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Journal Article
Research Support, Non-U.S. Gov't
Adenotonsillectomy and obstructive sleep apnea in children: a prospective survey.
Otolaryngology - Head and Neck Surgery 2007 Februrary
OBJECTIVE: Prospective survey of children up to 14 years of age with OSA submitted to adenotonsillectomy.
METHODS: Clinical evaluation, with questionnaires and clinical scales evaluating facial structures including tonsils and Mallampati scales and otolaryngologic evaluation; nocturnal polysomnography and repeat evaluation three to five months postsurgery.
RESULTS: Of 207 successively seen children, 199 had follow-up polysomnography, and 94 had still abnormal sleep recording. Multivariate analysis indicates that Mallampati scale score 3 and 4, retro-position of mandible, enlargement of nasal inferior turbinates at +3 (subjective scale 1 to 3), and deviated septum were significantly associated with persistence of abnormal polysomnography (with high 95% CI for Mallampati scale and deviated septum).
CONCLUSION: Mallampati scale scores are resultant of several facial factors involving maxilla, mandible, and oral versus oral breathing but add information on risk of partial response to adenotonsillectomy.
SIGNIFICANCE: Adenotonsillectomy may not resolve obstructive sleep apnea in children.
METHODS: Clinical evaluation, with questionnaires and clinical scales evaluating facial structures including tonsils and Mallampati scales and otolaryngologic evaluation; nocturnal polysomnography and repeat evaluation three to five months postsurgery.
RESULTS: Of 207 successively seen children, 199 had follow-up polysomnography, and 94 had still abnormal sleep recording. Multivariate analysis indicates that Mallampati scale score 3 and 4, retro-position of mandible, enlargement of nasal inferior turbinates at +3 (subjective scale 1 to 3), and deviated septum were significantly associated with persistence of abnormal polysomnography (with high 95% CI for Mallampati scale and deviated septum).
CONCLUSION: Mallampati scale scores are resultant of several facial factors involving maxilla, mandible, and oral versus oral breathing but add information on risk of partial response to adenotonsillectomy.
SIGNIFICANCE: Adenotonsillectomy may not resolve obstructive sleep apnea in children.
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