• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.4
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• pp.377-388
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• 2020

The aim of this study was to evaluate the association between various predicting tools and Apnea-Hypopnea Index (AHI) to identify children with sleep disordered breathing (SDB). From 5 to 10 years old who came for orthodontic counseling, 61 children, whom had lateral cephalograms, pediatric sleep questionnaire (PSQ) records, and portable sleep monitoring results, were included in this study. A total of 17 measurements (11 distances and 6 angles) were made on lateral cephalograms. The measurements of lateral cephalograms, PSQ scales and portable sleep monitoring results were statistically analyzed. 49 of 61 (80%) patients showed AHI > 1, which suspected to have SDB and their mean AHI was 2.75. In this study, adenoid size (A/N ratio), position of the hyoid bone from mandibular plane, gonial angle, and PSQ scale were related to a higher risk of pediatric SDB. Also, oxygen desaturation index (ODI) and snoring time from sleep monitoring results were statistically significant in children with SDB using Mann-Whitney test (p < 0.05). In conclusion, evaluation of hyoid bone position, adenoidal hypertrophy, gonial angle in lateral cephalogram, and PSQ scale was important to screen out potential SDB, especially in children with frequent snoring.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.1
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• pp.38-47
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• 2019

The most common cause of mouth breathing is obstacles caused by mechanical factors in upper airway. Mouth breathing could be consequently pathological cause of sleep-disordered breathing. Sleep-disordered breathing in children can cause growth disorders and behavioral disorders. The purpose of this study was to investigate relationship between upper airway and sleep-disordered breathing in children with mouth breathing. Twenty boys between 7 - 9 years old who reported to have mouth breathing in questionnaire were evaluated with clinical examination, questionnaires, lateral cephalometric radiographs, and portable sleep testing. This study assessed apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) for the evaluation of sleep-disordered breathing and was done to investigate the correlation between these values and the upper airway width measured by lateral cephalometric radiographs. There was no significant correlation with the size of the tonsils (p = 0.921), but the adenoid hypertrophy was higher in the abnormal group than in the normal group (p = 0.008). In the classification according to AHI and ODI, retropalatal and retroglossal distance showed a statistically significant decrease in the abnormal group compared to the normal group (p = 0.002, p = 0.001). As AHI and ODI increased, upper airway width tended to be narrower. This indicates that mouth breathing could affect the upper airway, which is related to sleep quality.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.4
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• pp.327-330
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• 2015

The safety and success of dental sedation for children depend mainly on respiratory status of patients. A special condition, that is, nasal breathing in supine position with their oral airway blocked by rubber dam, should be considered. Therefore, irrespective of medical consultation, pediatric dentists themselves should do respiratory assessment especially adenotonsillar hypertrophy, nasal obstruction, posterior nasal drainage and airway hypersensitivity. Patients with sinusitis, allergic rhinitis, asthma, snoring and OSAS(obstructive sleep apnea syndrome) can induce the sedation failure and complete management of these can improve the safety of dental sedation.

• The Journal of Pediatrics of Korean Medicine
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• v.17 no.1
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• pp.17-27
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• 2003

Background: Snoring in children, is associated Kith adenotonsillar hypertrophy and sinusitis which contribute to upper airway obstruction, so we studied the sinusitis and adenoid size of snoring children with plain radiography Materials and method: Fifty patients having snoring, nasal obstruction in our hospital between November 2001 and November 2002 were studied using plain radiology PNS(water's view) and Neck lateral view(adenoid size with A/N ratio) Results: 1. In oriental medicine, Hu-Bi means laryngopharyngeal edema and obstruction, laryngopharyngeal disease are due to Hwa-Yeoul( fire and hot), sinus disease are due to Fung-Han(wind and cold) and Fung-Yeoul(wind and hot). 2. Age ranged from 2 to 17 year-old ( mean age: 6 years), 5-7 year-old were 18 patients (36%). Age of on set, 25 patients were 1-4 year-old (50%). 3. Of the 50 snoring patients, 37 patients were sinusitis(74%), 20 patients had enlarged adenoid(40%). Of the 20 large adenoid patients, 19 patients were sinusitis(95%). 4. Of the 50 snoring patients, size of tonsil were flowed. Fifteen were severe(3+), 17 patients were moderate(2+) and 15 patients were mild(1+). Of the 20 enlarged adenoid patients, size of tonsil flowed. Five were severe(3+), 11 patients were moderate(2+) and 4 patients were mild(1+). Conclusion : Of the 50 Snoring patients, 37 patients showed sinusitis(74%), 32 patients showed large tonsil(64%), 20 patients showed large adenoid(40%).

• Journal of Preventive Medicine and Public Health
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• v.26 no.3 s.43
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• pp.430-441
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• 1993

The objectives of this study are two-fold : to identify geographic variations in the rate of tonsillectomy and adenoidectomy (T&A) and appendectomy and analyze the socioeconomic variables and health resources which affect geographic variation in the rate. The nationwide three month's cases of the two surgical procedures in 1991 are obtained from the record of the National Federation of Medical Insurance. The analysis shows two to ten-fold variations in the regional rates for the performance of two common procedures such as T&A and appendectomy. T&A shows a bigger regional variations than appendectomy. As a result of multiple regression, the factor of bed supply has been found significant for the dependent variable of the rate of T&A. The finding of large variations in the rate of surgical procedures throughout the country would have important implications for allocating scarce resources and managing quality of care. Further analysis is needed for the elaboration of the above implications.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.38-42
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• 1998

