AI Article Synopsis
- The study aimed to evaluate the impact of adenotonsillectomy (AT) and rapid maxillary expansion (RME) on the apnea-hypopnea index (AHI) in children, as well as the volumetric changes in their upper airway after each treatment.
- Thirty-nine children with maxillary constriction and enlarged tonsils were divided into two groups to receive either AT or RME, with assessments of AHI and airway volume conducted before and after the treatment.
- Results indicated that AT significantly improved AHI more than RME, largely due to greater increases in upper airway volume, highlighting AT's effectiveness in treating pediatric obstructive sleep apnea.
Article Abstract
Study Objectives: We aimed to determine the effects of adenotonsillectomy (AT) and rapid maxillary expansion (RME) on the apnea-hypopnea index (AHI) and compare volumetric changes in the upper airway (UA) arising from AT and RME.
Methods: Thirty-nine children who presented with maxillary constriction and grade III/IV tonsillar hypertrophy were randomized into two groups. One group underwent AT as the first treatment, and the other group underwent RME. Polysomnography (PSG) and cone-beam computed tomography (CBCT) were conducted before (T0) and 6 months after the first treatment (T1). In a crossover design, individuals with AHI>1 received the second treatment. Six months later, they underwent PSG and CBCT (T2). The influence of age, sex, tonsil and adenoid hypertrophy, initial AHI severity, initial volume of the UA, first treatment, and maxillary expansion amount was evaluated using linear regression analysis. Intra- and inter-group comparisons for AHI and inter-group comparisons of volumetric changes in each region of the UA were performed using a paired t-test and Wilcoxon test.
Results: The initial AHI severity and therapeutic sequence in which AT was the first treatment explained for 95.6% of AHI improvement. AT caused significant improvements in the AHI and volumetric increases in the buccopharynx and total UA areas compared to RME.
Conclusions: The initial AHI severity and AT as the first treatment accounted for most of the AHI improvement. Most reductions in AHI were due to AT, which promoted more volumetric increases in UA areas than RME. RME may have a marginal effect on pediatric obstructive sleep apnea.
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| http://dx.doi.org/10.1093/sleep/zsab304 | DOI Listing |
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