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives:Hypertrophy of adenoids was recognized as one of the main causes of snoring and obstructive sleep apnea (OSA) in pediatric patients. Recently, two endoscopic adenoid grading system was pro- posed, Parikh grade (P-G) and ACE grade (ACE-G). The aim of this study is to evaluate the correlation between obstructive sleep apnea severity and these two endoscopic adenoid grading systems. Materials and Methods: We retrospectively reviewed the medical records of 52 patients who underwent a polysomnography and endo- scopic nasal endoscopy in the secondary referral hospital from 2008 to 2017. Adenoid exam was performed with nasal endoscopy after nasal packing soaked with lidocaine and xylometazoline in out-patient clinic. It was evalu- ated the correlation between each adenoid grading system and apnea-hypopnea index, adjusted by sex, age, tonsil grade, body mass index, and presence of allergic rhinitis. Results:Mean age was 7.6 year (range : 2-15, SD : 2.57) and 75% of the patient had obstructive sleep apnea (AHI≥1). P-G was statistically correlated with OSA se- verity. (OR=11.8, 95% CI : 1.5-92.2, p=0.02) Only subgrade E of ACE-G has meaningful correlation with OSA severity (OR=2.07, 95% CI : 0.91-4.81 p=0.03). Conclusion:P-G and subgrade E of ACE-G were statistically related to sleep apnea severity in pediatric patients. Endoscopic adenoid grading system can be useful tool to eval- uate adenoid hypertrophy and upper airway in pediatric OSA patients.
Abstract
Background and Objectives:Hypertrophy of adenoids was recognized as one of the main causes of snoring and obstructive sleep apnea (OSA) in pediatric patients. Recently, two endoscopic adenoid grading system was pro- posed, Parikh grade (P-G) and ACE grade (ACE-G). The aim of this study is to evaluate the correlation between obstructive sleep apnea severity and these two endoscopic adenoid grading systems. Materials and Methods: We retrospectively reviewed the medical records of 52 patients who underwent a polysomnography and endo- scopic nasal endoscopy in the secondary referral hospital from 2008 to 2017. Adenoid exam was performed with nasal endoscopy after nasal packing soaked with lidocaine and xylometazoline in out-patient clinic. It was evalu- ated the correlation between each adenoid grading system and apnea-hypopnea index, adjusted by sex, age, tonsil grade, body mass index, and presence of allergic rhinitis. Results:Mean age was 7.6 year (range : 2-15, SD : 2.57) and 75% of the patient had obstructive sleep apnea (AHI≥1). P-G was statistically correlated with OSA se- verity. (OR=11.8, 95% CI : 1.5-92.2, p=0.02) Only subgrade E of ACE-G has meaningful correlation with OSA severity (OR=2.07, 95% CI : 0.91-4.81 p=0.03). Conclusion:P-G and subgrade E of ACE-G were statistically related to sleep apnea severity in pediatric patients. Endoscopic adenoid grading system can be useful tool to eval- uate adenoid hypertrophy and upper airway in pediatric OSA patients.
참고문헌 (15)
- Mitchell RB, "Clinical practice guideline:tonsillectomy in children (update)", Otolaryngol Head Neck Surg, 160(1_suppl), pp.S1~S24 (2019)
- Major MP, "Adenoid hypertrophy in pediatric sleep disordered breathing and craniofacial growth: the emerging role of dentistry", J Dent Sleep Med, 1(2), pp.83~87 (2014)
- Wang DY, "Fiberoptic examination of the nasal cavity and nasopharynx in children", Acta Otorhinolaryngol Belg, 45(3), pp.323~329 (1991)
- Guilleminault C, "Adenotonsillectomy and obstructive sleep apnea in children:a prospective study", Otolaryngol Head Neck Surg, 136(2), pp.169~175 (2007)
- Fregosi RF, "Sleep-disordered breathing, pharyngeal size and soft tissue anatomy in children", J Appl Physiol, 95(5), pp.2030~2038 (2003)
- Lertsburapa K, "Assessment of adenoid size: a comparison of lateral radiographic measurements, radiologist assessment, and nasal endoscopy", Int J Pediatr Otorhinolaryngol, 74(11), pp.1281~1285 (2010)
- Parikh SR, "Validation of a new grading system for endoscopic examination of adenoid hypertrophy", Otolaryngol Head Neck Surg Surgery, 135(5), pp.684~687 (2006)
- Varghese AM, "ACE grading-A proposed endoscopic grading system for adenoids and its clinical correlation", Int J Pediatr Otorhinolaryngol, 83, pp.155~159 (2016)
- Fujioka M, "Radiographic evaluation of adenoidal size in children: adenoidal-nasopharyngeal ratio", AJR Am J Roentgenol, 133(3), pp.401~404 (1979)
- Kemaloglu YK, "Radiographic evaluation of children with nasopharyngeal obstruction due to the adenoid", Ann Otol Rhinol Laryngol, 108(1), pp.67~72 (1999)
- Cohen D, "The evaluation of radiographs of the nasopharynx", Clin Otolaryngol Allied Sci, 10(2), pp.73~78 (1985)
- Lacosta JL, "A radiologic study of the nasopharynx", Acta Otorrhinolaringol Esp, 46(2), pp.115~119 (1995)
- Cassano P, "Adenoid tissue rhinopharyngeal obstruction grading based on fiberendoscopic findings: a novel approach to therapeutic management", Int J Pediatr Otorhinolaryngol, 67(12), pp.1303~1309 (2003)
- Caylakli F, "Correlation between adenoi-nasopharynx ratio and endoscopic examination of adenoid hypertrophy: a blind, prospective clinical study", Int J Pediatr Otorhinolaryngol, 73(11), pp.1532~1535 (2009)
- Al Maqbali T, "Radiosurgical correlation of obstructive adenoids in children", Eur Arch Otorhinolaryngol, 268(10), pp.1475~1478 (2011)