Risk Factors for Obstructive Sleep Apnea Syndrome in Children: State of the Art

Abstract

The obstructive sleep apnea syndrome (OSAS) represents only part of a large group of pathologies of variable entity called respiratory sleep disorders (RSD) which include simple snoring and increased upper airway resistance syndrome (UARS). Although the etiopathogenesis of adult OSAS is well known, many aspects of this syndrome in children are still debated. Its prevalence is about 2% in children from 2 to 8 years of age, mostly related to the size of the upper airways adenoid tissue. Several risk factors linked to the development of OSAS are typical of the pediatric age. The object of this paper is to analyze the state of the art on this specific topic, discussing its implications in terms of diagnosis and management.

Keywords: adenotonsillar hypertrophy; allergic rhinitis; craniofacial abnormalities; inflammation; obesity; pediatric OSAS.

Figure 1

Grade III tonsil hypertrophy in a 6 year-old child. Courtesy of Professor C. Vicini—Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy.

Figure 2

Lingual tonsil hypertrophy in a 11 year-old child. Courtesy of Professor C. Vicini—Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy.

Figure 3

Transoral robotic surgery (TORS) to remove an exuberant lingual tonsil in a 12-year-old child. Courtesy of Professor C. Vicini—Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy.