내시경적 아데노이드 등급과 소아 폐쇄성 수면무호흡증 중증도의 상관관계

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 proposed, 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 endoscopic 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 evaluated 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 severity. (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 evaluate adenoid hypertrophy and upper airway in pediatric OSA patients. (J Clinical Otolaryngol 2019;30:204-208)