Magnetic resonance imaging in the evaluation of anatomical risk factors for pediatric obstructive sleep apnoea-hypopnoea: a pilot study.
OBJECTIVE
Aim of our study was to identify anatomical risk factors involved in the development of pediatric OSAHS through a MRI-based case-control pilot study.


METHODS
MRI exams of the head and neck of 40 children affected by OSAHS were retrospectively evaluated. 25 indices referring to the air lumen, soft tissues and craniofacial skeleton were measured. Subsequently, the same process of measurement of indices was performed on MRI exams of 40 controls. For each index, then, we calculated in both groups mean, standard deviation, standard error and t value. Comparing the two series we finally calculated the degree of significance of each difference between children with OSAHS and controls through the Student's t-test.


RESULTS
Besides the expected and previously described differences of minimum retropharyngeal cross-sectional area (CSA), nasopharyngeal airway, combined upper airway volume, tonsillar and adenoid cross-sectional and volumetric indices, we found a higher midsagittal CSA of the soft palate and lower position of the hyoid bone, SNB angle and mandibular volume.


CONCLUSIONS
Results from our study population, certainly limited in terms of number of patients and considered age range, showed that not only adeno-tonsillar hypertrophy is important in determining the clinical syndrome: soft palate enlargement and certain skeletal pattern can even assume greater importance in the genesis and in the progression of the obstruction. MRI proved to be an accurate technique in the evaluation of the prevalent risk factor in children affected by OSAHS, leading to the most appropriate surgical approach.
Department of Clinical and Experimental Internistic "F. Magrassi, A. Lanzara", Unit of Radiology, Radiotherapy and Nuclear Medicine, Scientic Section of Radiology - Second University of Naples - I Policlinico di Napoli - 5, Piazza Miraglia - 80131, Naples, Italy.
Salvatore
S
Cappabianca
Francesco
F
Iaselli
Alberto
A
Negro
Angelo
A
Basile
Alfonso
A
Reginelli
Roberto
R
Grassi
Antonio
A
Rotondo
D000293:Adolescent; D000367:Age Factors; D016022:Case-Control Studies; D002508:Cephalometry / Q000379:methods; D002648:Child; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D010160:Palate, Soft / Q000473:pathology*; D010614:Pharynx / Q000473:pathology*; D010865:Pilot Projects; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000628:therapy