Characterization of upper airway obstruction using cine MRI in children with residual obstructive sleep apnea after adenotonsillectomy

Sleep Medicine
Amal IsaiahRon B Mitchell

Abstract

Tonsillectomy and adenoidectomy (T&A) lead to resolution of obstructive sleep apnea (OSA) in most children. However, OSA persists in about 25-40% of children. Cinematic magnetic resonance imaging (cine MRI) can aid the management of persistent OSA by localizing airway obstruction. We describe our experience in implementing and optimizing a cine MRI protocol by using a 3 Tesla MRI scanner, and the use of dexmedetomidine for sedation to improve reproducibility, safety, and diagnostic accuracy. Patients aged 3-18 years who underwent cine MRI for the evaluation of persistent OSA after T&A and failed positive airway pressure (PAP) therapy were included. Clinical data and the apnea-hyponea index were compared with quantitative and qualitative estimates of airway obstruction from imaging sequences. A total of 36 children were included with a mean age of 9.6 ± 4.6 (SD) years with 40% over 12 years of age. Two-thirds of them were boys. Seventeen out of 36 children (47%) had Down syndrome. Single site and multilevel obstruction were identified in 21 of 36 patients (58%) and in 12 of 36 patients (33%), respectively. All cine MRIs were performed without complications. Multiple regression analysis demonstrated that a combination of the mini...Continue Reading

Citations

Nov 11, 2019·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Xiao-Hong YanMin Chen
Dec 17, 2019·Paediatric Anaesthesia·Mon OhnBritta S von Ungern-Sternberg
Aug 28, 2020·Pediatric Investigation·Jason L Yu, Olufunke Afolabi-Brown
Mar 28, 2020·Journal of Clinical Medicine·David GozalLeila Kheirandish-Gozal
Jun 25, 2021·Sleep·Christopher M CieloRichard J Schwab

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