OBJECTIVES/HYPOTHESIS: To determine if adenotonsillar hypertrophy is an isolated factor in pediatric obstructive sleep apnea (OSA), or if it is part of larger spectrum of cervical lymphoid hypertrophy. STUDY DESIGN: Prospective case control study. METHODS: A total of 70 screened patients (mean age 7.47 years) underwent polysomnography to confirm OSA, and then underwent MRI of the upper airway. Seventy-six matched controls (mean age 8.00 years) who already had an MRI underwent polysomnography. Volumetric analysis of lymphoid tissue volumes was carried out. Chi-square analysis and Student's t test were used to compare demographic data and lymph node volumes between cohorts. Fisher's Exact test and Chi-square analysis were used to compare sleep data. RESULTS: Patients and controls demonstrated no significant difference in mean age (7.47 vs. 8.00 yrs), weight (44.87 vs. 38.71 kg), height (124.68 vs. 127.65 cm), or body-mass index (23.63 vs. 20.87 kg/m(2)). OSA patients demonstrated poorer sleep measures than controls (P < 0.05) in all polysomnography categories (sleep efficiency, apnea index, apnea-hypopnea index, baseline SpO2, SpO2 nadir, baseline ETCO2, peak ETCO2 , and arousal awakening index). Children with OSA had higher lymphoid tissue volumes than controls in the retropharyngeal region (3316 vs. 2403 mm(3), P < 0.001), upper jugular region (22202 vs. 16819 mm(3), P < 0.005), and adenotonsillar region (18994 vs. 12675 mm(3), P < 0.0001). CONCLUSIONS: Children with OSA have larger volumes of deep cervical lymph nodes and adenotonsillar tissue than controls. This finding suggests a new paradigm in the understanding of pediatric OSA, and has ramifications for future research and clinical care.
OBJECTIVES/HYPOTHESIS: To determine if adenotonsillar hypertrophy is an isolated factor in pediatric obstructive sleep apnea (OSA), or if it is part of larger spectrum of cervical lymphoid hypertrophy. STUDY DESIGN: Prospective case control study. METHODS: A total of 70 screened patients (mean age 7.47 years) underwent polysomnography to confirm OSA, and then underwent MRI of the upper airway. Seventy-six matched controls (mean age 8.00 years) who already had an MRI underwent polysomnography. Volumetric analysis of lymphoid tissue volumes was carried out. Chi-square analysis and Student's t test were used to compare demographic data and lymph node volumes between cohorts. Fisher's Exact test and Chi-square analysis were used to compare sleep data. RESULTS:Patients and controls demonstrated no significant difference in mean age (7.47 vs. 8.00 yrs), weight (44.87 vs. 38.71 kg), height (124.68 vs. 127.65 cm), or body-mass index (23.63 vs. 20.87 kg/m(2)). OSA patients demonstrated poorer sleep measures than controls (P < 0.05) in all polysomnography categories (sleep efficiency, apnea index, apnea-hypopnea index, baseline SpO2, SpO2 nadir, baseline ETCO2, peak ETCO2 , and arousal awakening index). Children with OSA had higher lymphoid tissue volumes than controls in the retropharyngeal region (3316 vs. 2403 mm(3), P < 0.001), upper jugular region (22202 vs. 16819 mm(3), P < 0.005), and adenotonsillar region (18994 vs. 12675 mm(3), P < 0.0001). CONCLUSIONS:Children with OSA have larger volumes of deep cervical lymph nodes and adenotonsillar tissue than controls. This finding suggests a new paradigm in the understanding of pediatric OSA, and has ramifications for future research and clinical care.
Authors: Jacob M van Laar; Marc Melchers; Y K Onno Teng; Boris van der Zouwen; Rozbeh Mohammadi; Randy Fischer; Leonid Margolis; Wendy Fitzgerald; Jean-Charles Grivel; Ferdinand C Breedveld; Peter E Lipsky; Amrie C Grammer Journal: Am J Pathol Date: 2007-08-09 Impact factor: 4.307
Authors: J L Paradise; C D Bluestone; R Z Bachman; D K Colborn; B S Bernard; F H Taylor; K D Rogers; R H Schwarzbach; S E Stool; G A Friday Journal: N Engl J Med Date: 1984-03-15 Impact factor: 91.245
Authors: Merrill S Wise; Cynthia D Nichols; Madeleine M Grigg-Damberger; Carole L Marcus; Manisha B Witmans; Valerie G Kirk; Lynn A D'Andrea; Timothy F Hoban Journal: Sleep Date: 2011-03-01 Impact factor: 5.849
Authors: Gloria Reeves; Carol Blaisdell; Manana Lapidus; Patricia Langenberg; Maya Ramagopal; Johanna Cabassa; Mary Beth Bollinger; Gagan Virk Nijjar; Bruno Anthony; Thomas Achenbach; Teodor T Postolache Journal: Int J Adolesc Med Health Date: 2010 Oct-Dec
Authors: Lane F Donnelly; Victoria Surdulescu; Barbara A Chini; Keith A Casper; Stacy A Poe; Raouf S Amin Journal: Radiology Date: 2003-02-28 Impact factor: 11.105
Authors: Richard J Schwab; Michael Pasirstein; Robert Pierson; Adonna Mackley; Robert Hachadoorian; Raanan Arens; Greg Maislin; Allan I Pack Journal: Am J Respir Crit Care Med Date: 2003-05-13 Impact factor: 21.405
Authors: Ehab Dayyat; Leila Kheirandish-Gozal; Oscar Sans Capdevila; Muna M A Maarafeya; David Gozal Journal: Chest Date: 2009-02-18 Impact factor: 9.410
Authors: Edward O Bixler; Alexandros N Vgontzas; Hung-Mo Lin; Duanping Liao; Susan Calhoun; Antonio Vela-Bueno; Fred Fedok; Vukmir Vlasic; Gavin Graff Journal: Sleep Date: 2009-06 Impact factor: 5.849