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Scientific Oral Presentations

Pediatric Otolaryngology

Session: Scientific Oral Presentations 7 - Pediatric Otolaryngology

Minimal-to-Mean Airway Area Ratio of the Pharynx: Novel Predictor of Pediatric Obstructive Sleep Apnea in 3D-Imaging

Tuesday, October 1, 2024
9:36 AM – 9:42 AM EDT
Location: MBCC, 244-245
Disclosure(s):
Wei-Chung Hsu, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Currently, there is a lack of reliable variables in 3-dimensional imaging to detect pediatric obstructive sleep apnea (OSA). This study aims to develop a novel predictor of OSA in children.

Methods: This prospective study recruited children with symptoms suggestive of OSA. All children received overnight polysomnography to stratified disease severity as: primary snoring (apnea-hypopnea index, AHI < 1), mild OSA (AHI 1-5), and moderate-to-severe OSA (AHI > 5). Three-dimensional imaging was obtained through cone-beam computed tomography. We measured the minimal to mean airway area (AA) ratio in all pharynx and each part of pharynx (i.e. nasopharynx, oropharynx, hypopharynx). Correlation between minimal to mean AA ratio of the pharynx and pediatric OSA was explored.

Results: Among 104 included children, 29 children were primary snoring, 25 were mild OSA, and 50 children were moderate-to-severe OSA. The minimal to mean AA of oropharynx was 0.51, 0.43, and 0.32 in primary snoring, mild OSA, and moderate-to-severe OSA groups (P < 0.001). As for the all pharynx, the minimal to mean AA ratio was 0.41, 0.36, and 0.28 in primary snoring, mild OSA, and moderate-to-severe OSA groups (P = 0.001). Pearson’s correlation showed the minimal to mean AA ratio was inversely correlated with OSA severity in oropharynx (r = -0.43, P < 0.001) and all pharynx (r = -0.37, P < 0.001). The receiver operating characteristic curve analysis revealed the optimal cut-off point for the minimal to mean AA ratio to predict OSA (i.e. AHI>1) was 0.34 (area under curve [AUC] = 71%, 55% sensitivity and 79% specificity) in oropharynx and 0.39 (AUC = 67%, 75% sensitivity and 55% specificity) in all pharynx. The AA ratio in nasopharynx or hypopharynx was not significantly correlated with OSA.

Conclusions: Minimal to mean AA ratio of the pharynx can be used as a novel tool to detect pediatric OSA in 3-dimensional airway imaging.

    Presenting Author(s)

  • Wei-Chung Hsu, MD, PhD

    Pr.
    Department of Otolaryngology, National Taiwan University Hospital and Children's Hospital, Taipei, Taiwan
    Taipei, Taipei, Taiwan (Republic of China)

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Wei-Chung Hsu, MD, PhD

    Pr.
    Department of Otolaryngology, National Taiwan University Hospital and Children's Hospital, Taipei, Taiwan
    Taipei, Taipei, Taiwan (Republic of China)

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • KK

    Kun-Tai Kang, MD, MPH

    Dr.
    Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
    New Taipei City, TWN

    Disclosure information not submitted.