Correlation of Radiological and Polysomnographic Indicators of Obstructive Sleep Apnea in Children with Adenoid Hypertrophy

Abstract

Adenoid inflammatory cytokines can facilitate accurate diagnosis and treatment. The adenoidal nasopharyngeal ratio (ANR) is a noninvasive simple tool to evaluate the adenoid size. Our study aimed to assess the correlation between ANR and obstructive sleep apnea (OSA) severity in children with adenoid hypertrophy based on inflammatory markers. This case-control study included 25 children with confirmed adenoid hypertrophy and 25 healthy children as controls (aged 3–13 years). ANR was determined using lateral nasopharynx radiography. Sleep-disordered breathing was evaluated using a sleep habit questionnaire and polysomnography. Clinical and polysomnographic data were correlated to ANR. 68% of children with adenoid hypertrophy had OSA. ANR was significantly higher in children with OSA than those without OSA. ANR has a significant positive correlation to the Apnea/Hypopnea Index and a significant negative correlation with sleep efficiency%, and sleep habit scores. At a cut-off point of ≥0.755, ANR has 76.5% sensitivity and 87.5% specificity to predict OSA in children with adenoid hypertrophy. Snoring (OR 26.667; C.I.95%:2.242 - 317.147) and ANR ≥0.752 (OR 22.75; C.I.95%:2.114 – 244.868) are predictors for OSA in children with adenoid hypertrophy. ANR is well correlated to sleep habit questionnaire scores and polysomnographic indicators of OSA. ANR and inflammatory cytokines can be used for screening of OSA in children with adenoid hypertrophy, helping identify those who need a referral for polysomnography. In children with adenotonsillar hypertrophy, instead of treatment, appropriate treatments for other factors are required as OSA.