Adenoid size is related to severity but not the number of episodes of obstructive apnea in children☆,☆☆,★,★★
Section snippets
METHODS
Thirty-three consecutive patients who were referred to the Sleep Disorders Center at Rainbow Babies and Childrens Hospital because of suspected OSA were evaluated with a physical examination, standard lateral neck roentgenography, and overnight PSG. Patients with obvious neurologic or craniofacial abnormalities were excluded.
RESULTS
Nineteen boys and 14 girls, ranging in age from 0.4 to 11.6 years, were studied. Their percent ideal body weight ranged from 72% to 250%. All of the patients reported snoring with trouble breathing or apneas witnessed by a parent, with a mean OSA score11 of 2.53 ± 2.09 SD. The patients' RDI ranged from 0 to 95.3 with a mean ± SD of 12.5 ± 19.1. The patients' AN ratio ranged from 0.48 to 0.98 with a mean of 0.76 ± 0.14. Thirty (91%) of the 33 patients had AN ratios greater than the mean reported
DISCUSSION
Obesity, not lymphoid hyperplasia, was the primary independent predictor of RDI in our sample of children who were referred for evaluation of OSA. Although adenoid size did not correlate with the number of respiratory events (RDI), the patients with larger adenoids had longer obstructive apneas and hence more severe oxyhemoglobin desaturation. These findings have important implications for understanding the pathophysiologic characteristics of OSA in children.
Marcus et al.12 showed that obese
Acknowledgements
We thank Juliann M. DiFiore for preparation of the figures and Therese Weaver and Linda L. Robinson for expert secretarial assistance.
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From the Division of Pulmonary Medicine, The Children's Regional Hospital, Robert Wood Johnson School of Medicine/UMDNJ, Camden, New Jersey, and the Pediatric Pulmonary Division and Sleep Disorders Center, Rainbow Babies and Childrens Hospital, Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio.
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Supported by a Summer Student Research Fellowship, Department of Pediatrics, Case Western Reserve University.
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Reprint requests: Lee J. Brooks, MD, The Children's Regional Hospital, Robert Wood Johnson School of Medicine/UMDNJ, Education and Research Building, 401 Haddon Ave., Camden, NJ 08103.
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0022-3476/98/$5.00 + 0 9/21/83224