ArticleNature and science of sleep2025
Impact of Upper Airway Comorbidities and Tonsil/Adenoid Synergistic Effects on Pediatric OSA Severity.
Article in Nature and science of sleep, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Ultrasonographic Airway Measurements and Difficult Laryngoscopy in Children Undergoing Adenotonsillectomy: A Prospective Observational Study.Journal of clinical medicine · 2026Article
- Development of a measure of knowledge and attitudes about obstructive sleep apnea for pediatric anesthesia (OSAKA-PedAn) and survey of knowledge and attitudes about pediatric obstructive sleep apnea among Italian anesthesiologists.Journal of anesthesia, analgesia and critical care · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: To investigate the factors influencing the severity of obstructive sleep apnea (OSA) in children and to elucidate the synergistic effects of upper airway comorbidities (chronic rhinosinusitis, nasal septum deviation and malocclusion) with tonsillar and adenoid hypertrophy on ventilation efficiency. Patients and Methods: A total of 404 pediatric patients with OSA aged 6-10 years diagnosed between January 2022 and January 2025 were included in this retrospective cohort study and underwent logistic regression analysis to identify the risk factors for pediatric OSA. Three-dimensional upper airway models under various comorbidity states were constructed via cone‒beam computed tomography (CBCT), and postoperative airway resistance changes were calculated via computational fluid dynamics (CFD) simulation and simulated surgery. Results: Grade 3 tonsillar or adenoid hypertrophy, the presence of comorbidities, and overweight/obesity were identified as independent risk factors for increased OSA severity. A dose‒response relationship was observed between the number of comorbidities and OSA severity, with the highest odds ratio (OR=9.392, 95% CI=2.459-35.875) for triple-positive comorbidities. CFD simulations demonstrated that tonsillectomy and adenoidectomy (T&A) significantly improved ventilation function across different OSA severities. Comorbidities influence airway resistance, with postoperative resistance in children with triple-positive comorbidities approaching preoperative levels in those without comorbidities. Conclusion: T&As hold therapeutic value for pediatric OSA patients, but comorbidities significantly mitigate surgical efficacy through synergistic effects.
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