Yuen Hoi Man, Au Chun Ting, Chu Winnie Chiu Wing, Li Albert Martin, Chan Kate Ching-Ching
Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Sleep. 2022 Jan 11;45(1). doi: 10.1093/sleep/zsab217.
Childhood obstructive sleep apnea (OSA) is an important and prevalent disease. A short lingual frenulum is a risk factor for OSA, but whether tongue mobility also plays a role in OSA etiology remains unknown. This study aimed to examine tongue mobility in children with and without OSA. We hypothesized that reduced tongue mobility was associated with OSA. We also evaluated the relationship between tongue mobility and craniofacial profile.
This was a cross-sectional case-control study. Prepubertal Chinese children aged 5-12 years, suspected to have OSA were recruited from our sleep disorder clinic. All subjects underwent overnight polysomnography. The lingual frenulum was evaluated based on tongue mobility and free tongue length. Craniofacial measurements were assessed by lateral cephalometry.
Eighty-two subjects (mean age: 8.32 ± 1.70 years, 57 males) were recruited. The mean tongue mobility was 58.2 (±19)% and 67.4 (±15)% (p = 0.019) in subjects with and without OSA, respectively. Tongue mobility was inversely correlated with OAHI (r = -0.218, p = 0.049). In multivariate logistic regression, low tongue mobility was independently associated with a higher risk of OSA after adjustment for age, sex, body mass index z-score, presence of large tonsils and turbinates, and nocturnal oral breathing (odds ratio = 3.65, 95% CI = 1.22 to 11.8). Tongue mobility was found to correlate with the cranial base angle (Ba-S-N) (r = 0.262, p = 0.018), which determines the relative position of the mandible.
In prepubertal children, reduced tongue mobility is associated with the occurrence and severity of OSA. Assessing tongue mobility is recommended in childhood OSA management.
儿童阻塞性睡眠呼吸暂停（OSA）是一种重要且普遍的疾病。舌系带过短是OSA的一个危险因素，但舌运动能力是否也在OSA病因中起作用尚不清楚。本研究旨在检查有和没有OSA的儿童的舌运动能力。我们假设舌运动能力降低与OSA有关。我们还评估了舌运动能力与颅面形态之间的关系。
这是一项横断面病例对照研究。从我们的睡眠障碍诊所招募了5至12岁疑似患有OSA的青春期前中国儿童。所有受试者均接受了整夜多导睡眠图检查。根据舌运动能力和游离舌长度评估舌系带。通过头颅侧位片评估颅面测量值。
共招募了82名受试者（平均年龄：8.32±1.70岁，57名男性）。有和没有OSA的受试者的平均舌运动能力分别为58.2（±19）%和67.4（±15）%（p = 0.019）。舌运动能力与OSA低通气指数（OAHI）呈负相关（r = -0.218，p = 0.049）。在多因素逻辑回归分析中，在调整了年龄、性别、体重指数z评分、扁桃体和鼻甲肿大的存在以及夜间口呼吸后，低舌运动能力与OSA的较高风险独立相关（优势比= 3.65，95%可信区间= 1.22至11.8）。发现舌运动能力与颅底角（Ba-S-N）相关（r = 0.262，p = 0.018），颅底角决定了下颌骨的相对位置。
在青春期前儿童中，舌运动能力降低与OSA的发生和严重程度有关。建议在儿童OSA管理中评估舌运动能力。
