Adenoid hypertrophy is directly associated with the severity of OSA in obese children: A pilot study
Objective: This study aimed to evaluate which physical findings, observed during both awake and DISE examinations, correlate best with polysomnographic severity in obese children with Obstructive Sleep Apnea (OSA). Methods: Children diagnosed with pediatric OSA and obesity (BMI > 95th percentile)...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-11-01
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| Series: | Brazilian Journal of Otorhinolaryngology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1808869425001387 |
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| author | Victor Hugo da Costa Ferreira Carolina Sponchiado Miura Bruna de Alencar Custodio Lupoli Denny Marcos Garcia Bruno Carvalho Portes Lopes Fernando Gustavo Stelzer Fábio Lourenço Romano Tabata Luna Garavazzo Tavares Alan Luiz Eckeli Fabiana Cardoso Pereira Valera |
| author_facet | Victor Hugo da Costa Ferreira Carolina Sponchiado Miura Bruna de Alencar Custodio Lupoli Denny Marcos Garcia Bruno Carvalho Portes Lopes Fernando Gustavo Stelzer Fábio Lourenço Romano Tabata Luna Garavazzo Tavares Alan Luiz Eckeli Fabiana Cardoso Pereira Valera |
| author_sort | Victor Hugo da Costa Ferreira |
| collection | DOAJ |
| description | Objective: This study aimed to evaluate which physical findings, observed during both awake and DISE examinations, correlate best with polysomnographic severity in obese children with Obstructive Sleep Apnea (OSA). Methods: Children diagnosed with pediatric OSA and obesity (BMI > 95th percentile) were evaluated. All underwent polysomnography to confirm the OSA diagnosis. Demographic data, physical exams, and ENT clinical evaluations were also collected. DISE (drug induced sleep endoscopy) was performed just before adenotonsillectomy, following Boudewyns' protocol to assess pharyngeal collapse. Results: Nineteen obese children with OSA were evaluated, with 37% showing adenoid hypertrophy (>75%) on nasal endoscopy, and 53% presented tonsillar hypertrophy on physical examination. The median AHI (apnea / hypopnea index) was 7 (range: 3; 17): 9 had mild, 2 moderate, and 8 severe OSA. Children with adenoid hypertrophy had higher arousal indices, AHI, REM (rapid eye movement) AHI, OAHI (obstructive AHI) and lower minimum saturation compared to those without obstruction, in both awake and DISE evaluations. The presence of other factors, such as tonsillar hypertrophy, tongue base obstruction, palatal and epiglottic collapses, or hypotonia, was not associated with OSA severity or polysomnographic findings in either awake or DISE exams. Conclusion: In our cohort, adenoid hypertrophy was the factor most strongly correlated with OSA severity in obese children. This correlation was consistent between awake physical examination and DISE findings. Level of evidence: 3. |
| format | Article |
| id | doaj-art-19c4dba57bbd4375886c513de01e4da9 |
| institution | Kabale University |
| issn | 1808-8694 |
| language | English |
| publishDate | 2025-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Otorhinolaryngology |
| spelling | doaj-art-19c4dba57bbd4375886c513de01e4da92025-08-20T03:58:00ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942025-11-0191610169410.1016/j.bjorl.2025.101694Adenoid hypertrophy is directly associated with the severity of OSA in obese children: A pilot studyVictor Hugo da Costa Ferreira0Carolina Sponchiado Miura1Bruna de Alencar Custodio Lupoli2Denny Marcos Garcia3Bruno Carvalho Portes Lopes4Fernando Gustavo Stelzer5Fábio Lourenço Romano6Tabata Luna Garavazzo Tavares7Alan Luiz Eckeli8Fabiana Cardoso Pereira Valera9Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Ribeirão Preto, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Ortopedia e Anestesiologia, Ribeirão Preto, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Neurologia e Ciências Comportamentais, Ribeirão Preto, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Odontologia de Ribeirão Preto (FORP), Departamento de Clínicas Pediátricas, Ortodontia, Ribeirão Preto, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Neurologia e Ciências Comportamentais, Ribeirão Preto, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Neurologia e Ciências Comportamentais, Ribeirão Preto, SP, BrazilUniversidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil; Corresponding author.Objective: This study aimed to evaluate which physical findings, observed during both awake and DISE examinations, correlate best with polysomnographic severity in obese children with Obstructive Sleep Apnea (OSA). Methods: Children diagnosed with pediatric OSA and obesity (BMI > 95th percentile) were evaluated. All underwent polysomnography to confirm the OSA diagnosis. Demographic data, physical exams, and ENT clinical evaluations were also collected. DISE (drug induced sleep endoscopy) was performed just before adenotonsillectomy, following Boudewyns' protocol to assess pharyngeal collapse. Results: Nineteen obese children with OSA were evaluated, with 37% showing adenoid hypertrophy (>75%) on nasal endoscopy, and 53% presented tonsillar hypertrophy on physical examination. The median AHI (apnea / hypopnea index) was 7 (range: 3; 17): 9 had mild, 2 moderate, and 8 severe OSA. Children with adenoid hypertrophy had higher arousal indices, AHI, REM (rapid eye movement) AHI, OAHI (obstructive AHI) and lower minimum saturation compared to those without obstruction, in both awake and DISE evaluations. The presence of other factors, such as tonsillar hypertrophy, tongue base obstruction, palatal and epiglottic collapses, or hypotonia, was not associated with OSA severity or polysomnographic findings in either awake or DISE exams. Conclusion: In our cohort, adenoid hypertrophy was the factor most strongly correlated with OSA severity in obese children. This correlation was consistent between awake physical examination and DISE findings. Level of evidence: 3.http://www.sciencedirect.com/science/article/pii/S1808869425001387Obstructive sleep apneaDrug-induced sleep endoscopyChildrenObesity |
| spellingShingle | Victor Hugo da Costa Ferreira Carolina Sponchiado Miura Bruna de Alencar Custodio Lupoli Denny Marcos Garcia Bruno Carvalho Portes Lopes Fernando Gustavo Stelzer Fábio Lourenço Romano Tabata Luna Garavazzo Tavares Alan Luiz Eckeli Fabiana Cardoso Pereira Valera Adenoid hypertrophy is directly associated with the severity of OSA in obese children: A pilot study Brazilian Journal of Otorhinolaryngology Obstructive sleep apnea Drug-induced sleep endoscopy Children Obesity |
| title | Adenoid hypertrophy is directly associated with the severity of OSA in obese children: A pilot study |
| title_full | Adenoid hypertrophy is directly associated with the severity of OSA in obese children: A pilot study |
| title_fullStr | Adenoid hypertrophy is directly associated with the severity of OSA in obese children: A pilot study |
| title_full_unstemmed | Adenoid hypertrophy is directly associated with the severity of OSA in obese children: A pilot study |
| title_short | Adenoid hypertrophy is directly associated with the severity of OSA in obese children: A pilot study |
| title_sort | adenoid hypertrophy is directly associated with the severity of osa in obese children a pilot study |
| topic | Obstructive sleep apnea Drug-induced sleep endoscopy Children Obesity |
| url | http://www.sciencedirect.com/science/article/pii/S1808869425001387 |
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