Primary care physicians have become increasingly reluctant to refer children for tonsillectomy and adenoidectomy (T and A) during the past years while antimicrobial therapy for pharyngotonsillitis and otitis media has become more common. Consequently, more children retain tonsils and adenoids throughout the childhood years. Airway compromise from adenotonsillar hypertrophy is reported in 11 cases-8 with insidious onset, 3 with acute onset. Typical symptoms occurring during sleep include snoring, snorting, enuresis and obstructive apnea. Daytime symptoms included hyponasal speech, oral respiration and morning cephalgia. Methods of assessing children with adenotonsillar hypertrophy and airway compromise included polysomnography and acoustic analysis of respiratory sounds. It appears that airway compromise from adenotonsillar hypertrophy is more common now that fewer children are undergoing T and A, is being more commonly recognized because of improved methods of assessment, or both.
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Article Synopsis
- Adenotonsillar hypertrophy is a leading cause of obstructive sleep apnea in children, and there is limited understanding of how clinical symptoms relate to the severity of the condition when adenoid size is not measurable.
- The study aimed to evaluate the relationship between patient characteristics, adenoid size, and clinical symptoms with obstructive sleep apnea severity in children scheduled for adenoidectomy.
- An analysis of 81 pediatric patients showed significant correlations between clinical symptom scores, adenoid-choanal ratios, and apnea-hypopnea index scores, indicating that larger adenoid size and worse symptoms are linked to more severe obstructive sleep apnea across different age groups.
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