Su Yonglong, Wang Zitong, Chang Huanhuan, Zhu Simin, Zhou Yanuo, Cao Zine, Ma Lina, Yuan Yuqi, Xie Yushan, Niu Xiaoxin, Lu Chendi, Zhang Yitong, Liu Haiqin, Shao Na, Yin Libo, Si Chao, Ren Xiaoyong, Shi Yewen
Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China.
Department of Otorhinolaryngology Head and Neck Surgery, Xi'an Children's Hospital, Xi'an, People's Republic of China.
Nat Sci Sleep. 2024 Dec 21;16:2151-2170. doi: 10.2147/NSS.S492714. eCollection 2024.
Aimed to analyze the developmental characteristics of craniofacial structures and soft tissues in children with obstructive sleep apnea (OSA) and to establish and evaluate prediction model.
It's a retrospective study comprising 747 children aged 2-12 years (337 patients and 410 controls) visited the Department of Otolaryngology-Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University (July 2017 to March 2024). Lateral head radiographs were obtained to compare the cephalometric measurements. The clinical prediction model was constructed using LASSO regression analysis. We analyzed 300 children from the Xi'an Children's Hospital for external validation.
Children with OSA had a higher body mass, a higher tonsil grade, larger AN ratio (ratio of the adenoids to the skeletal upper airway width), larger radius of the tonsils, a smaller angle between the skull base and maxilla (SNA) and smaller angle between the skull base and mandible (SNB), a larger distance from the hyoid to the mandibular plane (H-MP) and smaller distance between the third cervical vertebra and hyoid (H-C), a larger thickness of the soft palate (SPT) and smaller inclination angle of the soft palate than those of the controls (all < 0.05). A prediction model was constructed for 2-12 years group (AUC of 0.812 [95% CI: 0.781-0.842]). Age-specific prediction models were developed for preschool children (AUC of 0.769 [95% CI: 0.725-0.814]), for school-aged children (AUC of 0.854 [95% CI: 0.812-0.895]).
Our study findings support the important role of craniofacial structures such as the hyoid, maxilla, mandible, and soft palate in pediatric OSA. Age-stratified predictive models for pediatric OSA indicated varying parameters across different age groups which underscore the necessity for stratifying by age in future research. The prediction model designed will greatly assist health care practitioners with rapidly identifying.
旨在分析阻塞性睡眠呼吸暂停（OSA）患儿颅面结构和软组织的发育特征，并建立和评估预测模型。
这是一项回顾性研究，纳入了2017年7月至2024年3月期间就诊于西安交通大学第二附属医院耳鼻咽喉头颈外科的747名2至12岁儿童（337例患者和410例对照）。获取头颅侧位X线片以比较头影测量值。使用LASSO回归分析构建临床预测模型。我们分析了来自西安市儿童医院的300名儿童进行外部验证。
与对照组相比，OSA患儿体重更高、扁桃体分级更高、腺样体与骨骼上气道宽度之比（AN比）更大、扁桃体半径更大、颅底与上颌骨之间的角度（SNA）更小、颅底与下颌骨之间的角度（SNB）更小、舌骨至下颌平面的距离（H-MP）更大、第三颈椎与舌骨之间的距离（H-C）更小、软腭厚度（SPT）更大且软腭倾斜角度更小（均P<0.05）。为2至12岁组构建了预测模型（AUC为0.812 [95%CI：0.781-0.842]）。为学龄前儿童开发了年龄特异性预测模型（AUC为0.769 [95%CI：0.725-0.814]），为学龄儿童开发了年龄特异性预测模型（AUC为0.854 [95%CI：0.812-0.895]）。
我们的研究结果支持舌骨、上颌骨、下颌骨和软腭等颅面结构在小儿OSA中的重要作用。小儿OSA的年龄分层预测模型表明不同年龄组的参数不同，这突出了在未来研究中按年龄分层的必要性。所设计的预测模型将极大地帮助医护人员快速识别。