It has been reported that Tonsillectomy ＆ Adenoidectomy(T & A) resulted in the change of voice by structural changes directly to the vocal track. We studied the effect of T & A on the voice of patients comparing the pre-operative to the post-operative voice. It was performed using a Computerized Speech Lab(CSL50) which is currently used as a method for voice analysis. Forty-five patients who had T＆A, aging from 3 to 42 years old, took part in studies and wert evaluated for voice changes and the degree of formant changes of four basic vowels, /a/, /i/, /o/, and /u/. They were evaluated pre-operatively and post-operatively one month later using MDVP, CSL program of CSL50. The results obtained were as follows ; In using MDVP, there were some differences between pre-operative and post-operative shimmer measures within the normal range but other acoustic measures(Fo, jitter, NHR) show no significant differences(p>0.05). F3 of /a/ and /o/ were significantly decreased(p<0.05) and F2, F3 of /i/ were increased(p>0.05) in patients who only had Tonsillectomy in doing CSL spectrogram. For the patients who had T & A, Fl and F3 of /a/, F3 of /i/, Fl, F2 and F3 of /o/ were decreased with significant increase in F1 and F2 of /i/(p<0.05).

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.9 no.1
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• pp.173-179
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• 1996

Hypertropied palatine tonsil is a common disorder in pediatric otolaryngology. It could be easily observed and adenoid vegetation could induce maxillary sinusitis by the obstruction of nasopharynx and choanae. This is a study on the relationship of the hypertropied palatine tonsil, 42cases, with maxillary sinusitis and adenoid vegetation The results was as followings ; 1. The sex distribution was male 30cases($71.4\%$), female 12cases($28.6\%$) and age distribution was from 3 to 17year-old. 2. Hypertropied palatine tonsil distribution was the degree of both 3, 2cases($4.8\%$), one 3 the other 2, 3cases($7.l\%$), both 2, 22cases($52.4\%$), one 2 the other 1, 9cases($21.4\%$), both 1, 5 cases($11.9\%$). and only one 1, 1case($2.3\%$). 3. By the PNS X-ray, there were resulted 29 cases($69.0\%$) both maxillary sintis, 4cases($9.5\%$) only one maxillary sinusitis and 9cases($21.4\%$) norma] sinus. 4. By the Head latera] X-ray, there were resulted 13cases($31.0\%$) large adenoid, 24cases($57.l\%$) mediate adenoid, and 5cases($l1.9\%$) small adenoid.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.2
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• pp.119-122
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• 2011

Achondroplasia is one of the most common types of dwarfism and is inherited as an autosomal dominant trait. Clinical features of achondroplasia include disproportionate short stature with normal trunk length, shortening of the extremities, bowing of the lower extremities, short stubby trident hands, spinal stenosis and lumbar lordosis. Characteristic craniofacial features include macrocephaly, prominent forehead, depressed nasal bridge, maxillary hypoplasia, otolaryngeal system dysfunction, and foramen magnum stenosis. These characteristics may lead to number of complications including hydrocephalus, apnea, upper-airway obstruction, otitis media, sinusitis and dental malocclusion. Apart from these features, the affected children have good general health and normal intelligence. Dentists should be aware of the clinical characteristics of achondroplasia and the complications that may arise as a result of this disorder. This case report is to present dental treatment of a patient with achondroplasia under general anesthesia and discuss special considerations.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.1
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• pp.5-9
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• 2004

Some patients who have undergone adenotonsillectomy (AT) or tonsillectomy(T) complain of voice change. Research was designed to determine the relationship between subjective voice change and change of parameters in boice analysis and to find the degree of voice change according to age and excised tissue volume. In 34 patients who underwent AT and 17 patients who underwent T, we measured the masalance, the fundamental frequency of /a/phonation and the formants and bandwidths of /a/, /i/, /u/ phonations. These parameters were measured preoperatively and also 7 days after the operation. Excised tissue volume was measured on operation. Postoperative changes were statistically analyzed. Any subjective voice change was asked to be reported at the visit 7 days after the operation. There was analysis for the difference of above parameters between some who answered "voice change" (A group) and the others who answered "no voice change" (B group). 24 patients(71%) who underwent AT and 4 voice change. Nasals nasalance change is an important factor in subjective voice change after AT.

• IMMUNE NETWORK
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• v.7 no.2
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• pp.87-94
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• 2007

Background: Chronic rhino-sinusitis and persistent allergic rhinitis is often cited as risk factor for developing adenoid hypertrophy or adenoiditis, but this relationship has not been studied extensively. In this study, we evaluated the mucosal barrier, squamous changes of ciliated epithelium, IgA secretion and BCL-6 expression in adenoids, and adenoid size. Methods: Six children with allergic rhinitis and sinusitis, nine children with only allergic rhinitis, nine children with only sinusitis and six children without any history of allergic rhinitis and sinusitis were enrolled. H-E stain of adenoid for squamous metaplasia, immunohistochemical study of adenoid for IgA and BCL-6, cytokeratin stain for evaluation of mucosal barrier and lateral view X-ray for adenoid size were performed. ANOVA test was used in the analysis and data showing p value of less than 0.05 were considered significant. Results: The number of ciliated cells had tendency to be decreased and squamous metaplasia had tendency to be increased in three experimental groups (p>0.05). Deterioration of mucosal barrier had tendency to be detected in three experimental groups than control group (p>0.05). BCL-6 had tendency to be increased and IgA secretion had tendency to be decreased in three experimental groups (p>0.05). There is no difference in adenoid size between three experimental groups and control group. Conclusion: Despite the expectation that adenoid would be affectecd by allergic rhinitis and rhino-sinusitis, we found no evidence for influence of adenoid immunity.