Ultrasonographic changes of upper airway structures in children with obstructive sleep apnea after adenotonsillectomy.
Journal
Journal of the Formosan Medical Association = Taiwan yi zhi
ISSN
0929-6646
Date Issued
2025-07-29
Author(s)
Abstract
Background /Purpose: Adenotonsillar hypertrophy is a major cause of pediatric obstructive sleep apnea; however, up to 75 % of post-adenotonsillectomy patients still show polysomnographic alterations. We evaluated ultrasonographic changes in upper airway structures after adenotonsillectomy and their associations with sleep parameters. Method: We assessed 55 children (<18 years) with sleep-disordered breathing (14: primary snoring, 41: obstructive sleep apnea) who underwent polysomnography and upper airway ultrasonography before and 3 months after adenotonsillectomy. Result: Post-adenotonsillectomy, the oropharyngeal level neck thickness significantly increased in all children (49.2 ± 11.3 to 60.0 ± 8.4 mm; p < 0.05). The lateral pharyngeal wall thickness significantly decreased under Müller maneuver (from 26.1 ± 4.4 to 24.1 ± 3.7 mm; p < 0.05); similarly, its change during the maneuver decreased (from 3.0 ± 1.9 to 1.4 ± 1.4 mm; p < 0.05) as well as the change in the parapharyngeal neck thickness (from 8.1 ± 4.7 to 5.8 ± 3.5 mm; p < 0.05). However, the lateral pharyngeal wall change was only significant in children without residual obstructive sleep apnea (from 3.8 ± 2.2 to 1.3 ± 1.6 mm; p < 0.05). No associations emerged between ultrasonographic parameters and post-operative residual obstructive sleep apnea. Conclusion: Ultrasonographic measurements revealed increased neck thickness at the oropharyngeal level related to adenotonsillectomy. However, the lateral pharyngeal wall thickness during the Müller maneuver and collapsibility of the upper airway structures decreased in children with obstructive sleep apnea. Nonetheless, no upper airway structure ultrasonographic parameters could independently predict surgical outcomes in patients with obstructive sleep apnea.
Subjects
Children
Obstructive sleep apnea
Ultrasonography
Upper airway structures
adenotonsillectomy
Type
journal article