Introduction
Obstructive sleep apnea hypopnea syndrome (OSAHS) in children is
characterized by prolonged partial upper airway obstruction and/or
intermittent complete obstruction that disrupts normal ventilation
during sleep and normal sleep patterns, causing cognitive impairment and
cardiovascular diseases in children[1],. The
incidence rate of OSAHS in children ranges from 1.2% to 5.7%[2].
PSG is the gold standard for the diagnosis of OSAHS[3] .However, PSG
is difficult to perform universally in primary hospitals. Alternatively,
parent-reported history and physical examination are widely used for
clinical decision-making[4].The American Academy of Paediatrics
recommends alternative diagnostic tests or referral to a specialist for
more extensive evaluation when PSG is not available and when an adequate
treatment strategy has not been developed. Therefore, clinicians rely on
physical examination (e.g, tonsil size), radiological findings et al to
diagnose and determine paediatric OSA.
Adenoid hypertrophy is the main risk factor for OSAHS in
children[5,6], accounting for approximately 70% of cases.
Nasopharyngeal lateral radiographs are commonly used to assess adenoid
hypertrophy. The A/N ratio is used to assess the size of the adenoids.
Some studies[7,8]have shown that
adenoidal hypertrophy is associated with LSaO2 and the
severity of OSAHS in children. Additionally, some studies [9,10]
have shown a correlation between adenoid size and logAHI, apnoea index,
and duration of obstructive apnoea. However, a previous study[11]
revealed that adenoid size cannot be used to predict the severity of
AHI.
In summary, nasopharyngeal lateral radiography is a feasible tool for
screening OSAHS; however, its correlation with PSG monitoring results
still needs to be further investigated. Therefore, this study aims to
investigate the diagnostic value of the A/N ratio for the primary
screening of OSAHS in children.