title: Relationship between adenoid size and severity of obstructive sleep apnea in preschool children.
abstract: OBJECTIVE
  To investigate the contributions of adenoid and tonsil sizes to obstructive sleep apnea syndrome (OSAS) in normal-weight children in two age categories: preschool and schoolchildren.
  
  
  METHODS
  Fifty-eight normal-weight (body mass index z-score<2) symptomatic children with OSAS (apnea-hypopnea index ≥ 2) were evaluated. The patients were divided into two age categories: preschool (age<6; n=33) and schoolchildren (age ≥ 6; n=25). Polysomnographic findings and adenoid and tonsil sizes were compared. The relative contributions of body mass index and adenoid and tonsil sizes were also investigated with a regression analysis.
  
  
  RESULTS
  Adenoid grade and apnea index correlated significantly in preschool children (r=0.45, p<0.01). On regression analysis, adenoid grade was a significant predictor of the apnea index in preschool children. The influence of adenoid hypertrophy decreased from preschool to schoolchildren. Tonsil size had little influence on the apnea index in either group.
  
  
  CONCLUSIONS
  Adenoid hypertrophy was a major contributor to OSAS in normal-weight preschool children. The upper airway morphology of younger children with OSAS differed from that of older children with OSAS.
authors.affiliation: Department of Otorhinolaryngology, Graduate School of Medicine, Nagoya University, Nagoya, Japan. mi-man@ra2.so-net.ne.jp
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Tagaya
authors.forename: Seiichi
authors.initials: S
authors.lastname: Nakata
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Yasuma
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Sasaki
authors.forename: Mami
authors.initials: M
authors.lastname: Morinaga
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.forename: Hironao
authors.initials: H
authors.lastname: Otake
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakashima
mesh_terms: D000234:Adenoids / Q000473:pathology*; D017677:Age Distribution; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000150:complications; D015994:Incidence; D008297:Male; D009929:Organ Size; D017286:Polysomnography / Q000379:methods; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D018709:Statistics, Nonparametric