Document Detail

Pediatric tonsil size: objective vs subjective measurements correlated to overnight polysomnogram.
MedLine Citation:
PMID:  19393410     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare subjective and objective tonsil size measurements (weight, volume, intertonsillar distance) along with simple pharyngeal measurements in the prediction of pediatric obstructive sleep apnea hypopnea syndrome (OSAHS) severity. STUDY DESIGN: Prospective case series. SUBJECTS AND METHODS: Tonsil size (0-4+) and Mallampati/Friedman palate position were subjectively measured. During adenotonsillectomy, tonsil size was objectively measured along with simple pharyngeal dimensions. Spearman rank correlation coefficients were calculated and forward and reverse stepwise multivariate regression modeling was used to assess the prediction of preoperative OSAHS severity as determined by polysomnogram (PSG). Evaluation of possible outlier influence was also performed. RESULTS: Thirty-four pediatric patients (median age, 4; range, 2-9) were included. Objective tonsil weight (Spearman's rho = 0.6143, P = 0.0002), tonsil volume (rho = 0.4960, P = 0.0039), and intertonsillar distance (rho = -0.7559, P < 0.0001) were strongly correlated with subjective tonsil size but not with age, body mass index (BMI), or preoperative apnea-hypopnea index (AHI). Regression modeling demonstrated that only measured tonsil weight (beta = 1.43, P = 0.003), age (beta = -3.21, P = 0.001), and hard palate length (beta = 0.979, P = 0.003) were significant predictors of the preoperative AHI (R(2) = 0.5358). Evaluation of possible outliers indicated tonsil weight was the most robust predictor of preoperative AHI. CONCLUSION: Subjective tonsil size measurements correlate well with objective tonsil volume measurements. However, only objective tonsil measurements were significantly predictive of objective PSG-measured OSAHS severity.
N Scott Howard; Scott E Brietzke
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  140     ISSN:  0194-5998     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-27     Completed Date:  2009-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  675-81     Citation Subset:  IM    
Department of Otolaryngology, Walter Reed Army Medical Center, Washington, DC, USA.
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MeSH Terms
Child, Preschool
Jaw / anatomy & histology
Linear Models
Palatine Tonsil / anatomy & histology*
Predictive Value of Tests
Prospective Studies
Severity of Illness Index
Sleep Apnea Syndromes / etiology*,  physiopathology*

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