Patient evaluations
Besides polysomnography, those patients who were able to cooperate had
flexible laryngobronchoscopy, otoscopy, tympanograms, and audiometry.
The following evaluations were carried out: the annual number of
upper respiratory tract infections
(URTIs) and OME episodes; the degree of adenoid hypertrophy (Grade 1:
none of the adjacent structures such as vomer, soft palate and torus
tubaris contact with the adenoid tissue; Grade 2: the adenoid tissue
contacts with the torus tubaris; Grade 3: the adenoid tissue contacts
with torus tubaris and vomer; Grade 4: the adenoid tissue contacts with
torus tubaris, vomer and soft palate in resting position) [14]; the
degree of tonsillar hypertrophy (Grade 0: absence of tonsillar tissue;
Grade 1: within the pillars; Grade 2: extended to the pillars; Grade 3:
extended past the pillars; Grade 4: extended to the midline) [15];
the apnea-hypopnea index (AHI,
number of obstructive apnea and hypopnea events per hour of sleep), and
oxygen saturation (Sat % O2) to identify
obstructive sleep apnea syndrome
(OSAS).
We also used the infection score system [16] to evaluate the
severity of respiratory tract and otological infections. This includes
an evaluation of type of infection, systemic symptoms, daily activity,
therapy, hospitalization, and resolution time (Table 1; Total score ≤ 5:
mild respiratory tract and/or otological infection; Total score 6-11:
moderate respiratory tract and/or otological infection; Total score =
12: severe respiratory tract and/or otological infection).