Jain Anubhav, Sahni J K
Department of Otolaryngology, and Lady Hardinge Medical College and Associated Smt. Sucheta Kriplani and Kalawati Saran Children's Hospitals, New Delhi, India.
J Laryngol Otol. 2002 Sep;116(9):711-5. doi: 10.1258/002221502760238019.
Forty children (age group four to 12 years) undergoing adenoidectomy and/or tonsillectomy were subjected to pre- and post-operative polysomnography. Thorough clinical evaluation and X-ray soft tissue nasopharynx lateral view was carried out for all the patients. The tonsils were clinically graded from grade I to IV, whereas the adenoids were measured radiographically (using three different measurements) in all children. Thirty out of 40 (75 per cent) children presented with predominant obstructive symptoms, out of whom 22 (73.3 per cent) were found to have obstructive sleep apnoea (OSA), i.e. apnoea index > five per hour. The remaining 10 (25 per cent) had predominantly inflammatory symptoms on presentation and out of these two (20 per cent) were found to have OSA. Relative adenoid size expressed as a ratio between the distance from the point of maximum thickness of adenoids along a line drawn along a straight part of the basiocciput and distance from the posterior nasal spine to the antero-inferior edge of the sphenobasioccipital synchondrosis, was found to have a highly significant correlation with the grade of OSA. In our study, all patients with this ratio greater than 0.64 were found to have OSA. No correlation between tonsil size and grade of OSA was found. There was a highly significant improvement in polysomnographic scores following surgery in all patients.
40名接受腺样体切除术和/或扁桃体切除术的儿童（年龄在4至12岁之间）在术前和术后均接受了多导睡眠图检查。对所有患者进行了全面的临床评估和鼻咽部软组织X线侧位片检查。扁桃体根据临床情况分为I至IV级，而对所有儿童的腺样体进行了影像学测量（采用三种不同的测量方法）。40名儿童中有30名（75%）主要表现为阻塞性症状，其中22名（73.3%）被发现患有阻塞性睡眠呼吸暂停（OSA），即呼吸暂停指数>5次/小时。其余10名（25%）在就诊时主要表现为炎症症状，其中2名（20%）被发现患有OSA。腺样体相对大小表示为沿枕骨基部直线部分绘制的一条线从腺样体最大厚度点的距离与从鼻后棘到蝶枕软骨结合前下缘的距离之比，发现其与OSA分级具有高度显著的相关性。在我们的研究中，发现该比值大于0.64的所有患者均患有OSA。未发现扁桃体大小与OSA分级之间存在相关性。所有患者术后多导睡眠图评分均有高度显著改善。
