title: Upper airway findings in children with Down syndrome on sleep nasopharyngoscopy: case-control study.
abstract: OBJECTIVE
  To identify the pattern of upper airway endoscopic findings in Down syndrome (DS) children with sleep-disordered breathing (SDB) spectrum.
  
  
  METHODS
  Retrospective case-control study in a tertiary pediatric centre.
  
  
  METHODS
  DS children presenting with persistent snoring or SDB who underwent sleep nasopharyngoscopy (SNP) were identified from a prospectively kept surgical database. All SNPs were performed using a uniform intravenous sedation technique. Controls with persistent snoring or SDB from the same database were identified and pair-matched for age, gender, and body mass index (BMI) percentiles. The video recordings of the SNP for all subjects were reviewed. A comparison of the proportions of obstruction (O), mixed (M), and collapse (C) findings in each group was performed.
  
  
  RESULTS
  Over a period of 4.5 years, 23 consecutive DS children were identified (7 girls, 16 boys; mean age 7.09 ± 4.37 years). They were matched with 23 controls (mean age 7.6 ± 4.14 years). The DS group exhibited significantly more pharyngeal collapses than the controls (O:C:M, 2:6:15 and 12:0:10, respectively; p < .005). Lingual collapses were also noted more in DS children (11 vs 4), and a more significant number of collapses were seen (p < .004). Whereas nearly equal numbers exhibited tonsillar obstruction, adenoidal obstruction was significantly less in DS children (p < .05).
  
  
  CONCLUSIONS
  Generalized pharyngeal collapse dominates in DS children who present with SDB and is independent of age, gender, and BMI. Adenoidal hypertrophy causing obstruction is much less encountered than in controls.
authors.affiliation: Division of Otolaryngology, Dalhousie University, Halifax, NS.
authors.forename: Elaine
authors.initials: E
authors.lastname: Fung
authors.forename: Manisha
authors.initials: M
authors.lastname: Witmans
authors.forename: Monty
authors.initials: M
authors.lastname: Ghosh
authors.forename: Dominic
authors.initials: D
authors.lastname: Cave
authors.forename: Hamdy
authors.initials: H
authors.lastname: El-Hakim
mesh_terms: D000293:Adolescent; D002648:Child; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D010614:Pharynx / Q000473:pathology* / Q000503:physiopathology; D017286:Polysomnography; D012189:Retrospective Studies; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D012913:Snoring / Q000150:complications / Q000175:diagnosis*; D014059:Tongue / Q000473:pathology