The purpose of this study is to develop adequate and satisfactory tools using reliable clinical and physical factors in predicting pediatric obstructive sleep apnea/hypopnea syndrome (OSAHS) and allow greater access to appropriate therapy in children.
The prevalence of OSAHS is estimated to be about 1% to 4% in children, however, it is frequently underdiagnosed because of the difficulties for evaluation.Current diagnostic approaches are based on the patient's history, clinical presentation and physical examination, endoscopy, and radiological imaging examinations, and confirmation is made by the current gold standard of full-night polysomnography (PSG). Previous studies have reported the use of a clinical history, physical examination and questionnaires for predicting pediatric OSAHS but there were lacking of adequate and satisfactory results. Despite the potential diagnostic benefits, PSG for pediatric patients are not routinely used in clinical practice. Therefore, to obtain a reliable, valid, and easily-performed diagnostic or screening tool for the clinical assessment of pediatric OSAHS is essential for the cost-effective care of these patients.
Study Type
OBSERVATIONAL
Enrollment
88
Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital
Kaohsiung City, Taiwan, Taiwan
RECRUITINGClinical predictors for apnea/hypopnea index (AHI)
When all variables were analyzed individually with the AHI, Spearman rank correlation analysis was used to explore the relationships between clinical predictor variables and AHI.Significant variables were entered into stepwise multiple linear regression analysis to identify independent predictors for pediatric OSAHS and to develop a predictive equation for AHI values.
Time frame: up to 4 months
Anthropometric measurements: body mass index z-score (BMI z-score)
BMI z-score: a measure of relative weight adjusted for the child's age and gender, and calculated by dividing the difference between the measured value and the mean by the standard deviation.
Time frame: up to 4 months
Anthropometric measurements: tonsil size grading
Tonsil size grading: 0, surgically removed tonsils; 1, tonsils hidden within the pillars; 2, tonsils extending to the pillars; 3, tonsils were beyond the pillars but not to the midline; and 4, tonsils extended to the midline.
Time frame: up to 4 months
Anthropometric measurements: modified Mallampati grade (aka updated Friedman's tongue position
updated Friedman's tongue position: I: visualization of the entire uvula and tonsils/pillars.; IIa: visualization of most of the uvula, but the tonsils/pillars are absent.; IIb: visualization of the entire soft plate to the base of the uvula.; III: visualization of some of the soft palate, but the distal structures are absent.; IV: visualization of the hard palate only.
Time frame: up to 4 months
Anthropometric measurements: uvular length
uvular length in centimeter
Time frame: up to 4 months
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Snoring visual analogue scale (Snoring VAS)
Snoring VAS (Units on a Scale): 0-10, 0 = "no snoring noise" and 10 = "the loudest sound imaginable
Time frame: up to 4 months
Apnea/hypopnea index (AHI)
AHI: total number of apneas and hypopneas per hour of electroencephalographic sleep.
Time frame: up to 4 months