CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2018; 22(01): 055-059
DOI: 10.1055/s-0037-1602702
Original Research
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Adenotonsillar Hypertrophy in Pre-School Children with Sickle Cell Disease and Diagnostic Accuracy of the Sleep Disturbance Scale for Children

Carlos Rodolfo Tavares de Góis
1   Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brazil
,
Jeferson Sampaio D'Ávila
1   Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brazil
,
Rosana Cipolotti
1   Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brazil
,
Amanda da Silva Lira
2   Department of Statistics and Actuarial Sciences, Universidade Federal de Sergipe (UFS), São Cristóvão, SE, Brazil
,
Ana Letícia Leite Silva
1   Department of Medicine, Universidade Federal de Sergipe (UFS), Aracaju, SE, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

12. November 2016

18. März 2017

Publikationsdatum:
02. Mai 2017 (online)

Abstract

Introduction Adenotonsillar hypertrophy is more common in children with sickle cell disease, and can lead to sleep-disordered breathing.

Objectives To determine the frequency of adenotonsillar hypertrophy in pre-school children with sickle cell disease and assess the diagnostic accuracy of the sleep-disordered breathing subscale in the Sleep Disturbance Scale for Children.

Method Observational study with a group of 48 children with sickle cell disease and a control group of 35 children without the disease. The children underwent oropharingoscopy and video nasal endoscopy. The parents and/or guardians answered the questions of the subscale.

Results Adenotonsillar hypertrophy was observed in 25% of the children in the study group, and in 20% of the children in the control group, with no statistical difference between the groups. The subscale score ranged from 3 to 11 in both groups. There was a statistical significance in the study group. The average was 4.79 (standard deviation [SD] ± 2.50), with 4.19 (SD ± 1.72) among the children without adenotonsillar hypertrophy, and 6.5 (SD ± 3.40) among the children with adenotonsillar hypertrophy. There was also a statistical significance in the control group. The average was 5.23 (SD ± 2.81), with 4.44 (SD ± 2.2) among the children without adenotonsillar hypertrophy, and 7.87 (SD ± 2.89) among the children with adenotonsillar hypertrophy.

Conclusion Adenotonsillar hypertrophy was not associated with sickle cell disease in pre-school children. The subscale of sleep-disordered breathing in the Sleep Disturbance Scale for Children was a useful tool for the diagnostic suspicion of adenotonsillar hypertrophy in children in this age group.

