Nasal resistances are useful in identifying children with severe obstructive sleep apnea before polysomnography.
OBJECTIVE
In this study, we would like to show that anterior rhinometry measurement of nasal resistance would be a simple and useful test to identify severe obstructive sleep apnea (OSA) in a population of children affected by adenotonsillar hypertrophy.


METHODS
Seventy-three consecutive children (44 males; mean age 5.4+/-1.2 years) with adenotonsillar hypertrophy, who complained sleep-disordered breathing, were studied. All the parents completed a questionnaire concerning the children's sleeping habits and sleep complaints before consultation; each child underwent a general paediatric examination and an evaluation of craniofacial features and upper airway patency. In all 73 children polysomnography was performed and anterior rhinometry nasal patency was measured.


RESULTS
The diagnosis of OSA was confirmed in 44/73 patients (60%). Total nasal resistance showed a significant direct correlation with apnea hypopnea index, arousal index, snoring time, percentage of sleep time spent at SaO(2)<90% and a significant inverse correlation with total sleep time, sleep efficiency and the mean of SaO(2)% during sleep. Total nasal resistance was significantly related to snoring, mouth breathing and daytime sleepiness. The receiver operator characteristics (ROC) curve indicates that in the range of age of our sample a nasal resistance value of 0.59 Pa/cm(3)/s has a sensitivity of 91% and specificity of 96% for identifying the children with adenotonsillar hypertrophy affected by OSA.


CONCLUSIONS
Our study shows that in children with adenotonsillar hypertrophy nasal resistance seems to be risk factor for OSA. The anterior rhinometry appears as a useful tool in routine evaluation of sleep-disordered breathing in these patients.
Servizio Fisiopatologia Respiratoria, Università di Milano, Ospedale Luigi Sacco Azienda Ospedaliera, Polo Universitario, Via G.B. Grassi 74, Italy.
Maurizio
M
Rizzi
Josè
J
Onorato
Arnaldo
A
Andreoli
Stefano
S
Colombo
Marica
M
Pecis
Paola
P
Marchisio
Marco
M
Morelli
Nicola
N
Principi
Susanna
S
Esposito
Margherita
M
Sergi
D000403:Airway Resistance; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009296:Nasal Cavity / Q000503:physiopathology*; D017286:Polysomnography; D011336:Probability; D011446:Prospective Studies; D012372:ROC Curve; D025363:Rhinomanometry / Q000379:methods*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*