Deep cervical lymph node hypertrophy: a new paradigm in the understanding of pediatric obstructive sleep apnea.

Deep cervical lymph node hypertrophy: a new paradigm in the understanding of pediatric obstructive sleep apnea.
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DOI:
10.1002/lary.23748
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发表时间:
2013-08
期刊:
影响因子:
2.6
通讯作者:
Arens, Raanan
Arens, Raanan
中科院分区:
医学2区
文献类型:
--
作者:
Parikh, Sanjay R.;Sadoughi, Babak;Sin, Sanghun;Willen, Seth;Nandalike, Kiran;Arens, Raanan

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To determine if adenotonsillar hypertrophy is an isolated factor in pediatric obstructive sleep apnea (OSA) or if it is part of larger spectrum of cervical lymphoid hypertrophy. Prospective case control study. A total of 70 screened patients (mean age 7.47 years) underwent polysomnography to confirm OSA and then underwent MRI of the upper airway. 76 matched controls (mean age 8.00 years) who already had an MRI underwent polysomnography. Volumetric analysis of lymphoid tissue volumes was carried out. Chi-square analysis and Student’s t-test were used to compare demographic data and lymph node volumes between cohorts. Fisher’s Exact test and Chi-square analysis were used to compare sleep data. Patients and controls demonstrated no significant difference in mean age (7.47 vs 8.00 yrs), weight (44.87 vs 38.71 kg), height (124.68 vs 127.65 cm), or body-mass index (23.63 vs 20.87 kg/m2). OSA patients demonstrated poorer sleep measures than controls(p<0.05)in all polysomnography categories (sleep efficiency, apnea index, apnea-hypopnea index, baseline SpO2, SpO2 nadir, baseline ETCO2, peak ETCO2, and arousal awakening index). Children with OSA had higher lymphoid tissue volumes than controls in the retropharyngeal region (3316 vs 2403 mm3, p<0.001) upper jugular region (22202 vs 16819 mm3, p<0.005), and adenotonsillar region (18994 vs 12675 mm3, p<0.0001). Children with OSA have larger volumes of deep cervical lymph nodes and adenotonsillar tissue than controls. This finding suggests a new paradigm in the understanding of pediatric OSA and has ramifications for future research and clinical care.
DOI: 10.1016/s0022-3476(84)80348-0
发表时间: 1984-01-01
影响因子: 5.1
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