 
  • References

  • 1 Okoli K, Irani F, Horvath W. Pathophysiologic considerations for the interactions between obstructive sleep apnea and sickle hemoglobinopathies. Med Hypotheses 2009; 72 (05) 578-580
  • 2 Franceschi L. Pathophisiology of sickle cell disease and new drugs for the treatment. Medit J Hemat Infect Dis. 2009. Open Journal System
  • 3 Serjeant GR, Serjeant BE. Sickle cell disease. Oxford UK: Oxford University Press; 2001
  • 4 Potsic WP. Assessment and treatment of adenotonsillar hypertrophy in children. Am J Otolaryngol 1992; 13 (05) 259-264
  • 5 Yaseen ET, Khammas AH, Anbaky FA. Adenoid enlargement assessment by plain X- ray and nasoendoscopy. Iraqui J Comm Med. 2012; 1: 88-91
  • 6 Strauss T, Sin S, Marcus CL. , et al. Upper airway lymphoid tissue size in children with sickle cell disease. Chest 2012; 142 (01) 94-100
  • 7 Warrier R, Chauhan A, Athale U. Tonsillectomy and adenoidectomy for obstructive sleep apnea in sickle cell anemia. Indian J Pediatr 2010; 77 (06) 669-672
  • 8 Ferreira VR, Carvalho LBC, Ruotolo F, de Morais JF, Prado LBF, Prado GF. Sleep disturbance scale for children: translation, cultural adaptation, and validation. Sleep Med 2009; 10 (04) 457-463
  • 9 Brodsky L. Modern assessment of tonsils and adenoids. Pediatr Clin North Am 1989; 36 (06) 1551-1569
  • 10 Valera FCP, Avelino MAG, Pettermann MB. , et al. OSAS in children: correlation between endoscopic and polysomnographic findings. Otolaryngol Head Neck Surg 2005; 132 (02) 268-272
  • 11 Salles C, Ramos RTT, Daltro C, Nascimento VM, Matos MA. Association between adenotonsillar hypertrophy, tonsillitis and painful crises in sickle cell disease. J Pediatr (Rio J) 2009; 85 (03) 249-253
  • 12 Felix AA, Souza HM, Ribeiro SBF. Aspectos epidemiológicos e sociais da anemia falciforme. Rev Bras Hematol Hemoter 2010; 32 (3): 203-208
  • 13 Platt OS, Brambilla DJ, Rosse WF. , et al. Mortality in sickle cell disease. Life expectancy and risk factors for early death. N Engl J Med 1994; 330 (23) 1639-1644
  • 14 Tagaya M, Nakata S, Yasuma F. , et al. Relationship between adenoid size and severity of obstructive sleep apnea in preschool children. Int J Pediatr Otorhinolaryngol 2012; 76 (12) 1827-1830
  • 15 Pac A, Karadag A, Kurtaran H, Aktas D. Comparison of cardiac function and valvular damage in children with and without adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2005; 69 (04) 527-532
  • 16 Kara CO, Ergin H, Koçak G, Kiliç I, Yurdakul M. Prevalence of tonsillar hypertrophy and associated oropharyngeal symptoms in primary school children in Denizli, Turkey. Int J Pediatr Otorhinolaryngol 2002; 66 (02) 175-179
  • 17 Abreu RR, Rocha RL, Lamounier JA, Guerra AF. Etiology, clinical manifestations and concurrent findings in mouth-breathing children. J Pediatr (Rio J) 2008; 84 (06) 529-535
  • 18 Salles C, Ramos RTT, Matos MA. Apneia obstrutiva do sono em portadores de anemia falciforme. Rev Bras Hematol Hemoter 2010; 32 (01) 70-75
  • 19 Aubertin G. Le syndrome d'apnées obstructives du sommeil chez l'enfant. Rev Pneumol Clin 2013; 69 (04) 229-236
  • 20 Piteo AM, Lushington K, Roberts RM. , et al. Prevalence of snoring and associated factors in infancy. Sleep Med 2011; 12 (08) 787-792
  • 21 Miranda GN. Trastornos respiratorios del sueño en la edad pediátrica. Rev Med Clin Las Condes 2013; 24: 403-411
  • 22 Salles C, Bispo M, Trindade-Ramos RT. Association between morphometric variables and nocturnal desaturation in sickle-cell anemia. J Pediatr (Rio J) 2014; 90 (04) 420-425
  • 23 Cho D-Y, Sinha SR, Gardner JM. , et al. Effect of intratonsillar injection of steroids on the palatine tonsils of rabbits. Laryngoscope 2014; 124 (12) 2811-2817
  • 24 Demain JG, Goetz DW. Pediatric adenoidal hypertrophy and nasal airway obstruction: reduction with aqueous nasal beclomethasone. Pediatrics 1995; 95 (03) 355-364
  • 25 Al-Ghamdi SA, Manoukian JJ, Morielli A, Oudjhane K, Ducharme FM, Brouillette RT. Do systemic corticosteroids effectively treat obstructive sleep apnea secondary to adenotonsillar hypertrophy?. Laryngoscope 1997; 107 (10) 1382-1387
  • 26 Samuels MP, Stebbens VA, Davies SC, Picton-Jones E, Southall DP. Sleep related upper airway obstruction and hypoxaemia in sickle cell disease. Arch Dis Child 1992; 67 (07) 925-929
  • 27 D'Ávila JS, Naves AB, Chagas L. , et al. Adenoidectomia: novos princípios. Estudo interdisciplinar. Rev Bras Otorrinolaringol 1999; 65: 511-516
  • 28 Bruni O, Ottaviano S, Guidetti V. , et al. The Sleep Disturbance Scale for Children (SDSC). Construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res 1996; 5 (04) 251-261
  • 29 Simola P, Niskakangas M, Liukkonen K. , et al. Sleep problems and daytime tiredness in Finnish preschool-aged children-a community survey. Child Care Health Dev 2010; 36 (06) 805-811
  • 30 Romeo DM, Bruni O, Brogna C. , et al. Application of the sleep disturbance scale for children (SDSC) in preschool age. Eur J Paediatr Neurol 2013; 17 (04) 374-382