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내시경적 아데노이드 등급과 소아 폐쇄성 수면무호흡증 중증도의 상관관계

Correlation between Endoscopic Adenoid Grading and Obstructive Sleep Apnea Severity in Pediatric Patients

임상이비인후과 2019년 30권 2호 p.204 ~ 208
조용태 ( Cho Yong-Tae ) - 을지대학교 의과대학 을지병원 이비인후과학교실

김지선 ( Kim Ji-Sun ) - 을지대학교 의과대학 을지병원 이비인후과학교실
김호찬 ( Kim Ho-Chan ) - 을지대학교 의과대학 을지병원 이비인후과학교실

Abstract


Background and Objectives:Hypertrophy of adenoids was recognized as one of the main causes of snoring and obstructive sleep apnea (OSA) in pediatric patients. Recently, two endoscopic adenoid grading system was pro- posed, Parikh grade (P-G) and ACE grade (ACE-G). The aim of this study is to evaluate the correlation between obstructive sleep apnea severity and these two endoscopic adenoid grading systems.

Materials and Methods: We retrospectively reviewed the medical records of 52 patients who underwent a polysomnography and endo- scopic nasal endoscopy in the secondary referral hospital from 2008 to 2017. Adenoid exam was performed with nasal endoscopy after nasal packing soaked with lidocaine and xylometazoline in out-patient clinic. It was evalu- ated the correlation between each adenoid grading system and apnea-hypopnea index, adjusted by sex, age, tonsil grade, body mass index, and presence of allergic rhinitis.

Results:Mean age was 7.6 year (range : 2-15, SD : 2.57) and 75% of the patient had obstructive sleep apnea (AHI≥1). P-G was statistically correlated with OSA se- verity. (OR=11.8, 95% CI : 1.5-92.2, p=0.02) Only subgrade E of ACE-G has meaningful correlation with OSA severity (OR=2.07, 95% CI : 0.91-4.81 p=0.03).

Conclusion:P-G and subgrade E of ACE-G were statistically related to sleep apnea severity in pediatric patients. Endoscopic adenoid grading system can be useful tool to eval- uate adenoid hypertrophy and upper airway in pediatric OSA patients.

키워드

폐쇄성 수면무호흡; 아데노이드; 내시경적 검사
Obstructive sleep apnea; Adenoid; Endoscopic examination
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