title: Predicting the effect of treatment in paediatric OSA by clinical examination and functional respiratory imaging.
abstract: The aim of this study was to investigate whether functional respiratory imaging (FRI) or clinical examination could predict treatment outcome for obstructive sleep apnea (OSA) in normal-weight, non-syndromic children.
  
  
  
  Normal weight children diagnosed with OSA by polysomnography were prospectively included. All children got a thorough evaluation and an ultra-low dose computed tomography scan of the upper airway (UA). A 3-D reconstruction was built combined with computational fluid dynamics for FRI. Decisions on the need and type of surgery were based upon findings during drug-induced sleep endoscopy. A second polysomnography was performed 3-12 months after surgery.
  
  
  
  Ninety-one children were included: 62 boys, 5.0 ± 2.7 years, and BMI z-score of -0.1 ± 1.2. Children with more severe OSA had a smaller volume of the overlap region between the adenoids and tonsils. Nineteen out of 60 patients had persistent OSA (oAHI >2/h). A lower conductance in the UA and a higher tonsil score predicted successful treatment.
  
  
  
  A less constricted airway, as characterized by both FRI and a lower tonsil score, was associated with a less favorable response to (adeno) tonsillectomy. Further studies after treatment using FRI and DISE are warranted to further characterize the UA of these subjects.
authors.affiliation: Department of Paediatrics, Antwerp University Hospital, Edegem, Belgium.|Laboratory of Experimental Medicine and Paediatrics (LEMP), University of Antwerp, Universiteitsplein 1, Antwerp, Belgium.
authors.forename: Monique
authors.identifier: 0000-0001-5146-1323
authors.initials: M
authors.lastname: Slaats
authors.affiliation: FLUIDDA, Kontich, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Vos
authors.affiliation: FLUIDDA, Kontich, Belgium.
authors.forename: Cedric
authors.initials: C
authors.lastname: Van Holsbeke
authors.affiliation: FLUIDDA, Kontich, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: De Backer
authors.affiliation: FLUIDDA, Kontich, Belgium.
authors.forename: Dieter
authors.initials: D
authors.lastname: Loterman
authors.affiliation: Laboratory of Experimental Medicine and Paediatrics (LEMP), University of Antwerp, Universiteitsplein 1, Antwerp, Belgium.|Department of Respiratory Medicine, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Wilfried
authors.initials: W
authors.lastname: De Backer
authors.affiliation: Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: An
authors.initials: A
authors.lastname: Boudewyns
authors.affiliation: Department of Paediatrics, Antwerp University Hospital, Edegem, Belgium.|Laboratory of Experimental Medicine and Paediatrics (LEMP), University of Antwerp, Universiteitsplein 1, Antwerp, Belgium.
authors.forename: Stijn
authors.initials: S
authors.lastname: Verhulst
mesh_terms: D000233:Adenoidectomy; D000234:Adenoids / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D014066:Palatine Tonsil / Q000502:physiology; D010808:Physical Examination; D017286:Polysomnography; D012137:Respiratory System / Q000000981:diagnostic imaging*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014068:Tonsillectomy; D016896:Treatment Outcome
keywords: children; computational fluid dynamics; obstructive sleep apnea; prediction; treatment