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Introduction: Besides hypertrophy of the tonsils being the main factor for OSA in children, several children show OSA persistence after adenotonsillectomy. Obstruction of the upper airway is related to the smallest cross-sectional area of the air passage, the pharyngeal dimensions being possibly a predictor for surgical treatment outcome. The cone beam computed tomography (CBCT) allows an evaluation of layered structures, reproducing sections of the human body in 3 D. Aims: to evaluate the size of the upper airways in OSA children and after adenotonsillectomy, using CT scan images of the pharynx. Methods: 30 OSA children, both genders, aged 5 to 8 years old, hypertrophy of the tonsils, were submitted to PSG and CT scan of the pharynx before adenotonsillectomy, 10 repeated exams 1 year after surgery. Images were analyzed by the software Dolphin Image ® 11.0 Premium. Pharyngeal volume was compared for gender and for OSA severity. After 1-year follow-up we analyzed growing of the midface and gain of the pharyngeal volume. Results: We evaluated 30 children, 15boys, mean age aged 7–11 years years. 30%children showed mild OSA, 30% moderate and 10% severe OSA. We found a difference of the pharyngeal volume between mild OSA and moderate to severe OSA children. 60% children improved pharyngeal volume after surgery. OSA persistence was observed in 5% children, 10% showed reduced gain of pharyngeal volume. Statistic analysis was limited due to the small number of involved children. Conclusion: In our study, severity and persistence of OSA was associated to smaller pharyngeal volume. Normal pharyngeal growing and its role in persistence of OSA should be investigated in larger studies. |
