Comparative evaluation of the upper pharyngeal airway among children with/without UCLP and with/without OSA.

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY Sleep and Breathing Pub Date : 2024-11-30 DOI:10.1007/s11325-024-03195-x

Prang Wiwattanadittakul, Nuntigar Sonsuwan, Sangsom Prapayasatok, Marasri Chaiworawitkul

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Abstract

Background: To evaluate the volume and the most constricted cross-sectional area (lumen) sizes of the upper pharyngeal airway among children with/without unilateral cleft lip and palate (UCLP) and with/without obstructive sleep apnea (OSA).

Methods: This prospective study was conducted on 66 Thai children aged 5 to 12 years, encompassing demographic information, polysomnographic data, and sex distribution: 34 with non-syndromic UCLP (16 with OSA; 18 without OSA) and 32 non-cleft children (16 with OSA; 16 without OSA). Subjects were divided into two age groups: preadolescent group (ages 10-12) and younger group (ages 5-9). Cone-beam computed tomography images were acquired with subjects in a supine position. Subsequent measurements were conducted using the Dolphin imaging program (version 11.7 premium) to investigate and compare the volumes and lumens of the nasopharyngeal, oropharyngeal, and hypopharyngeal airways.

Results: In the younger group, the UCLP with OSA group exhibited significantly smaller volumes and lumens in the oropharyngeal airway compared to the non-cleft group without OSA (volume: p = 0.044; lumen: p = 0.031, 95% CI). All upper pharyngeal airway parts had comparable volumes and lumens between age groups. However, preadolescence reported no significant differences.

Conclusions: Statistically significant differences were observed only in the oropharyngeal airway measurements in the younger sample compared to the adolescent sample. This underscores the importance of considering oropharyngeal airway structure in diagnosing and preventing OSA in children. However, it is essential to note that while airway size is a fundamental factor, it may not be the sole determinant of OSA occurrence. Other factors likely contribute to the condition as well.

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有/不存在UCLP和有/不存在OSA的儿童上咽气道的比较评价

背景：评估患有/不患有单侧唇腭裂（UCLP）和患有/不患有阻塞性睡眠呼吸暂停（OSA）的儿童的上咽气道体积和最大收缩截面积（管腔）大小。方法：这项前瞻性研究对66名年龄在5至12岁的泰国儿童进行了研究，包括人口统计信息、多导睡眠图数据和性别分布：34名患有非综合征性UCLP(16名患有OSA；无OSA 18例，非唇裂32例(有OSA 16例；16例无OSA)。受试者被分为两个年龄组：青春期前组（10-12岁）和青少年组（5-9岁）。获得受试者仰卧位的锥束计算机断层图像。随后使用Dolphin成像程序（版本11.7 premium）进行测量，以调查和比较鼻咽、口咽和下咽气道的体积和管腔。结果：在年轻组中，合并OSA的UCLP组的口咽气道体积和管腔明显小于未合并OSA的非腭裂组(体积：p = 0.044；流明：p = 0.031, 95% CI)。所有上咽气道部分在年龄组间的容积和管腔均相当。然而，青春期前没有显著差异。结论：与青少年样本相比，仅在年轻样本的口咽气道测量中观察到统计学上的显著差异。这强调了考虑口咽气道结构在诊断和预防儿童阻塞性睡眠呼吸暂停中的重要性。然而，必须注意的是，虽然气道大小是一个基本因素，但它可能不是OSA发生的唯一决定因素。其他因素也可能导致这种情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.