Shen Ling, Lin Zongtong, Xu Yangyang, Yang Zhongjie
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Mar;28(6):381-5.
To investigate the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and adenoid size as well as tonsil size in Children.
A total of 545 patients, 338 OSAHS patients (treated group) diagnosed by PSG and 207 patients with vocal cord nodules but symptoms of upper airway obstruction (control group), were enrolled from inpatient and outpatient between June, 2008 and October, 2010. The oropharynx and electron-nasopharyngolaryngoscopy examination records of the two groups were retrospectively analyzed. The patients in the treated group were also divided into mild group, moderate group and severe group according to obstructive apnea index (OAI) or AHI. SPSS 17.0 was used for statistical analysis.
In the treated group, 89.7% had grade III-V adenoid and 68.4% had grade III-IV tonsil, compared with 30.9% (adenoid) and 13.5% (tonsil) in the control group. The significant differences were found (all P < 0.01). The comparison between patients with different grades of adenoidal size and tonsil size in the treated group had indicated that patients with grade IV adenoid or grade IV tonsil have a higher risk of OSAHS than patients with grade III adenoid or grade III tonsil. In the treated group, the ratio of patients with different severity of adenoid or tonsil had increased with the severity of OSAHS (P < 0.01). This retrospective study had also found that most of the grading results from Electron-nasopharyngolaryngoscopy examination were consistent with that from oropharynx examination. 13 (37.1%) of 35 patients with grade I or II tonsil diagnosed by Oropharynx examination were considered as grade III by Electron-nasopharyngolaryngoscopy examination.
Adenoidal hypertrophy and tonsil hypertrophy are the risk factors for OSAHS in children. The risk of OSAHS and the severity of OSAHS are positively associated with the severity of adenoid and tonsil. The electron-nasopharyngolaryngoscopy examination is an important examination method for diagnosing OSAHS in children, as well as determination of tonsil size.
探讨儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与腺样体大小及扁桃体大小之间的关系。
选取2008年6月至2010年10月期间住院及门诊患者共545例，其中经多导睡眠监测（PSG）确诊的OSAHS患者338例（治疗组），声带小结但有上气道梗阻症状的患者207例（对照组）。对两组患者的口咽及电子鼻咽喉镜检查记录进行回顾性分析。治疗组患者还根据阻塞性呼吸暂停指数（OAI）或呼吸暂停低通气指数（AHI）分为轻度组、中度组和重度组。采用SPSS 17.0进行统计学分析。
治疗组中，89.7%的患者腺样体为Ⅲ - Ⅴ度，68.4%的患者扁桃体为Ⅲ - Ⅳ度，而对照组中腺样体为Ⅲ - Ⅴ度的患者占30.9%，扁桃体为Ⅲ - Ⅳ度的患者占13.5%。差异有统计学意义（均P < 0.01）。治疗组中不同腺样体大小及扁桃体大小分级患者之间的比较表明，腺样体Ⅳ度或扁桃体Ⅳ度的患者患OSAHS的风险高于腺样体Ⅲ度或扁桃体Ⅲ度的患者。在治疗组中，腺样体或扁桃体不同严重程度的患者比例随OSAHS严重程度的增加而升高（P < 0.01）。该回顾性研究还发现，电子鼻咽喉镜检查的大部分分级结果与口咽检查结果一致。口咽检查诊断为Ⅰ或Ⅱ度扁桃体的35例患者中，13例（37.1%）经电子鼻咽喉镜检查被认为是Ⅲ度。
腺样体肥大和扁桃体肥大是儿童OSAHS的危险因素。OSAHS的风险及严重程度与腺样体和扁桃体的严重程度呈正相关。电子鼻咽喉镜检查是诊断儿童OSAHS以及确定扁桃体大小的重要检查方法。
