title: [Upper airway morphology in Down Syndrome patients under dexmedetomidine sedation].
abstract: OBJECTIVE
  Children with Down Syndrome are vulnerable to significant upper airway obstruction due to relative macroglossia and dynamic airway collapse. The objective of this study was to compare the upper airway dimensions of children with Down Syndrome and obstructive sleep apnea with normal airway under dexmedetomidine sedation.
  
  
  METHODS
  IRB approval was obtained. In this retrospective study, clinically indicated dynamic sagittal midline magnetic resonance images of the upper airway were obtained under low (1mcg/kg/h) and high (3mcg/kg/h) dose dexmedetomidine. Airway anteroposterior diameters and sectional areas were measured as minimum and maximum dimensions by two independent observers at soft palate (nasopharyngeal airway) and at base of the tongue (retroglossal airway).
  
  
  CONCLUSIONS
  Minimum anteroposterior diameter and minimum sectional area at nasopharynx and retroglossal airway were significantly reduced in Down Syndrome compared to normal airway at both low and high dose dexmedetomidine. However, there were no significant differences between low and high dose dexmedetomidine in both Down Syndrome and normal airway. The mean apnea hypopnea index in Down Syndrome was 16±11. Under dexmedetomidine sedation, children with Down Syndrome and obstructive sleep apnea when compared to normal airway children show significant reductions in airway dimensions most pronounced at the narrowest points in the nasopharyngeal and retroglossal airways.
authors.affiliation: Departamento de Anestesiologia, Cincinnati Children's Hospital Medical Center, OH, EUA. Electronic address: Rajeev.Subramanyam@cchmc.org.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Subramanyam
authors.affiliation: Departamento de Radiologia, Cincinnati Children's Hospital Medical Center, OH, EUA.
authors.forename: Robert
authors.initials: R
authors.lastname: Fleck
authors.affiliation: Departamento de Anestesiologia, Cincinnati Children's Hospital Medical Center, OH, EUA.
authors.forename: John
authors.initials: J
authors.lastname: McAuliffe
authors.affiliation: Departamento de Radiologia, Cincinnati Children's Hospital Medical Center, OH, EUA.
authors.forename: Rupa
authors.initials: R
authors.lastname: Radhakrishnan
authors.affiliation: Departamento de Radiologia, Cincinnati Children's Hospital Medical Center, OH, EUA.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Jung
authors.affiliation: Departamento de Anestesiologia, Cincinnati Children's Hospital Medical Center, OH, EUA.
authors.forename: Mario
authors.initials: M
authors.lastname: Patino
authors.affiliation: Departamento de Anestesiologia, Cincinnati Children's Hospital Medical Center, OH, EUA.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Mahmoud
keywords: Airway; Apneia obstrutiva do sono; Dexmedetomidina; Dexmedetomidine; Down syndrome; Imagem; Imaging; Obstructive sleep apnea; Sedation; Sedação; Síndrome de Down; Vias aéreas