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J Otolaryngol Head Neck Surg. 2012 Apr;41(2):138-44.

Upper airway findings in children with Down syndrome on sleep nasopharyngoscopy: case-control study.

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Division of Otolaryngology, Dalhousie University, Halifax, NS.



To identify the pattern of upper airway endoscopic findings in Down syndrome (DS) children with sleep-disordered breathing (SDB) spectrum.


Retrospective case-control study in a tertiary pediatric centre.


DS children presenting with persistent snoring or SDB who underwent sleep nasopharyngoscopy (SNP) were identified from a prospectively kept surgical database. All SNPs were performed using a uniform intravenous sedation technique. Controls with persistent snoring or SDB from the same database were identified and pair-matched for age, gender, and body mass index (BMI) percentiles. The video recordings of the SNP for all subjects were reviewed. A comparison of the proportions of obstruction (O), mixed (M), and collapse (C) findings in each group was performed.


Over a period of 4.5 years, 23 consecutive DS children were identified (7 girls, 16 boys; mean age 7.09 ± 4.37 years). They were matched with 23 controls (mean age 7.6 ± 4.14 years). The DS group exhibited significantly more pharyngeal collapses than the controls (O:C:M, 2:6:15 and 12:0:10, respectively; p < .005). Lingual collapses were also noted more in DS children (11 vs 4), and a more significant number of collapses were seen (p < .004). Whereas nearly equal numbers exhibited tonsillar obstruction, adenoidal obstruction was significantly less in DS children (p < .05).


Generalized pharyngeal collapse dominates in DS children who present with SDB and is independent of age, gender, and BMI. Adenoidal hypertrophy causing obstruction is much less encountered than in controls.

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