Allergy Asthma Respir Dis.  2018 May;6(3):168-173. 10.4168/aard.2018.6.3.168.

Factors associated with chronic and recurrent rhinosinusitis in preschool children with obstructive sleep apnea syndrome

• Yun HH
• Ahn YM
• Kim HJ

• KMID: 2412520
• DOI: http://doi.org/10.4168/aard.2018.6.3.168

Abstract

PURPOSE
Obstructive sleep apnea syndrome (OSAS) in young children is frequently caused by adenoid and/or tonsillar hypertrophy. Adenoidectomy is the first operative method for childhood chronic rhinosinusitis (CRS). We investigated factors associated with recurrent rhinosinusitis in preschool aged children with OSAS to determine the association of 2 common diseases.
METHODS
One hundred forty-six children aged 2-5 years who were diagnosed as having OSAS after polysomnography between December 2003 and April 2016 were enrolled in this study. Children were divided into 2 groups with and without CRS. The 2 groups were compared in the severity of OSAS and allergy diseases and were evaluated for recurrent rhinosinusitis during the follow-up period, 1 year after diagnosis.
RESULTS
Among 108 patients with OSAS who were followed up, 81 patients (75%) were diagnosed with CRS. There were no significant difference clinical and allergic characteristics between groups with and without CRS. However, bronchial asthma and otitis media was significantly more prevalent in patients with CRS than in those without (P=0.045 and P=0.000, respectively). Bronchial asthma and adenotonsillectomy was significantly associated with recurrent rhinosinusitis (P=0.005 and P=0.04, respectively) during the 1-year follow-up.
CONCLUSION
Approximately 75% of preschool children with OSAS have suffered from CRS. Bronchial asthma is associated with CRS among OSAS children. Recurrent rhinosinusitis is decreased after adenotonsillectomy, and bronchial asthma is an associated factor for recurrent rhinosinusitis after a follow-up. This close relationship childhood OSAS and recurrent rhinosinusitis/bronchial asthma needs further studies to investigate their role in the association.

Keyword

Obstructive sleep apnea; Asthma; Rhinitis; Sinusitis

MeSH Terms

Adenoidectomy
Adenoids
Asthma
Child
Child, Preschool*
Diagnosis
Follow-Up Studies
Humans
Hypersensitivity
Hypertrophy
Methods
Otitis Media
Polysomnography
Rhinitis
Sinusitis
Sleep Apnea, Obstructive*

Figure

• 

  Fig. 1. Linear-by-linear association of chronic rhinosinusitis and recurrent rhinosinusitis in obstructive sleep apnea syndrome according to age. Linear-by-linear association test indicates the prevalence of chronic rhinosinusitis and recurrent rhinosinusitis decreases not significantly as age increases (P for trend=0.051 and P for trend=0.076, respectively). ReRS, recurrent rhinosinusitis; CRS, chronic rhinosinusitis and recurrent rhinosinusitis. Trend in proportions assessed with Linear-by-linear association test.

• 

  Fig. 2. The proportion of chronic rhinosinusitis and recurrent rhinosinusitis in obstructive sleep apnea syndrome by obstructive sleep apnea syndrome severity. The proportion of chronic rhinosinusitis and recurrent rhinosinusitis in obstructive sleep apnea syndrome was not significantly rising trend with increasing obstructive sleep apnea syndrome severity (P for trend=0.292 and P for trend=0.480, respectively). CRS, chronic rhinosinusitis and recurrent rhinosinusitis; ReRS, recurrent rhinosinusitis; OSAS, obstructive sleep apnea syndrome. Trend in proportions assessed with Linear-by-linear association test.

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